Scientific article

Clinical validity of A beta-protein deposition staging in brain aging and Alzheimer disease

Published inJournal of neuropathology and experimental neurology, vol. 60, no. 10, p. 946-952
Publication date2001

Braak's neurofibrillary tangle (NFT) pathology staging system of Alzheimer disease (AD) correlates generally with clinical data. Recently, Braak's group proposed an Abeta-protein staging based on the progression of amyloid deposition in the medial temporal lobe. To examine its clinical validity and evaluate whether it adds predictive power to NFT-based staging, we performed a study comparing both neuropathological classifications with clinical dementia rating scale (CDR) scores in a large autopsy series. The 2 neuropathological staging systems were strongly correlated. Their association with clinical severity was highly significant. However, the strength of the relationship was greater for NFT-based staging. It accounted for 26.5% of the variability in clinical severity, Abeta-protein-based staging for 13.0%, and age for 4.4%. Compared to NFT-based staging, the Abeta-protein-based system was less able to distinguish mild cognitive changes from dementia and showed marked overlap among the various stages of cognitive decline. In a multivariate model, NFT and age together accounted for 27.2% of the clinical variability and the addition of Abeta-protein deposition staging could only explain an extra 2.9%. Our data support the close relationship between NFT progression and amyloid formation within the medial temporal lobe proposed by Braak's group but demonstrate the limited value of Abeta-protein deposition staging in terms of clinicopathological correlations.

  • Aged
  • Aged, 80 and over
  • Aging/*metabolism/*pathology
  • Alzheimer Disease/classification/*metabolism/pathology/psychology
  • Amyloid beta-Protein/analysis/*metabolism
  • Brain/*metabolism/*pathology
  • Cognition Disorders/classification/pathology/psychology
  • Female
  • Human
  • Logistic Models
  • Male
  • Middle Age
  • Multivariate Analysis
  • Neurofibrillary Tangles/metabolism/pathology
  • Statistics, Nonparametric
  • Support, Non-U.S. Gov't
  • Support, U.S. Gov't, P.H.S.
Citation (ISO format)
GOLD, Gabriel et al. Clinical validity of A beta-protein deposition staging in brain aging and Alzheimer disease. In: Journal of neuropathology and experimental neurology, 2001, vol. 60, n° 10, p. 946–952.
Main files (1)
ISSN of the journal0022-3069

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