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

Corte, G.
Bussiere, T.
Hof, P. R.
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Published in Journal of Neuropathology and Experimental Neurology. 2001, vol. 60, no. 10, p. 946-952
Abstract 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.
Keywords AgedAged, 80 and overAging/*metabolism/*pathologyAlzheimer Disease/classification/*metabolism/pathology/psychologyAmyloid beta-Protein/analysis/*metabolismBrain/*metabolism/*pathologyCognition Disorders/classification/pathology/psychologyFemaleHumanLogistic ModelsMaleMiddle AgeMultivariate AnalysisNeurofibrillary Tangles/metabolism/pathologyStatistics, NonparametricSupport, Non-U.S. Gov'tSupport, U.S. Gov't, P.H.S.
PMID: 11589425
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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. https://archive-ouverte.unige.ch/unige:28098

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Deposited on : 2013-05-28

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