Correlations between mental state and quantitative neuropathology in the Vienna Longitudinal Study on Dementia
Abstract
Quantitative clinicopathological correlation studies are one way to address the question of the relevance of morphological abnormalities in Alzheimer's dementia (AD). This paper summarizes results of the Vienna Longitudinal Study on Dementia obtained during the past few years and presents a critical discussion on the relevance of clinicopathological correlation studies for the pathogenesis of AD. Plotting of psychometric test scores against the numbers of plaques, tangles and neuropil threads in various cortical areas shows that significant correlations are due primarily to very high lesion counts in severely demented patients. These data indicate that neocortical neurofibrillary pathology can be considered an end-stage marker in the pathology of AD. On the other hand, the topographical staging of neuritic Alzheimer changes proposed by Braak and Braak (1991) appears to be a better reflection of the progression of the degenerative process than numerical lesion counts; there is a linear correlation between the Braak stages and Mini-Mental State scores in 122 aged individuals. Significant correlations are further obtained between the severity of dementia and the levels of a number of synaptic proteins including synaptophysin and the chromogranins. Taken together, our data suggest that none of the classical AD lesions, plaques and tangles, play a central role in the pathogenesis of dementia, a fact that is supported by a molecular biological study showing that there is no close relationship between these lesions and the neurons undergoing degeneration in AD. Whereas neuritic pathology is a useful histopathological marker for the diagnosis and staging of AD, the major correlate of cognitive deficits is the loss of corticocortical and subcorticocortical connections reflected by a depletion of synapses. This pathology may be induced by a mismetabolism of the beta-amyloid precursor proteins or their interaction with cytoskeletal proteins related to neuronal degeneration.
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Most brains from elderly human subjects show abnormalities that fall somewhere along particular continua of pathologic severity.
“We consider it to be an important clue that most brains from elderly human subjects show abnormalities that fall somewhere along particular continua of pathologic severity (60, 96-100).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [98]
Subsequent studies have established that the densities of NPs correlate with antemortem cognitive impairment better than the densities of diffuse AβPs.
“Subsequent studies have established that the densities of NPs correlate with antemortem cognitive impairment better than the densities of diffuse AβPs (45, 98, 106, 154, 189, 261).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [98]
More than 40 CPC studies have assessed the correlation between AβPs and severity of antemortem cognitive impairment.
“More than 40 CPC studies have assessed the correlation between AβPs and severity of antemortem cognitive impairment (38, 98, 103, 105-108, 158, 162, 171, 185, 189, 191, 223-260).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [98]
Numerous CPC studies have assessed the association between NFTs and cognitive status.
“Numerous CPC studies have assessed the association between NFTs and cognitive status (38, 98, 154, 158, 162, 185, 188, 189, 191, 223-232, 235-240, 244, 250-252, 258, 261, 264, 287-296).”
From Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature (2012) · cites this paper as [98]
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- Authors
- Bancher, C., Jellinger, K., Lassmann, H., Fischer, P., & Leblhuber, F.
- Affiliations
- Ludwig Boltzmann für Klinische Neurobiologie (AT)
- Austrian Academy of Sciences (AT)
- University of Vienna (AT)
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 1996-05
- Volume
- 246
- Issue
- 3
- Pages
- 137-146
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W2042065186
- Cited by
- 130
- References
- 81
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 1 · 2012: 4
- FWCI
- 5.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- Alzheimer's disease, clinicopathological correlation, neuropathology, neuritic plaques, neurofibrillary tangles, neuropil threads, Braak staging, synaptophysin, chromogranin, synaptic loss, cognitive decline, dementia severity, amyloid precursor protein, neurodegeneration
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Austria, Dementia, DNA Damage, Female, Humans, Immunohistochemistry, Longitudinal Studies, Male, Nerve Degeneration, Prospective Studies, Psychiatric Status Rating Scales, Psychometrics, Immunoblotting, Amyloid beta-Peptides, Synaptophysin, Neurofibrillary Tangles
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