TY - JOUR
T1 - The need to unify neuropathological assessments of vascular alterations in the ageing brain
T2 - Multicentre survey by the BrainNet Europe consortium
AU - Alafuzoff, Irina
AU - Gelpi, Ellen
AU - Al-Sarraj, Safa
AU - Arzberger, Thomas
AU - Attems, Johannes
AU - Bodi, Istvan
AU - Bogdanovic, Nenad
AU - Budka, Herbert
AU - Bugiani, Orso
AU - Englund, Elisabet
AU - Ferrer, Isidro
AU - Gentleman, Stephen
AU - Giaccone, Giorgio
AU - Graeber, Manuel B
AU - Hortobagyi, Tibor
AU - Höftberger, Romana
AU - Ironside, James W
AU - Jellinger, Kurt
AU - Kavantzas, Nikolaos
AU - King, Andrew
AU - Korkolopoulou, Penelope
AU - Kovács, Gábor G
AU - Meyronet, David
AU - Monoranu, Camelia
AU - Parchi, Piero
AU - Patsouris, Efstratios
AU - Roggendorf, Wolfgang
AU - Rozemuller, Annemieke
AU - Seilhean, Danielle
AU - Streichenberger, Nathalie
AU - Thal, Dietmar R
AU - Wharton, Stephen B
AU - Kretzschmar, Hans
PY - 2012/11
Y1 - 2012/11
N2 - Here, we summarise the results after carrying out a large survey regarding the assessment of vascular alterations, both vessel changes and vascular lesions in an inter-laboratory setting. In total, 32 neuropathologists from 22 centres, most being members of BrainNet Europe (BNE), participated by filling out a questionnaire with emphasis on assessment of common vascular alterations seen in the brains of aged subjects. A certain level of harmonisation has been reached among BNE members regarding sectioning of the brain, harvesting of brain tissue for histology and staining used when compared to the survey carried out in 2006 by Pantoni and colleagues. The most significant variability was seen regarding the assessment of severity and of clinical significance of vascular alterations. Two strategies have recently been recommended regarding the assessment of vascular alterations in aged and demented subjects. The National Institute on Aging - Alzheimer's Association (NIA-AA) recommends the assessment of hippocampal sclerosis, vascular brain injury and microvascular lesions in 12 regions. Although this strategy will be easy to follow, the recommendations do not inform how the load of observed alterations should be assessed and when the observed lesions are of significance. Deramecourt and his colleagues recommend an assessment and semiquantitative grading of various pathologies in 4 brain regions. This strategy yielded a total score of 0 to 20 as an estimate of pathology load. It is, however, not clear which score is considered to be of clinical significance. Furthermore, in several BNE trials the semiquantitative assessment has yielded poor agreement rates; an observation that might negatively influence the strategy proposed by Deramecourt and his colleagues. In line with NIA-AA, a dichotomised approach of easily recognisable lesions in a standardised set of brain regions harvested for neuropathological assessment and applying reproducible sampling and staining strategies is recommended by BNE. However, a simple strategy regarding assessment of load of alteration is urgently needed to yield reproducible, and at the same time, comparable results between centres.
AB - Here, we summarise the results after carrying out a large survey regarding the assessment of vascular alterations, both vessel changes and vascular lesions in an inter-laboratory setting. In total, 32 neuropathologists from 22 centres, most being members of BrainNet Europe (BNE), participated by filling out a questionnaire with emphasis on assessment of common vascular alterations seen in the brains of aged subjects. A certain level of harmonisation has been reached among BNE members regarding sectioning of the brain, harvesting of brain tissue for histology and staining used when compared to the survey carried out in 2006 by Pantoni and colleagues. The most significant variability was seen regarding the assessment of severity and of clinical significance of vascular alterations. Two strategies have recently been recommended regarding the assessment of vascular alterations in aged and demented subjects. The National Institute on Aging - Alzheimer's Association (NIA-AA) recommends the assessment of hippocampal sclerosis, vascular brain injury and microvascular lesions in 12 regions. Although this strategy will be easy to follow, the recommendations do not inform how the load of observed alterations should be assessed and when the observed lesions are of significance. Deramecourt and his colleagues recommend an assessment and semiquantitative grading of various pathologies in 4 brain regions. This strategy yielded a total score of 0 to 20 as an estimate of pathology load. It is, however, not clear which score is considered to be of clinical significance. Furthermore, in several BNE trials the semiquantitative assessment has yielded poor agreement rates; an observation that might negatively influence the strategy proposed by Deramecourt and his colleagues. In line with NIA-AA, a dichotomised approach of easily recognisable lesions in a standardised set of brain regions harvested for neuropathological assessment and applying reproducible sampling and staining strategies is recommended by BNE. However, a simple strategy regarding assessment of load of alteration is urgently needed to yield reproducible, and at the same time, comparable results between centres.
KW - Severity of Illness Index
KW - Questionnaires
KW - Reproducibility of Results
KW - Humans
KW - Aging
KW - Specimen Handling
KW - Brain
KW - Cerebrovascular Circulation
KW - Dementia
KW - Staining and Labeling
KW - Cerebrovascular Disorders
U2 - 10.1016/j.exger.2012.06.001
DO - 10.1016/j.exger.2012.06.001
M3 - Article
C2 - 22705312
VL - 47
SP - 825
EP - 833
JO - Experimental gerontology
JF - Experimental gerontology
IS - 11
ER -