Parenchymal and vascular Aβ-deposition and its effects on the degeneration of neurons and cognition in Alzheimer's disease

The deposition of the amyloid β-protein (Aβ) is one of the pathological hallmarks of Alzheimer's disease (AD). Aβ-deposits show the morphology of senile plaques and cerebral amyloid angiopathy (CAA). Senile plaques and vascular Aβ-deposits occur first in neocorti-cal areas. Then, they expand hierarchically into further brain regions. The distribution of Aβ plaques throughout the entire brain, thereby correlates with the clinical status of the patients. Imaging techniques for Aβ make use of the hierarchical distribution of Aβ to distinguish AD patients from non-AD patients. However, pathology seen in AD patients represents a late stage of a pathological process starting 10–30 years earlier in cognitively normal individuals. In addition to the fibrillar amyloid of senile plaques, oligomeric and monomeric Aβ is found in the brain. Recent studies revealed that oligomeric Aβ is presumably the most toxic Aβ-aggregate, which interacts with glutamatergic synapses. In doing so, dendrites are presumed to be the primary target for Aβ-toxicity. In addition, vascular Aβ-deposits can lead to capillary occlusion and blood flow disturbances presumably contributing to the alteration of neurons in addition to the direct neurotoxic effects of Aβ. All these findings point to an important role of Aβ and its aggregates in the neurodegenerative process of AD. Since there is already significant neuron loss in AD patients, treatment strategies aimed at reducing the amyloid load will presumably not cure the symptoms of dementia but they may stop disease progression. Therefore, it seems to be necessary to protect the brain from Aβ-toxicity already in stages of the disease with minor neuron loss before the onset of cognitive symptoms

Pathologische Veränderungen bei sporadischem Morbus Parkinson : induziert ein neurotropes Pathogen die Erkrankung?

Der Morbus Parkinson tritt in der Regel sporadisch auf und ist nach dem Morbus Alzheimer die häufigste degenerative Erkrankung des menschlichen Nervensystems. Sie ist bei nicht-menschlichen Wirbeltieren unbekannt und befällt außer dem Nervensystem keine anderen Organe. Wie bei vielen anderen Krankheiten auch erkennt der Kliniker nur die späten und bereits Symptome verursachenden Stadien des Morbus Parkinson. Spezielle Fehlfunktionen der Motorik, wie Hypokinese, Rigor, Ruhetremor weisen zwar auf die Erkrankung hin, können jedoch unter dem Bild eines »Parkinsonismus« auch bei anderen Krankheiten auftreten. Kennzeichnend dagegen ist ein eigenartiger pathologischer Prozess, der sich durch die Entwicklung von Einschlusskörpern in Nervenzellen auszeichnet. Der Prozess beschränkt sich auf wenige empfängliche Nervenzelltypen im zentralen, peripheren und enterischen Nervensystem. Die Einschlusskörper entwickeln sich nicht spontan und erscheinen auch nicht regelmäßig im Verlauf der Alterung des Nervensystems, selbst bei über Hundertjährigen nicht. Man hat also Grund, sie als pathologische Bildungen zu betrachten, auch wenn sie anfänglich in nur geringer Dichte im Nervengewebe auftreten. Die frühen symptomfreien Stadien der Krankheit lassen sich erst nach dem Tod der Patienten nachweisen. Wesentliche Kriterien für die Stellung einer postmortalen Diagnose sind die Einschlusskörper. Wie sie sich entwickeln und in den verschiedenen Stadien der Krankheit im Nervensystem ausbreiten, beschreiben Prof. Dr. Heiko Braak und Dr. Dr. Kelly Del Tredici

Mit Mangan und Eisen ko-dotiertes Germanium: ein ferromagnetischer Halbleiter?

Die vorliegende Arbeit befasst sich mit der Herstellung und Charakterisierung ferromagnetischer Halbleiter. Durch Ko-Dotieren von Germanium mit Mangan und Eisen soll ein ferromagnetisches, halbleitendes Material synthetisiert werden und dessen Curie-Temperatur gegenüber Ge(Mn)-Filmen erhöht werden. Epitaktische Ge(Mn,Fe)-Schichten werden in einer MBE-Anlage durch lagenweises Aufdampfen der Elemente hergestellt. Durch nachträgliches Anlassen durchmischen sich die Multilagen. Das sukzessive Hinzufügen von Eisen verändert das magnetische Verhalten drastisch. Die in Ge(Mn)-Filmen detektierte Mn11Ge8-Phase ist nicht mehr nachweisbar. Verglichen mit den Ge(Mn)-Schichten steigt der Anteil der Mn5Ge3- Phase an der Magnetisierung stark an. Zusätzlich tritt eine unbekannte magnetische Tieftemperatur-Phase (TT-Phase) mit einer Curie-Temperatur von 210K auf. Der Beitrag dieser TT-Phase zur Magnetisierung ist gering. Die Ge(Mn,Fe)- Filme haben halbleitende Eigenschaften. Der anomale Halleffekt ist vernachlässigbar. Die Mikrostrukturanalyse zeigt eine inhomogene Schicht mit Mn-haltigen Clustern. Das Reduzieren der Anlasstemperatur verringert die Anzahl der Cluster, die der Mn5Ge3-Phase zugeordnet werden können, signifikant. Die Temperaturabhängigkeit der Magnetisierung zeigt wieder die Signatur der beiden magnetischen Phasen. Der Anteil der TT-Phase an der Magnetisierung ist jedoch stark erhöht und viel größer als jene der Cluster-Phase. Zylinderförmige Inhomogenitäten mit einer, im Vergleich zur Matrix, erhöhten Mn- und Fe-Konzentration durchsetzen die Probe. Sowohl für die TT- als auch für die Cluster-Phase lässt sich ein deutlicher anomaler Halleffekt nachweisen. Eine Optimierung der relativen Mn- und Fe-Konzentration unterdrückt die Bildung der Cluster-Phase, und die Magnetisierungsmessung zeigt nur noch die TT-Phase. Die kristalline Ordnung der zylinderförmigen Strukturen im Film zeigen eine klare epitaktische Beziehung zur umgebenden Matrix. Der optimierte Ge(Mn,Fe)-Film zeigt halbleitenden Charakter mit Löcherleitung. Der anomale Halleffekt der TT-Phase ist etwa eine Gröÿenordnung stärker als in den Ge(Mn,Fe)-Filmen, die Cluster enthalten. Um die Frage zu beantworten, ob die optimierten, einphasigen Ge(Mn,Fe)- Filme ferromagnetische Halbleiter sind, bedarf es weiterer Experimente, die den intrinsischen, ladungsträger-induzierten Ferromagnetismus direkt nachweisen. Das Auftreten des anomalen Halleffekts ist zwar eine notwendige aber nicht hinreichende Bedingung für einen ferromagnetischen Halbleiter, da wie hier gezeigt auch Cluster-Phasen zum anomalen Halleffekt beitragen können

Dystrophic (senescent) rather than activated microglial cells are associated with tau pathology and likely precede neurodegeneration in Alzheimer’s disease

The role of microglial cells in the pathogenesis of Alzheimer’s disease (AD) neurodegeneration is unknown. Although several works suggest that chronic neuroinflammation caused by activated microglia contributes to neurofibrillary degeneration, anti-inflammatory drugs do not prevent or reverse neuronal tau pathology. This raises the question if indeed microglial activation occurs in the human brain at sites of neurofibrillary degeneration. In view of the recent work demonstrating presence of dystrophic (senescent) microglia in aged human brain, the purpose of this study was to investigate microglial cells in situ and at high resolution in the immediate vicinity of tau-positive structures in order to determine conclusively whether degenerating neuronal structures are associated with activated or with dystrophic microglia. We used a newly optimized immunohistochemical method for visualizing microglial cells in human archival brain together with Braak staging of neurofibrillary pathology to ascertain the morphology of microglia in the vicinity of tau-positive structures. We now report histopathological findings from 19 humans covering the spectrum from none to severe AD pathology, including patients with Down’s syndrome, showing that degenerating neuronal structures positive for tau (neuropil threads, neurofibrillary tangles, neuritic plaques) are invariably colocalized with severely dystrophic (fragmented) rather than with activated microglial cells. Using Braak staging of Alzheimer neuropathology we demonstrate that microglial dystrophy precedes the spread of tau pathology. Deposits of amyloid-beta protein (Aβ) devoid of tau-positive structures were found to be colocalized with non-activated, ramified microglia, suggesting that Aβ does not trigger microglial activation. Our findings also indicate that when microglial activation does occur in the absence of an identifiable acute central nervous system insult, it is likely to be the result of systemic infectious disease. The findings reported here strongly argue against the hypothesis that neuroinflammatory changes contribute to AD dementia. Instead, they offer an alternative hypothesis of AD pathogenesis that takes into consideration: (1) the notion that microglia are neuron-supporting cells and neuroprotective; (2) the fact that development of non-familial, sporadic AD is inextricably linked to aging. They support the idea that progressive, aging-related microglial degeneration and loss of microglial neuroprotection rather than induction of microglial activation contributes to the onset of sporadic Alzheimer’s disease. The results have far-reaching implications in terms of reevaluating current treatment approaches towards AD

Two histological methods for recognition and study of cortical microinfarcts in thick sections

Cortical microinfarcts are the most widespread form of brain infarction but frequently remain undetected by standard neuroimaging protocols. Moreover, microinfarcts are only partially detectable in hematoxylin-eosin-stained (H and E) 4-10 µm paraffin sections at routine neuropathological examination. In this short report, we provide two staining protocols for visualizing cortical microinfarcts in 100-300 µm sections. For low-power microscopy, the first protocol combines aldehyde fuchsine staining for detection of lipofuscin granules and macrophages with Darrow red counterstaining for Nissl material. The second protocol combines collagen IV immunohistochemistry with aldehyde fuchsine/Darrow red or with erythrosin-phosphotungstic acid-aniline blue staining for detailed study of the capillary network. In the first protocol, microinfarcts are recognizable as radially-oriented funnel-like accumulations of aldehyde fuchsine-positive macrophages. The second protocol recognizes microinfarcts and alterations of the capillary network, at whose center accumulations of dead neurons and aldehyde fuchsine-positive macrophages cluster. In addition, the second protocol permits visualization of abnormalities within the capillary network associated with more recent microinfarcts. Both protocols can be useful for comparing MRI datasets with cortical microinfarcts in corresponding whole brain sections of 100-300 µm thickness

Microbes and Alzheimer\u27s Disease

We are researchers and clinicians working on Alzheimer\u27s disease (AD) or related topics, and we write to express our concern that one particular aspect of the disease has been neglected, even though treatment based on it might slow or arrest AD progression. We refer to the many studies, mainly on humans, implicating specific microbes in the elderly brain, notably herpes simplex virus type 1 (HSV1), Chlamydia pneumoniae, and several types of spirochaete, in the etiology of AD. Fungal infection of AD brain has also been described, as well as abnormal microbiota in AD patient blood. The first observations of HSV1 in AD brain were reported almost three decades ago. The ever-increasing number of these studies (now about 100 on HSV1 alone) warrants re-evaluation of the infection and AD concept

PART is part of Alzheimer disease

It has been proposed that tau aggregation confined to entorhinal cortex and hippocampus, with no or only minimal Aβ deposition, should be considered as a 'primary age-related tauopathy' (PART) that is not integral to the continuum of sporadic Alzheimer disease (AD). Here, we examine the evidence that PART has a pathogenic mechanism and a prognosis which differ from those of AD. We contend that no specific property of the entorhinal-hippocampal tau pathology makes it possible to predict either a limited progression or the development of AD, and that biochemical differences await an evidence base. On the other hand, entorhinal-hippocampal tau pathology is an invariant feature of AD and is always associated with its development. Rather than creating a separate disease entity, we recommend the continued use of an analytical approach based on NFT stages and Aβ phases with no inference about hypothetical disease processes.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Longitudinal Diffusion Tensor Imaging Resembles Patterns of Pathology Progression in Behavioral Variant Frontotemporal Dementia (bvFTD)

Objective: Recently, the characteristic longitudinal distribution pattern of the underlying phosphorylated TDP-43 (pTDP-43) pathology in the behavioral variant of frontotemporal dementia (bvFTD) excluding Pick's disease (PiD) across specific brain regions was described. The aim of the present study was to investigate whether in vivo investigations of bvFTD patients by use of diffusion tensor imaging (DTI) were consistent with these proposed patterns of progression. Methods: Sixty-two bvFTD patients and 47 controls underwent DTI in a multicenter study design. Of these, 49 bvFTD patients and 34 controls had a follow-up scan after ~12 months. Cross-sectional and longitudinal alterations were assessed by a two-fold analysis, i.e., voxelwise comparison of fractional anisotropy (FA) maps and a tract of interest-based (TOI) approach, which identifies tract structures that could be assigned to brain regions associated with disease progression. Results: Whole brain-based spatial statistics showed white matter alterations predominantly in the frontal lobes cross-sectionally and longitudinally. The TOIs of bvFTD neuroimaging stages 1 and 2 (uncinate fascicle—bvFTD pattern I; corticostriatal pathway—bvFTD pattern II) showed highly significant differences between bvFTD patients and controls. The corticospinal tract-associated TOI (bvFTD pattern III) did not differ between groups, whereas the differences in the optic radiation (bvFTD pattern IV) reached significance. The findings in the corticospinal tract were due to a “dichotomous” behavior of FA changes there. Conclusion: Longitudinal TOI analysis demonstrated a pattern of white matter pathways alterations consistent with patterns of pTDP-43 pathology

Staging of Neurofibrillary Pathology in Alzheimer's Disease: A Study of the BrainNet Europe Consortium

It has been recognized that molecular classifications will form the basis for neuropathological diagnostic work in the future. Consequently, in order to reach a diagnosis of Alzheimer's disease (AD), the presence of hyperphosphorylated tau (HP-tau) and β-amyloid protein in brain tissue must be unequivocal. In addition, the stepwise progression of pathology needs to be assessed. This paper deals exclusively with the regional assessment of AD-related HP-tau pathology. The objective was to provide straightforward instructions to aid in the assessment of AD-related immunohistochemically (IHC) detected HP-tau pathology and to test the concordance of assessments made by 25 independent evaluators. The assessment of progression in 7-µm-thick sections was based on assessment of IHC labeled HP-tau immunoreactive neuropil threads (NTs). Our results indicate that good agreement can be reached when the lesions are substantial, i.e., the lesions have reached isocortical structures (stage V–VI absolute agreement 91%), whereas when only mild subtle lesions were present the agreement was poorer (I–II absolute agreement 50%). Thus, in a research setting when the extent of lesions is mild, it is strongly recommended that the assessment of lesions should be carried out by at least two independent observers