How neuropathology can contribute to the understanding of dementia

Written by Ellen Gelpi

Neuropathologists require years of specialized training to acquire sufficient skill for the adequate interpretation of brain changes in the context of disease states. Carrying out neuropathological studies can be time consuming and for some studies require weeks of tissue fixation before results are obtained. Some may argue that for the study of dementia, neuropathology has become obsolete, overtaken by highly advanced neuro-imaging and molecular biology techniques. However, as highlighted here, neuropathology remains an integral part of the multidisciplinary approach of the study of dementia, complimenting studies in clinical neurology, neuro-epidemiology, neuro-imaging and molecular biology.

The level of interest in performing postmortem brain studies for dementia, and the extent of the pathological studies carried out depends on the center in which the autopsy is performed that range from general pathology departments to neuroscience research institutes. There has been a decline in clinical autopsies in several countries, especially those performed on older individuals (>70 years of age) [1]. In this age group, patients with dementia frequently do not die at the hospital but at home or in nursing facilities. To facilitate the study of the brains of patients in these different centers brain banks and networks have been established worldwide [2–6] and provide guidelines for optimization of diagnostic and tissue preservation procedures to ensure diagnostic and tissue quality [7]. In our institution, an arrangement between consenting patients and families, funeral homes, local hospitals and our Brain Bank, facilitates donations from patients dying at home [8].

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