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Washington University Experience | NEURODEGENERATION | Primary Age-Related Tauopathy (PART) | 2D Case 2 Denouement
Neuro Final Diagnosis: Primary age-related tauopathy (PART); Age-related tau astrogliopathy (ARTAG); Alzheimer disease neuropathologic change (ADNC: Low: A1, B2, C0) ---- Neuro Diagnosis Comment: There are no major lesions in this brain. The changes observed are of a modest nature and include: neurofibrillary tangles in the medial temporal lobe consistent with an entity called primary age-related tauopathy (PART). In addition, patches of tau-immunoreactive thorn-shaped astrocytes are present in the amygdala, medial temporal lobe and basal forebrain consistent with a recently described entity called age-related tau astrogliopathy (ARTAG) and there are very modest Alzheimer disease changes. Most areas of the neocortex are devoid of beta-amyloid plaques. However, a few diffuse plaques are seen in the parietal lobe and parahippocampal gyrus. Diffuse beta-amyloid plaques and neurofibrillary tangles are present in distributions and densities consistent with Braak and Braak neurofibrillary tangle stage III (range: 0-VI) and beta-amyloid stage A (range: A-C). These modest findings do not support a neuropathological diagnosis of AD by Khachaturian, CERAD, or NIA-Regan criteria. Using the NIA-AA criteria, this case is Alzheimer disease neuropathologic change (ADNC: Low: A1, B2, C0, where A = beta-amyloid stage, range 0-3 (Thal beta-amyloid stage 1/5); B = neurofibrillary tangle stage, range 0-3; and C = neuritic plaque stage, range: 0-3). Vascular pathology is present in the form of mild arteriolosclerosis and mild CAA, but no infarcts are observed. Overall, the vasculopathy is modest and likely had no effect on cognition. In conclusion, this Participant’s brain has evidence of age-related tauopathy and very early stage AD neuropathologic change; these were insufficiently advanced to have caused any significant cognitive impairment.
