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Tau and alpha-synuclein brainstem pathology in Alzheimer disease: relation with extrapyramidal signs

Lookup NU author(s): Professor Johannes Attems


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Extrapyramidal symptoms (EPS) in Alzheimer disease (AD) often increase with disease severity. Their neuropathological substrate is a matter of discussion. We investigated tau and alpha-synuclein (AS) pathologies in brainstem in AD patients with and without EPS. Among 160 elderly subjects with autopsy-proven AD (110 female, 50 male, aged 61-102, mean 84.1 +/- 8.3 SD years), 151 (94.4%) being demented, 35 (21.9%) had clinically reported EPS (rigidity, bradykinesia, gait impairment). Neuropathological examination included standardized classification of AD according to current criteria, and semiquantitative assessment of neuronal loss in substantia nigra (SN), locus coeruleus (LC), and of tau and AS lesions in brainstem, and, in addition, of cerebrovascular lesions. The prevalence of EPS was only slightly more frequent in higher Braak stages. Tau pathology in brainstem significantly increased with increasing Braak stages, while AS lesions did not. EPS correlated best with SN cell loss (P

Publication metadata

Author(s): Attems J, Quass M, Jellinger KA

Publication type: Article

Publication status: Published

Journal: Acta Neuropathologica

Year: 2007

Volume: 113

Issue: 1

Pages: 53-62

ISSN (print): 0001-6322

ISSN (electronic): 1432-0533

Publisher: Springer


DOI: 10.1007/s00401-006-0146-9


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