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Magnetic resonance imaging of fixed post mortem brains reliably reflects subcortical vascular pathology of frontal, parietal and occipital white matter

Lookup NU author(s): Dr Kirsty McAleese, Dr Michael FirbankORCiD, Dr David Hunter, Dr Li Sun, Professor John O'Brien, Professor Johannes Attems


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AimsSubcortical vascular pathology of the white and deep gray matter (WM and DGM) is associated with cognitive impairment. Routine neuropathological assessment of subcortical vascular pathology is based on semi-quantitative scoring of characteristic lesions in a limited number of histological slides from selected WM and DGM areas. Clinically, WM and DGM lesions are visualised as hyperintensities on magnetic resonance imaging (MRI). The aim of this study was to evaluate the feasibility of MRI on fixed post mortem brain hemispheres to complement routine neuropathological assessment of subcortical vascular pathology. MethodsWe assessed subcortical vascular pathology in 40 post mortem brain hemispheres from demented (n=26) and non-demented (n=14) individuals (mean age 83.2 ±14.8 years; 62.5% female) using i) routine histological assessment, ii) extensive histological assessment of the entire hemisphere at 7 mm intervals and iii) full T2-weighted MRI performed on fixed post mortem brain hemispheres. ResultsIn both WM and DGM routine histological scores for subcortical vascular pathology were significantly lower (P<0.01) than the corresponding scores obtained by extensive histological assessment. By contrast, no significant differences were seen between scores obtained by MRI and extensive histological assessment in frontal, parietal and occipital lobes while MRI scores were significantly lower in the temporal WM and DGM (P<0.01). ConclusionsThe results of our study indicate that routine histological assessment underrates subcortical vascular pathology and we conclude that MRI could be used in addition to complement neuropathological post mortem assessment of subcortical vascular pathology of the WM.

Publication metadata

Author(s): McAleese KE, Firbank M, Hunter D, Sun L, Hall R, Neal JW, Mann DM, Esiri M, Jellinger KA, O'Brien JT, Attems J

Publication type: Article

Publication status: Published

Journal: Neuropathology and Applied Neurobiology

Year: 2013

Volume: 39

Issue: 5

Pages: 485-497

Print publication date: 17/10/2012

ISSN (print): 0305-1846

ISSN (electronic): 1365-2990

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/j.1365-2990.2012.01310.x

PubMed id: 23075072


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Funder referenceFunder name
Alzheimer's Research UK
National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre for Ageing and Age-related based at Newcastle upon Tyne Hospitals National Health Service (NHS) Foundation Trust
Newcastle University
Alzheimer's Society
G0400074UK Medical Research Council
R173/1110Dunhill Medical Trust