Neuropathological assessment of Parkinson's disease: refining the diagnostic criteria

Summary To date, there have been few systematic attempts to provide a standard operating procedure for the neuropathological diagnosis of Parkinson's disease (PD). Pathological examination cannot classify the clinical syndrome with certainty; therefore, the neuropathological diagnosis is, at be...

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Bibliographic Details
Published in:Lancet neurology 2009-12, Vol.8 (12), p.1150-1157
Main Authors: Dickson, Dennis W, MD, Braak, Heiko, MD, Duda, John E, MD, Duyckaerts, Charles, MD, Gasser, Thomas, MD, Halliday, Glenda M, PhD, Hardy, John, PhD, Leverenz, James B, MD, Del Tredici, Kelly, MD, Wszolek, Zbigniew K, MD, Litvan, Irene, MD
Format: Article
Language:English
Subjects:
alpha-Synuclein - genetics
Humans
Lewy Bodies - pathology
Neurology
Parkinson Disease - diagnosis
Parkinson Disease - genetics
Parkinson Disease - pathology
Parkinson's disease
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Summary:Summary To date, there have been few systematic attempts to provide a standard operating procedure for the neuropathological diagnosis of Parkinson's disease (PD). Pathological examination cannot classify the clinical syndrome with certainty; therefore, the neuropathological diagnosis is, at best, a probability statement. The neuropathological diagnosis of parkinsonism has become increasingly based on fundamental molecular underpinnings, with recognition that the genetics of parkinsonism is heterogeneous and includes disorders that are associated with and without Lewy bodies. The advent of α-synuclein immunohistochemistry has substantially improved the ability to identify Lewy pathology, particularly cortical Lewy bodies and smaller aggregates within processes and the neuropil. In this Review we discuss the diagnostic criteria for the neuropathological assessment of PD. These criteria are provisional and need to be validated through an iterative process that could help with their refinement. Additionally, we suggest future directions for neuropathology research on PD.
ISSN:1474-4422
1474-4465
DOI:10.1016/S1474-4422(09)70238-8