1. PPMI Pathology Core
Tatiana Foroud &
Tom Montine

2. Pathology Core Infrastructure
Stanford University Pathology Core
Indiana University Pathology Core

3. PPMI Pathology Core Overview
Plan Brain Donation
Introduction to Participant
Brain Collection
Neuropath
Evaluation
Specimen
Repository

4. Site Coordinators are the Key!
Provide talking points for site coordinators and stress their important role in helping with engagement
Contribution to understanding PD progression
No additional cost to subject
Post mortem report provided to family

5. Pathology Core Referral

6. PPMI Site Referrals to Pathology Core
Pending Amend 12 approval: (19) University of South Florida, (28) JHU, (88) NWU

7. PPMI Subject Referrals by Arm

8. PPMI Pathology Core Update
PPMI Site Referral to PPMI Path Core
(n=367)
PPMI Path Core: Contacts Subject, explains Core
(n= 367)
Not yet successfully contacted (n=52) & Request delayed planning (n=16)
Decline/lost to
f-up
(n=54)
Subject sent IC and CRF (paper/electronic)
(n=245)
IC pending completion; reminder sent every 3 weeks (n=110)
Completed IC and CRF received
(n=135)
Still planning
(n=8)
Brain removal plan in place and documented
(n=127)

9. Planning Challenges
Finding removal specialists with 24/7 coverage to help with <8 hr removal goals
Coordinating donations for subjects enrolled in multiple donations programs
Identifying subjects who might have already donated to other brain banks

10. Brain Donation Three PPMI subjects have samples at Stanford University
One individual was planned by PPMI Pathology Core and brain was successfully obtained
Two individuals had planned for donation prior to the establishment of the PPMI Pathology Core
Tissue/slides from recipient brain banks transferred to Stanford
Preliminary evaluation of one case completed
ClinicoPathologic Case (CPC) conference to be scheduled

11. Goals for the Coming Year
Annual confirmation with PPMI participants who have a plan in place
Continue to receive referrals from US PPMI sites
European and International PPMI site expansion
Establish harmonized IHC staining protocol across international sites
Neuropathology evaluation to be performed at either international site with data transfer to Stanford or at Stanford
Finalize plans for data transfer with LONI
Pathology slide images (Stanford University)
Pathology specimen catalog (Indiana University)

12. Case
80 yo woman with history of movement disorder and cognitive impairment
Brain
1370 gm
Mild cerebral cortical atrophy
Enlarged lateral ventricles
Moderate atrophy of hippocampus
Moderate pallor of SN and LC

13. Anti-Amyloid B (6E10) IHC, Cerebellum

14. Anti-PHF-tau IHC; BA17

15. H&E/LFB; Substantia Nigra

16. Anti-P129 alpha-Synuclein IHC; DMN X

17. Anti-P129 alpha-Synuclein IHC; BA9

18. Anti-P129 alpha-Synuclein IHC; amygdala

19. PPMI Case 2018-01 High Level AD Neuropathologic Change
A3, B3, C3
CAA (grade 2/3)
Neocortical LB Disease
DMNX, SN, anterior cingulate gyrus, BA9
Amygdala
No evidence of:
Microinfarcts
Hippocampal sclerosis
TDP-43 cytoplasmic inclusions