1. Center-Specific Neuropathology Procedures Survey Erin M. Pfeiffer 10/12/2002 NACC National Alzheimer’s Coordinating Center

2. NACC Center-Specific Neuropathology Survey Dr. Cochran, Dr. Dickson, Dr. Ghetti Special Thanks – Dr. Jim Leverenz 10-page detailed survey 90.6 % response rate (29/32 surveys) Complete answers & thoughtful comments

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7. NACC General Questions: # NP-related data elements maintained in each Center’s Database # Variables StoredCountPercent 1-25 518 % 26-50 2 7 % 51-75 518 % 76-100 518 % > 1001139 % Frequency Missing = 1

8. NACC General Questions (cont’d) > 90% maintaining data on:  AD pathological dx  Plaques/tangles  PD pathological dx  Lewy bodies  Infarcts ~ 46% maintain genetic data ~ 62% collect circumstance of death (Including Centers who collect for some/not all subjects)

9. NACC Specimen and Tissue Preparation: Postmortem Interval Postmortem Interval (hrs) # of Centers

10. NACC Specimen and Tissue Preparation: Specimens Collected from Autopsy Percent of Centers Collecting Samples Specimen TypeFixedParaffinFrozenNone Hippocampus86 %100 %93 %-- Temporal Cortex86 %100 %90 % 3 % Pituitary Gland12 %28 %14 %52 % PNT* 7 % 3 %93 % * PNT = Peripheral Nervous Tissue

11. NACC Specimen and Tissue Preparation: Cryoprotection 40% store fixed tissue in cryoprotective solution Average time tissue fixed prior to transfer to cryoprotective solution = 2 days Cryoprotective solutions include: – 16% sucrose – 20% glycerol, 2% DMSO – Isopentane Liquid Nitrogen – Sucrose/ethylene glycol in phosphate buffer

12. NACC Specimen and Tissue Preparation: Biological Specimen Banking Biological SpecimenCountPercent DNA1763 % Serum1348 % Lymphocytes: Buffy Coat 830 % Lymphocytes: Lymphoblastoid ICL* 1 4 % Antemortem CSF 519 % * ICL = Immortalized Cell Lines Frequency Missing = 2

13. NACC Stains for identifying beta-amyloid pathology – 69 % Silver Stain (e.g. Bielschowsky, Bodian, Campbell-Switzer, Microwave King, Gallyas) – 35 % Thioflavin-S – 24 % Congo Red – 72 % Aß immunostain (e.g. GFAP, Novocastra, DAKO monoclonal mouse) Histopathology: Stains

14. NACC Stains for identifying neurofibrillary pathology – 76 % Silver Stain (e.g. Bielschowsky, Modified-Biel, Bodian, Microwave King, Gallyas) – 36 % Thioflavin-S – 83 % Tau immunostain (e.g. AT8, PHF-1, ALZ-50, Tau-2) Histopathology: Stains

15. NACC Neuropathology: Criteria AD PathologyCountPercent NIA/Reagan Institute2586 % CERAD2276 % ADRDA/Khachaturian 621 % Tierney-- Other * 517 % * Washington U modified Koch (1985), In house semi-quantitative methods, etc

16. NACC Neuropathology: Criteria FTD PathologyCountPercent Lund and Manchester* 932 % Work Group on FTD & PiD**1968 % Other 414 % * Lund and Manchester Groups. Clinical and neuropathological criteria for frontotemporal dementia. J of Neurology, Neurosurgery, and Neuropsychiatry 1994:416-18 **McKhann GM et al. Clinical and Pathological Diagnosis of Frontotemporal Dementia: report of the work group on frontotemporal dementia and Pick’s disease. Arch of Neurol 2001:1803-09 Frequency Missing = 1

17. NACC Percentage of Centers that perform: – Immunoassays = 40% – In situ hybridization = 14% – Image analysis = 36% – Stereology = 25% – Microarray analysis = 32% Additional Procedures: Performed on NP core tissue

18. NACC Summary / Plans for NP Survey Data Detailed summary of NP procedures & specific specimens available at each ADC Dataset created - After NYC, contact a few ADCs for brief clarifications Survey results will be available via NACC’s website Data will be integrated into overall database (i.e. linked to MDS, Neuropathology data, other Centers data) Thanks again!

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