Alzheimer Disease

Abstract

The diseased brain is from a patient who had had cognitive decline for 5 years and died of aspiration pneumonia. What is the most likely diagnosis and neuropathologic finding?a.Pick disease; tau protein deposits in neuronsb.Lewy body dementia; α-synuclein deposits in neuronsc.Hepatic encephalopathy; Alzheimer type II gliosisd.Alzheimer disease; neurofibrillary tangles and neuritic plaques Answer: d. Alzheimer disease; neurofibrillary tangles and neuritic plaques Alzheimer disease is the most common neurodegenerative disease, and unlike the other diseases listed, classically exhibits global cerebral atrophy.1Knopman D.S. Petersen R.C. Mild cognitive impairment and mild dementia: a clinical perspective.Mayo Clin Proc. 2014; 89: 1452-1459Abstract Full Text Full Text PDF Scopus (162) Google Scholar The atrophy is typically greatest in the medial temporal lobe/hippocampus. Alzheimer disease is characterized by tau and amyloid protein deposition. Tau protein forms neurofibrillary tangles within affected neurons and also forms neuritic plaques in conjunction with β-amyloid protein.2Josephs K.A. Dickson D.W. Murray M.E. et al.Quantitative neurofibrillary tangle density and brain volumetric MRI analyses in Alzheimer's disease presenting as logopenic progressive aphasia.Brain Lang. 2013; 127: 127-134Crossref Scopus (43) Google Scholar β-Amyloid protein may also deposit as diffuse plaques within the cortex or as amyloid angiopathy within leptomeningeal and cortical vessels.