Cerebrovascular Lesions in Pick Complex Diseases – A Neuropathological Study with a 7.0-Tesla Magnetic Resonance Imaging Study

Abstract

Pick complex refers to a spectrum of diseases that include the presence of tau. The main neuropathological phenotypes comprise tau-frontotemporal lobar degeneration (tau-FTLD), progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The present neuropathological study investigated the incidence of cerebrovascular lesions, including the small lesions detected microscopically on a large coronal section of a cerebral hemisphere at the level of the mammillary body. In addition the severity and distribution of white matter changes (WMCs), cortical microinfarcts (CoMIs) and cortical microbleeds (CoMBs) are examined with 7.0-tesla magnetic resonance imaging (MRI) on three coronal sections of a cerebral hemisphere. On neuropathological examination severe WMCs and more CoMBs are observed in tau-FTLD, while the latter are also more frequent in CBD. The MRI examination shows that severe WMCs are present in the frontal section of not only the tau-FTLD, but the PSP and CBD brains, albeit to a lesser degree. Severe WMCs and the increased number of CoMBs are related directly to the neurodegenerative process and do not represent additional cerebrovascular disease. The Pick complex diseases have a low incidence of real cerebrovascular lesions in common.