Chapter 7 Brain banking and the human hypothalamus — factors to match for, pitfalls and potentials

Abstract

The study of an increasing number of processes occurring in the human brain can be carried out on autopsy material. The availability of this material, whether fresh, frozen or fixed, makes it possible to develop methodologies for studying the neuroanatomical and neurochemical aspects of the human brain. It has also become possible in recent years to correlate functional changes with neurochemical changes and with neuroanatomical abnormalities in disease states. Some compounds and structures are damaged irreversibly within minutes after death and some brain components are known to disintegrate within seconds. This led to the widespread idea that autopsy material would not be suitable for basic research purposes and would not supply the necessary answers on the various fundamental questions regarding processes occurring in normal or diseased brain. However, from data published in recent years in which autopsy material has been routinely used, it becomes more and more evident that this is a misconception. There is an increasing number of reports based on the use of normal and pathological human brain tissue obtained by autopsies in spite of the fact that there is a worrying continuous decline in autopsy rate which causes serious concern among scientists world-wide (Anderson and Hill, 1989). It also became evident that when using the proper fixation procedures, sufficient structural integrity is retained in the tissue to allow morphological and morphometrical studies (Swaab and Uylings, 1988). Electron microscopic examination of synaptosomal preparations from post-mortem human brain showed them to be only slightly less pure than preparations from fresh tissue although there was some degree of damage (Hardy et al., 1982). Agonal state effects the stability of brain compounds and causes brain hypoxia. This again forms a tremendous difficulty for the study of human neurological and psychiatric diseases as one of the frequent causes of death is bronchopneumonia which leads to brain hypoxia and results in pronounced lactic acidosis. The Netherlands Brain Bank has succeeded to partly circumvent some of the serious problems encountered in providing human tissue for research by performing rapid autopsies with an average post-mortem delay of 2-4 h. This has become possible by a close collaboration of numerous nursing homes in Amsterdam and its vicinity and with the neuropathologists of the Free University in Amsterdam. We also measure the pH of the tissue as indicator of agonal state in order to reveal unsuitable specimens. The human hypothalamus contains various nuclei manifesting a wide variety of changes in different conditions.(ABSTRACT TRUNCATED AT 400 WORDS)