Abstract
Prominent behavioral changes and language dysfunction are features of frontotemporal lobar degeneration (FTLD) but can also occur in AD. Recently, application of TAR DNA-binding protein 43 (TDP-43) antibody has been shown to be useful for demonstrating the pathologic lesions of FTLD-U and FTLD-MND. Since these cases might represent combined disorders (FTD and AD), we studied the utility of TDP-43 staining to demonstrate inclusion bodies in brains of patients with clinical features of frontal or temporal lobe dysfunction but with autopsy features of AD. METHODS: Eight patients from 1998 to 2005 were identified, including 1 with combined pathologic features of FTLD-U (previously identified with anti-ubiquitin staining) and mild AD (Braak stage IV). Sections of hippocampus and frontal and temporal lobes were stained with anti-TDP-43 antibody (Proteintech Group). RESULTS: Of the 8 patients, 1 had advanced AD (Braak stage VI) and scattered TDP-43 positive cytoplasmic inclusions in hippocampal dentate granular cells and frontal and temporal neocortical neurons. The previously identified patient with combined FTLD-U and mild AD also had TDP-43 positive cytoplasmic and nuclear inclusions. CONCLUSION: TDP-43 aids in the identification of case with dual pathologies, particularly in advanced AD where inclusion may be masked by overwhelming AD pathology.
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