Visual association pathology in preclinical Alzheimer disease

Ann C. McKee, Rhoda Au, Howard J. Cabral, Neil W. Kowall, Sudha Seshadri, Caroline A. Kubilus, Jon Drake, Philip A. Wolf

Research output: Contribution to journalArticle

110 Scopus citations

Abstract

The transition from normal aging to mild cognitive impairment to Alzheimer disease (AD) is often indistinct. Imaging studies suggest early changes in posterior brain regions, including posterior temporoparietal and occipital cortex, but pathologic studies show initial changes in the medial temporal lobe with progressive neocortical involvement as cognition deteriorates. We evaluated the regional distribution of AD pathology in 41 elderly brain donors from the Framingham Heart Study who were cognitively intact, mildly impaired, or demented on the basis of probable AD. We found that 52% of the cognitively intact subjects, and all subjects with mild cognitive impairment or dementia, had dense neurofibrillary tangles (NFTs), neuropil threads, and tau-immunoreactive neurites surrounding neuritic plaques (NPs) in visual association cortex Brodmann area 19. All cognitively intact subjects with area 19 NFTs also had dense core NP and β amyloid (Aβ) angiopathy in area 19. Area 19 pathology was occasionally present in the absence of substantial pathology in the hippocampus or entorhinal cortex and was not correlated with medial temporal lobe pathology. Dense AD pathology in area 19 is present in some cognitively intact subjects with preclinical AD. The unique metabolic, connectional, and vascular features of this region may confer enhanced vulnerability to neurodegeneration.

Original languageEnglish (US)
Pages (from-to)621-630
Number of pages10
JournalJournal of Neuropathology and Experimental Neurology
Volume65
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

Keywords

  • Alzheimer disease
  • Brodmann area 19
  • Preclinical Alzheimer disease
  • Visual association cortex

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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  • Cite this

    McKee, A. C., Au, R., Cabral, H. J., Kowall, N. W., Seshadri, S., Kubilus, C. A., Drake, J., & Wolf, P. A. (2006). Visual association pathology in preclinical Alzheimer disease. Journal of Neuropathology and Experimental Neurology, 65(6), 621-630. https://doi.org/10.1097/00005072-200606000-00010