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AJNR - American Journal of Neuroradiology

Published ahead of print on October 9, 2007
doi: 10.3174/ajnr.A0781

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Neuropathology for the Neuroradiologist: Plaques and Tangles

F.J. Wippold, II^a,b,c,d, N. Cairns^d,e,f, K. Vo^a,b, D.M. Holtzman^d,f,g and J.C. Morris^d,g

^a Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Mo
^b Department of Radiology, Barnes-Jewish Hospital South, St. Louis, Mo
^c Department of Radiology/Nuclear Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md
^d Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Mo
^e Neuropathology Division, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Mo
^f Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Mo
^g Department of Neurology and Neurological Surgery, Washington University School of Medicine, St. Louis, Mo

View larger version (113K): [in this window] [in a new window]   Fig 1. A, Atrophy of the brain. On the left, a section of the hemibrain of a 70-year-old patient with AD and, on the right, a healthy aged control brain. The AD brain shows marked atrophy, dilation of the lateral ventricle, and a small hippocampus. B, Neurofibrillary tangles (N) and neuritic plaques (P) in the hippocampus. Modified Bielschowsky silver impregnation. C, β-amyloidosis in the frontal lobe: a diffuse plaque (D), a cored plaque (C), and cerebral amyloid angiopathy (A). β-amyloid (10D5) immunohistochemistry. D, Neurofibrillary tangles (N) and neuritic plaques (P) in the frontal lobe. Phosphorylated ô immunohistochemistry.

View larger version (21K): [in this window] [in a new window]   Fig 2. Diagrammatic representation of APP processing. APP is a transmembrane protein with both extra- and intracellular components. APP is processed by 2 competing pathways. The -secretase pathway generates sAPP and C83 protein by cleavage of the -secretase enzyme (). In the β-secretase pathway, the enzyme β-secretase (β) cleaves APP into an sAPPβ fragment and a C99 fragment. The C99 fragment is further cleaved by -secretase enzyme () into an amyloid β fragment (Aβ) and an AICD fragment. The Aβ fragments polymerize. The oligomers and polymers exhibit neurotoxicity. As polymerization proceeds to more complex forms, senile plaques are developed. The C83 fragment is also further processed. However, the function of its products is not fully understood. (The relative sizes of the protein fragments are not drawn to scale.)