title: Neuropathological assessment of Parkinson's disease: refining the diagnostic criteria.
abstract: To date, there have been few systematic attempts to provide a standard operating procedure for the neuropathological diagnosis of Parkinson's disease (PD). Pathological examination cannot classify the clinical syndrome with certainty; therefore, the neuropathological diagnosis is, at best, a probability statement. The neuropathological diagnosis of parkinsonism has become increasingly based on fundamental molecular underpinnings, with recognition that the genetics of parkinsonism is heterogeneous and includes disorders that are associated with and without Lewy bodies. The advent of alpha-synuclein immunohistochemistry has substantially improved the ability to identify Lewy pathology, particularly cortical Lewy bodies and smaller aggregates within processes and the neuropil. In this Review we discuss the diagnostic criteria for the neuropathological assessment of PD. These criteria are provisional and need to be validated through an iterative process that could help with their refinement. Additionally, we suggest future directions for neuropathology research on PD.
authors.affiliation: Mayo Clinic, Jacksonville, FL, USA.
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Dickson
authors.forename: Heiko
authors.initials: H
authors.lastname: Braak
authors.forename: John E
authors.initials: JE
authors.lastname: Duda
authors.forename: Charles
authors.initials: C
authors.lastname: Duyckaerts
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
authors.forename: Glenda M
authors.initials: GM
authors.lastname: Halliday
authors.forename: John
authors.initials: J
authors.lastname: Hardy
authors.forename: James B
authors.initials: JB
authors.lastname: Leverenz
authors.forename: Kelly
authors.initials: K
authors.lastname: Del Tredici
authors.forename: Zbigniew K
authors.initials: ZK
authors.lastname: Wszolek
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
mesh_terms: D006801:Humans; D016631:Lewy Bodies / Q000473:pathology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology*; D051844:alpha-Synuclein / Q000235:genetics
chemical_list: D051844:alpha-Synuclein