title: Feasibility Study: Comparison of Frontal Cortex Needle Core Versus Open Biopsy for Detection of Characteristic Proteinopathies of Neurodegenerative Diseases.
abstract: The clinical diagnosis and classification of neurodegenerative diseases based on clinical examination or available biomarkers are currently insufficiently accurate. Although histologic examination is considered the gold standard for diagnosis, brain biopsies have been avoided because of the high risk-benefit ratio. However, brain biopsies have previously been performed with a craniotomy and excision of approximately 1 cm of cerebral cortex tissue, and it is possible that needle core brain biopsies would have a lower morbidity and mortality risk. Here, we compared the ability of simulated needle core biopsy versus simulated open biopsy to detect the frontal cortex histopathology associated with common neurodegenerative diseases in the elderly using 144 autopsy-proven cases. Simulated needle core biopsy, as compared with simulated open biopsy, gave close to 90% sensitivity and specificity for identifying graded densities of β-amyloid and neuritic plaques, neurofibrillary tangles, phosphorylated α-synuclein, and phosphorylated TDP-43 pathology. This study shows that the presence and densities of the most common molecular pathologies may be histopathologically assessed in simulated frontal cortex needle biopsies, with accuracy very close to that obtained by open cortical biopsy. An accurate estimation of the morbidity and mortality risk associated with cortical needle core biopsy will require specifically designed clinical trials in appropriate subjects.
authors.affiliation: From the Banner Sun Health Research Institute, Sun City (GES, AI, JC, GC, JAH, LIS, BND, MS-L, JF, AS, JP, BEF, SS, MNS, TGB); and Mayo Clinic Arizona, Scottsdale (CHA), Arizona; and Tokyo Metropolitan Institute of Medical Science, Setagayaku, Tokyo, Japan (HA).
authors.forename: Geidy E
authors.initials: GE
authors.lastname: Serrano
authors.forename: Anthony
authors.initials: A
authors.lastname: Intorcia
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Carew
authors.forename: Glenn
authors.initials: G
authors.lastname: Chiarolanza
authors.forename: Jose A
authors.initials: JA
authors.lastname: Hidalgo
authors.forename: Lucia I
authors.initials: LI
authors.lastname: Sue
authors.forename: Brittany N
authors.initials: BN
authors.lastname: Dugger
authors.forename: Megan
authors.initials: M
authors.lastname: Saxon-LaBelle
authors.forename: Jessica
authors.initials: J
authors.lastname: Filon
authors.forename: Alex
authors.initials: A
authors.lastname: Scroggins
authors.forename: Joel
authors.initials: J
authors.lastname: Pullen
authors.forename: Brandon E
authors.initials: BE
authors.lastname: Fornwalt
authors.forename: Sarah
authors.initials: S
authors.lastname: Scott
authors.forename: Marwan N
authors.initials: MN
authors.lastname: Sabbagh
authors.forename: Charles H
authors.initials: CH
authors.lastname: Adler
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Beach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D008297:Male; D019636:Neurodegenerative Diseases / Q000175:diagnosis*