Acta Neuropathologica: Assessing the Consensus Standard for Neuropathology in Post-Death Brain Louis Pathology: A Multi-Center Study

Louis body disease (LBD) includes Parkinson's disease (PD), mild cognitive impairment Parkinson's disease (PD-MCI), dementia Parkinson's disease (PDD) and Louisian dementia (DLB), all of which have characteristic clinical manifestations and associated clinical diagnostic criteria.
neuropathology characteristics of these clinical symptoms are Lewy Pathology (LP), which includes the α-synth nuclear protein aggregation process in nerve cells and nerve cells: Louis (LB) and Lewy neurotaste (LN).
, however, LPs can also be seen in individuals who lack obvious clinical symptoms.
the term "occasional LBD" was originally created for LPs that lack Parkinson's disease or cognitive symptoms but are limited to the brain, but more recently it has been extended to include LP with amygdala as the primary and olfactory only.
currently, neuropathological diagnosis of Louis Body Disease (LBD) can be performed under several sting systems, including Braak-Lewy, McKeith and his colleagues' Consensus Standards (McKeith), Leverenz and colleagues' improved McKeith system, and Beach and his colleagues (Beach' unified sting system).
all these systems use a semi-quantitative score (4 or 5 scale) of Louis Pathology (LP, i.e. Louis and Louis nerve protrusions) in the identified subsurgery and subsurgery regions.
these systems are widely used, some systems are less reliable and/or cannot be clearly classified by LPs.
To address these limitations, we designed a new system, the LP Consistency Standard (LPC), which is based on the McKeith system, but is suitable for the LP scoring of the two-way method and includes the amygdala-based and olfactory phase only.
study was conducted by 16 raters who scanned and evaluated α-synaptic nucleoprotein staining slices in 34 LP patients based on Braak, McKeith, Leverenz, Beach, and LPC systems.
McKeith, Leverenz and LPC systems were able to perform well (Krippendorff's α≈0.6), while Braak and Beach's scorers had lower confidence (Krippendorff's α≈0.4).
the LPC system, most raters were able to categorize all cases explicitly, up from 97.1% when using the Beach system.
, however, when using the Leverenz (11.8%), McKeith (26.5%) or Braak (29.4%) systems, a significant number of cases cannot be classified.
, the LPC system has good repeatability and allows all cases to be classified into different categories, promising to be the standard method for future LP basic autopsy assessments.
Attems, J., Toledo, J.B., Walker, L. et al. Neuropathological consensus criteria for the evaluation of Lewy pathology in post-mortem brains: a multi-centre study. Acta Neuropathol (2021). MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Original" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
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