Feasibility Study: Comparison of Frontal Cortex Needle Core Versus Open Biopsy for Detection of Characteristic Proteinopathies of Neurodegenerative Diseases

Geidy E. Serrano, Anthony Intorcia, Jeremiah Carew, Glenn Chiarolanza, Jose A. Hidalgo, Lucia I. Sue, Brittany N. Dugger, Megan Saxon-Labelle, Jessica Filon, Alex Scroggins, Joel Pullen, Brandon E. Fornwalt, Sarah Scott, Marwan N. Sabbagh, Charles Howard Adler, Haruhiko Akiyama, Thomas G. Beach

Research output: Contribution to journalArticle

4 Scopus citations

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<sup>3</sup> 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.

Original languageEnglish (US)
Pages (from-to)934-942
Number of pages9
JournalJournal of Neuropathology and Experimental Neurology
Volume74
Issue number9
DOIs
StatePublished - Sep 29 2015

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Keywords

  • Alzheimer disease
  • Amyloid plaque
  • Brain biopsy
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Neuritic plaque
  • Neurofibrillary tangle
  • TDP-43

ASJC Scopus subject areas

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

Cite this

Serrano, G. E., Intorcia, A., Carew, J., Chiarolanza, G., Hidalgo, J. A., Sue, L. I., Dugger, B. N., Saxon-Labelle, M., Filon, J., Scroggins, A., Pullen, J., Fornwalt, B. E., Scott, S., Sabbagh, M. N., Adler, C. H., Akiyama, H., & Beach, T. G. (2015). Feasibility Study: Comparison of Frontal Cortex Needle Core Versus Open Biopsy for Detection of Characteristic Proteinopathies of Neurodegenerative Diseases. Journal of Neuropathology and Experimental Neurology, 74(9), 934-942. https://doi.org/10.1097/NEN.0000000000000235