The major purpose of the Neuropathology Core (NP Core) is to perform diagnostic neuropathologic evaluations on brains of participants in the Einstein Aging Study (EAS) and to support research for the Projects. The NP Core integrates its activities with the Montefiore Pathology Departmental on-call service for harvesting brains in a timely fashion of subjects enrolled in the EAS. The NP Core uses standardized dissection and processing procedures and collects neuropathologic data from all brains. Diagnostic reports are communicated with key personnel of the EAS as soon as they are completed by electronic communication. Clinicopathologic correlation analyses are discussed in person at annual meetings.
The Specific Aims of the NP Core are as follows:
Aim 1. Perform brain autopsies and prepare tissue for transport from Montefiore Hospital to Mayo Clinic.
Aim 2. Diagnostic neuropathology using a standardized and systematic approach that has been used over the life of the EAS, permitting use of the entire autopsy cohort for clinicopathologic correlative studies and for use in research studies.
Aim 3. Data entry from neuropathology report. A written report is generate in text form for easy communication with clinicians and family members, but a digital form is created for long-term storage and linkage to NP Core databases - one specific to the Einstein Aging Study and the other a part of the Mayo Clinic brain bank for neurodegenerative disorders, which is linked to tissue inventory, ancillary data (e.g., genetic data), as well as quantitative pathology and demographics, which permits pooling of Einstein Aging Study cases into larger clinicopathologic studies. Neuropathologic data are transferred to Biostatistics and Data Management Core.
Aim 4. Conduct exploratory studies in support of Projects. As pain and stress measures are associated with reduced hippocampal volume (Project 1), we assess a range of cellular pathologies in the hippocampus with respect to subsectors of Ammon's horn. Cardiac autonomic abnormalities leading to heart rate variability are linked to risk for cognitive impairment and correlate with white matter hyperintensities (Project 2). The NP Core assesses of cerebrovascular pathology and measures of microvascular and white matter pathology to explore possible pathologic relationships to cardiovascular and autonomic measures.
Aim 5. Sharing of tissue. The Neuropathology Core banks fixed and frozen brain tissue, as well as paraffin blocks on all cases. DNA and RNA are extracted from tissue, and they are also banked. Fixed and frozen tissue, as well as DNA, slides and paraffin blocks are available for sharing with qualified investigators with approval of the Administrative Core.
A definite diagnosis of neurodegenerative disorders, such as Alzheimer's disease, is only possible at autopsy, which also permits collection of brain tissue that can be used for research. The NP Core collects brain tissue on participants in the Einstein Aging Study for both diagnosis and to promote research on neurodegenerative disorders of the elderly.
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