Invited review: Neuropathology of tauopathies: principles and practice

Tauopathies are clinically, morphologically and biochemically heterogeneous neurodegenerative diseases characterized by the deposition of abnormal tau protein in the brain. The neuropathological phenotypes are distinguished based on the involvement of different anatomical areas, cell types and presence of distinct isoforms of tau in the pathological deposits. The nomenclature of primary tauopathies overlaps with the modern classification of frontotemporal lobar degeneration. Neuropathological phenotypes comprise Pick's disease, progressive supranuclear palsy, corticobasal degeneration, argyrophilic grain disease, primary age‐related tauopathy, formerly called also as neurofibrillary tangle‐only dementia, and a recently characterized entity called globular glial tauopathy. Mutations in the gene encoding the microtubule‐associated protein tau are associated with frontotemporal dementia and parkinsonism linked to chromosome 17. In addition, further neurodegenerative conditions with diverse aetiologies may be associated with tau pathologies. Thus, the spectrum of tau pathologies and tauopathy entities expands beyond the traditionally discussed disease forms. Detailed multidisciplinary studies are still required to understand their significance.

[1]  A. Lees,et al.  Concomitant progressive supranuclear palsy and multiple system atrophy: More than a simple twist of fate? , 2009, Neuroscience Letters.

[2]  J. Hardy,et al.  Pantothenate kinase-associated neurodegeneration is not a synucleinopathy , 2012, Neuropathology and applied neurobiology.

[3]  D. Dickson,et al.  Neuropathology of variants of progressive supranuclear palsy. , 2010, Current opinion in neurology.

[4]  J. Hardy,et al.  Widespread Lewy body and tau accumulation in childhood and adult onset dystonia-parkinsonism cases with PLA2G6 mutations , 2012, Neurobiology of Aging.

[5]  J. Trojanowski,et al.  Sporadic Pick's disease: A tauopathy characterized by a spectrum of pathological τ isoforms in gray and white matter , 2002, Annals of neurology.

[6]  P. Hof,et al.  Pathological τ proteins in postencephalitic parkinsonism: Comparison with Alzheimer's disease and other neurodegenerative disorders , 1997 .

[7]  David R Williams,et al.  Progressive supranuclear palsy: clinicopathological concepts and diagnostic challenges , 2009, The Lancet Neurology.

[8]  K. Jellinger,et al.  Accumulation of abnormally phosphorylated τ precedes the formation of neurofibrillary tangles in Alzheimer's disease , 1989, Brain Research.

[9]  D. Munoz,et al.  Qualitative and Quantitative Differences in Senile Plaque Dystrophie Neurites of Alzheimer's Disease and Normal Aged Brain , 1995, Journal of neuropathology and experimental neurology.

[10]  G. Lace,et al.  Mesial Temporal Astrocyte Tau Pathology in the MRC-CFAS Ageing Brain Cohort , 2012, Dementia and Geriatric Cognitive Disorders.

[11]  H. Akiyama,et al.  Numerous glial fibrillary tangles in oligodendroglia in cases of subacute sclerosing panencephalitis with neurofibrillary tangles , 1995, Neuroscience Letters.

[12]  J. Schneider,et al.  Neuropathologic diagnostic and nosologic criteria for frontotemporal lobar degeneration: consensus of the Consortium for Frontotemporal Lobar Degeneration , 2007, Acta Neuropathologica.

[13]  T. Hortobágyi,et al.  Neuropathology of the hippocampus in FTLD‐Tau with Pick bodies: a study of the BrainNet Europe Consortium , 2013, Neuropathology and applied neurobiology.

[14]  A. McKee,et al.  Chronic traumatic encephalopathy: a spectrum of neuropathological changes following repetitive brain trauma in athletes and military personnel , 2014, Alzheimer's Research & Therapy.

[15]  S. Lovestone,et al.  The extended haplotype of the microtubule associated protein tau gene is not associated with Pick's disease , 2001, Neuroscience Letters.

[16]  Fumiaki Tanaka,et al.  Tuft-shaped astrocytes in Lewy body disease , 2005, Acta Neuropathologica.

[17]  K. Jellinger Absence of α-synuclein pathology in postencephalitic parkinsonism , 2009, Acta Neuropathologica.

[18]  Isidro Ferrer,et al.  Globular glial tauopathies (GGT): consensus recommendations , 2013, Acta Neuropathologica.

[19]  I. Alafuzoff,et al.  The Effect of Prolonged Fixation Time on Immunohistochemical Staining of Common Neurodegenerative Disease Markers , 2010, Journal of neuropathology and experimental neurology.

[20]  Isidre Ferrer,et al.  Delineation of Early Changes in Cases with Progressive Supranuclear Palsy‐Like Pathology. Astrocytes in Striatum are Primary Targets of Tau Phosphorylation and GFAP Oxidation , 2009, Brain pathology.

[21]  D. Dickson,et al.  Lewy Bodies in Progressive Supranuclear Palsy Represent an Independent Disease Process , 2006, Journal of neuropathology and experimental neurology.

[22]  A. McKee,et al.  Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury , 2009, Journal of neuropathology and experimental neurology.

[23]  Jennifer L. Whitwell,et al.  Corticobasal degeneration: a pathologically distinct 4R tauopathy , 2011, Nature Reviews Neurology.

[24]  Martin Beibel,et al.  Transmission and spreading of tauopathy in transgenic mouse brain , 2009, Nature Cell Biology.

[25]  D. Dickson Pick's Disease: A Modern Approach , 1998, Brain pathology.

[26]  B. Ghetti,et al.  Hereditary prion protein amyloidoses. , 2003, Clinics in laboratory medicine.

[27]  A. McKee,et al.  The spectrum of disease in chronic traumatic encephalopathy. , 2013, Brain : a journal of neurology.

[28]  J. Shiota,et al.  Argyrophilic grain disease presenting with frontotemporal dementia: A neuropsychological and pathological study of an autopsied case with presenile onset , 2005, Neuropathology : official journal of the Japanese Society of Neuropathology.

[29]  D. Dickson Neuropathologic differentiation of progressive supranuclear palsy and corticobasal degeneration , 1999, Journal of Neurology.

[30]  Michel Goedert,et al.  Tau pathology and neurodegeneration , 2013, The Lancet Neurology.

[31]  K. Wakabayashi,et al.  Hippocampal sclerosis with four-repeat tau-positive round inclusions in the dentate gyrus: a new type of four-repeat tauopathy , 2009, Acta Neuropathologica.

[32]  Y. Hirayasu,et al.  Tau accumulation in the nucleus accumbens in tangle-predominant dementia , 2014, Acta neuropathologica communications.

[33]  John Q Trojanowski,et al.  Lewy bodies in the amygdala: increase of alpha-synuclein aggregates in neurodegenerative diseases with tau-based inclusions. , 2004, Archives of neurology.

[34]  Udo Rüb,et al.  High prevalence of thorn-shaped astrocytes in the aged human medial temporal lobe , 2004, Neurobiology of Aging.

[35]  J. Trojanowski,et al.  Tau isoform profile and phosphorylation state in dementia pugilistica recapitulate Alzheimer's disease , 2001, Acta Neuropathologica.

[36]  Dennis W Dickson,et al.  Progressive Supranuclear Palsy: Pathology and Genetics , 2007, Brain pathology.

[37]  K. Ikeda,et al.  Argyrophilic grain disease mimicking temporal Pick's disease: a clinical, radiological, and pathological study of an autopsy case with a clinical course of 15 years , 2001, Acta Neuropathologica.

[38]  M. Murray,et al.  Corticobasal degeneration with olivopontocerebellar atrophy and TDP-43 pathology: an unusual clinicopathologic variant of CBD , 2013, Acta Neuropathologica.

[39]  D. Dickson,et al.  Co-localization of tau and α-synuclein in the olfactory bulb in Alzheimer’s disease with amygdala Lewy bodies , 2008, Acta Neuropathologica.

[40]  Peter Davies,et al.  Identification of normal and pathological aging in prospectively studied nondemented elderly humans , 1992, Neurobiology of Aging.

[41]  R. A. Crowther,et al.  Multiple isoforms of human microtubule-associated protein tau: sequences and localization in neurofibrillary tangles of Alzheimer's disease , 1989, Neuron.

[42]  H. Braak,et al.  Argyrophilic grains: characteristic pathology of cerebral cortex in cases of adult onset dementia without Alzheimer changes , 1987, Neuroscience Letters.

[43]  H. Braak,et al.  A sequence of cytoskeleton changes related to the formation of neurofibrillary tangles and neuropil threads , 2004, Acta Neuropathologica.

[44]  D. Dickson,et al.  Ubiquitin immunoreactive structures in normal human brains. Distribution and developmental aspects. , 1990, Laboratory investigation; a journal of technical methods and pathology.

[45]  Douglas Walker,et al.  Hippocampal Sclerosis Dementia with Tauopathy , 2003, Brain pathology.

[46]  Thomas G Beach,et al.  Neuropathological findings of PSP in the elderly without clinical PSP: possible incidental PSP? , 2011, Parkinsonism & related disorders.

[47]  J. Miklossy,et al.  Enduring involvement of tau, β-amyloid, α-synuclein, ubiquitin and TDP-43 pathology in the amyotrophic lateral sclerosis/parkinsonism–dementia complex of Guam (ALS/PDC) , 2008, Acta Neuropathologica.

[48]  Kevin F. Bieniek,et al.  Tau pathology in frontotemporal lobar degeneration with C9ORF72 hexanucleotide repeat expansion , 2013, Acta Neuropathologica.

[49]  T. Ohm,et al.  Cholesterol storage and tau pathology in Niemann–Pick type C disease in the brain , 2003, The Journal of pathology.

[50]  J. Trojanowski,et al.  Neurodegenerative tauopathies. , 2001, Annual review of neuroscience.

[51]  A. Lees,et al.  Pure akinesia with gait freezing: A third clinical phenotype of progressive supranuclear palsy , 2007, Movement disorders : official journal of the Movement Disorder Society.

[52]  I. Grundke‐Iqbal,et al.  Mechanisms of tau-induced neurodegeneration , 2009, Acta Neuropathologica.

[53]  D. Dickson,et al.  The Pathogenesis of Senile Plaques , 1997, Journal of neuropathology and experimental neurology.

[54]  H. Budka,et al.  Genetic Creutzfeldt-Jakob disease associated with the E200K mutation: characterization of a complex proteinopathy , 2010, Acta Neuropathologica.

[55]  D. Dickson,et al.  Argyrophilic Grain Disease Is a Sporadic 4‐Repeat Tauopathy , 2002, Journal of neuropathology and experimental neurology.

[56]  H. Budka,et al.  Current concepts of neuropathological diagnostics in practice: neurodegenerative diseases. , 2010, Clinical neuropathology.

[57]  Brian J Cummings,et al.  Plaque biogenesis in brain aging and Alzheimer’s disease. II. Progressive transformation and developmental sequence of dystrophic neurites , 1998, Acta Neuropathologica.

[58]  S. Murayama,et al.  Staging of Argyrophilic Grains: An Age‐Associated Tauopathy , 2004, Journal of neuropathology and experimental neurology.

[59]  A. Delacourte,et al.  Tau protein as a differential biomarker of tauopathies. , 2005, Biochimica et biophysica acta.

[60]  H. Yamaguchi,et al.  Glial fibrillary tangles in diffuse neurofibrillary tangles with calcification , 2003, Acta Neuropathologica.

[61]  Wen-Lang Lin,et al.  Frequency and Relation of Argyrophilic Grain Disease and Thorn-Shaped Astrocytes in Alzheimer’s Disease , 2008 .

[62]  E. Kuusisto,et al.  Use of p62/SQSTM1 antibodies for neuropathological diagnosis , 2008, Neuropathology and applied neurobiology.

[63]  E. Gelpí,et al.  Pick's pathology in Parkinson's disease with dementia , 2012, Neuropathology and applied neurobiology.

[64]  J. Trojanowski,et al.  Acetylated tau, a novel pathological signature in Alzheimer's disease and other tauopathies. , 2012, Brain : a journal of neurology.

[65]  M. Tolnay,et al.  Argyrophilic grain disease: A late‐onset dementia with distinctive features among tauopathies , 2004, Neuropathology : official journal of the Japanese Society of Neuropathology.

[66]  J. Hardy,et al.  α-Synucleinopathy associated with G51D SNCA mutation: a link between Parkinson’s disease and multiple system atrophy? , 2013, Acta Neuropathologica.

[67]  Gabor G. Kovacs,et al.  Patterns of Hippocampal Tau Pathology Differentiate Neurodegenerative Dementias , 2014, Dementia and Geriatric Cognitive Disorders.

[68]  T. Uchihara,et al.  Specific Detection of Pathological Three‐repeat Tau after Pretreatment with Potassium Permanganate and Oxalic Acid in PSP/CBD Brains , 2011, Brain pathology.

[69]  B. Ghetti,et al.  White Matter Tauopathy With Globular Glial Inclusions: A Distinct Sporadic Frontotemporal Lobar Degeneration , 2008, Journal of neuropathology and experimental neurology.

[70]  Miklós Palkovits,et al.  A peculiar constellation of tau pathology defines a subset of dementia in the elderly , 2011, Acta Neuropathologica.

[71]  Andrew Kertesz,et al.  Argyrophilic thorny astrocyte clusters in association with Alzheimer’s disease pathology in possible primary progressive aphasia , 2007, Acta Neuropathologica.

[72]  J. Newcombe,et al.  Globular glial tauopathies (GGT) presenting with motor neuron disease or frontotemporal dementia: an emerging group of 4-repeat tauopathies , 2011, Acta Neuropathologica.

[73]  H. Iwata,et al.  Non-Alzheimer non-Pick dementia with Fahr's syndrome. , 1992, Clinical neuropathology.

[74]  H. Budka,et al.  Protein coding of neurodegenerative dementias: the neuropathological basis of biomarker diagnostics , 2010, Acta Neuropathologica.

[75]  H. Akiyama,et al.  Identification of amino‐terminally cleaved tau fragments that distinguish progressive supranuclear palsy from corticobasal degeneration , 2004, Annals of neurology.

[76]  J. Trojanowski,et al.  Concurrence of α-synuclein and tau brain pathology in the Contursi kindred , 2002, Acta Neuropathologica.

[77]  B. Ghetti,et al.  Brain homogenates from human tauopathies induce tau inclusions in mouse brain , 2013, Proceedings of the National Academy of Sciences.

[78]  S. Lovestone,et al.  The Importance of Tau Phosphorylation for Neurodegenerative Diseases , 2013, Front. Neurol..

[79]  Shinji Ohara,et al.  Corticobasal degeneration with focal, massive tau accumulation in the subcortical white matter astrocytes , 2006, Acta Neuropathologica.

[80]  Ranjan Duara,et al.  Neuropathologically defined subtypes of Alzheimer’s disease differ significantly from neurofibrillary tangle-predominant dementia , 2012, Acta Neuropathologica.

[81]  I. Ferrer,et al.  Interlaboratory Comparison of Assessments of Alzheimer Disease-Related Lesions: A Study of the BrainNet Europe Consortium , 2006, Journal of neuropathology and experimental neurology.

[82]  D. Neary,et al.  Pathological correlates of frontotemporal lobar degeneration in the elderly , 2011, Acta Neuropathologica.

[83]  V. Lee,et al.  Cell-to-cell transmission of pathogenic proteins in neurodegenerative diseases , 2014, Nature Medicine.

[84]  F. García-Sierra,et al.  Earliest stages of tau conformational changes are related to the appearance of a sequence of specific phospho-dependent tau epitopes in Alzheimer's disease. , 2007, Journal of Alzheimer's disease : JAD.

[85]  R. Petersen,et al.  Neuropathologically defined subtypes of Alzheimer's disease with distinct clinical characteristics: a retrospective study , 2011, The Lancet Neurology.

[86]  A. Lladó,et al.  Globular glial-like inclusions in a patient with advanced Alzheimer’s disease , 2013, Acta Neuropathologica.

[87]  J. Holton,et al.  Pathological inclusion bodies in tauopathies contain distinct complements of tau with three or four microtubule‐binding repeat domains as demonstrated by new specific monoclonal antibodies , 2003, Neuropathology and applied neurobiology.

[88]  P. Lantos,et al.  Office of Rare Diseases Neuropathologic Criteria for Corticobasal Degeneration , 2002, Journal of neuropathology and experimental neurology.

[89]  K. Kosaka Diffuse neurofibrillary tangles with calcification: a new presenile dementia. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[90]  Thomas Meitinger,et al.  Mutations in LRRK2 Cause Autosomal-Dominant Parkinsonism with Pleomorphic Pathology , 2004, Neuron.

[91]  Marc Cruts,et al.  Locus-Specific Mutation Databases for Neurodegenerative Brain Diseases , 2012, Human mutation.

[92]  C. van Broeckhoven,et al.  TARDBP mutation p.Ile383Val associated with semantic dementia and complex proteinopathy , 2014, Neuropathology and applied neurobiology.

[93]  Janna H. Neltner,et al.  Primary age-related tauopathy (PART): a common pathology associated with human aging , 2014, Acta Neuropathologica.

[94]  M. Kirschner,et al.  A protein factor essential for microtubule assembly. , 1975, Proceedings of the National Academy of Sciences of the United States of America.

[95]  J. Hardy,et al.  Concomitant progressive supranuclear palsy and chronic traumatic encephalopathy in a boxer , 2014, Acta neuropathologica communications.

[96]  A. Probst,et al.  Astrocytes expressing hyperphosphorylated tau protein without glial fibrillary tangles in argyrophilic grain disease , 1999, Acta Neuropathologica.

[97]  A. Probst,et al.  Argyrophilic grain disease. , 2008, Handbook of clinical neurology.

[98]  A. Lees,et al.  Pathological tau burden and distribution distinguishes progressive supranuclear palsy-parkinsonism from Richardson's syndrome. , 2007, Brain : a journal of neurology.

[99]  A. Kakita,et al.  Sporadic four-repeat tauopathy with frontotemporal lobar degeneration, Parkinsonism, and motor neuron disease: a distinct clinicopathological and biochemical disease entity , 2010, Acta Neuropathologica.

[100]  Toshiki Uchihara,et al.  Silver diagnosis in neuropathology: principles, practice and revised interpretation , 2007, Acta Neuropathologica.

[101]  Wen-Lang Lin,et al.  Atypical Progressive Supranuclear Palsy With Corticospinal Tract Degeneration , 2006, Journal of neuropathology and experimental neurology.

[102]  Gloria Lee,et al.  Tau and tauopathies. , 2012, Progress in molecular biology and translational science.

[103]  Isidre Ferrer,et al.  Glial and neuronal tau pathology in tauopathies: characterization of disease-specific phenotypes and tau pathology progression. , 2014, Journal of neuropathology and experimental neurology.

[104]  E. Huang,et al.  Argyrophilic grain disease differs from other tauopathies by lacking tau acetylation , 2013, Acta Neuropathologica.

[105]  K. Arima Ultrastructural characteristics of tau filaments in tauopathies: Immuno‐electron microscopic demonstration of tau filaments in tauopathies , 2006, Neuropathology : official journal of the Japanese Society of Neuropathology.

[106]  Kenji Ikeda,et al.  Glial fibrillary tangles and argyrophilic threads: Classification and disease specificity , 1996 .

[107]  D. Dickson,et al.  Selective Neurofibrillary Degeneration of the Hippocampal CA2 Sector Is Associated with Four‐Repeat Tauopathies , 2002, Journal of neuropathology and experimental neurology.

[108]  H. Akiyama,et al.  Clinicopathological study of diffuse neurofibrillary tangles with calcification With special reference to TDP-43 proteinopathy and alpha-synucleinopathy , 2011, Journal of the Neurological Sciences.

[109]  A. Klug,et al.  Structural characterization of the core of the paired helical filament of Alzheimer disease. , 1988, Proceedings of the National Academy of Sciences of the United States of America.

[110]  C. Shaw,et al.  Mixed tau, TDP-43 and p62 pathology in FTLD associated with a C9ORF72 repeat expansion and p.Ala239Thr MAPT (tau) variant , 2013, Acta Neuropathologica.

[111]  J. Trojanowski,et al.  Concurrence of alpha-synuclein and tau brain pathology in the Contursi kindred. , 2002, Acta neuropathologica.

[112]  Thomas G Beach,et al.  Clinicopathological outcomes of prospectively followed normal elderly brain bank volunteers. , 2014, Journal of neuropathology and experimental neurology.

[113]  Christine Haberler,et al.  Non-Alzheimer neurodegenerative pathologies and their combinations are more frequent than commonly believed in the elderly brain: a community-based autopsy series , 2013, Acta Neuropathologica.

[114]  L. Martinian,et al.  Regional distribution of amyloid-Bri deposition and its association with neurofibrillary degeneration in familial British dementia. , 2001, The American journal of pathology.

[115]  J. Trojanowski,et al.  Concomitant TAR-DNA-Binding Protein 43 Pathology Is Present in Alzheimer Disease and Corticobasal Degeneration but Not in Other Tauopathies , 2008, Journal of neuropathology and experimental neurology.

[116]  K. Jellinger,et al.  Neurofibrillary tangle-predominant dementia: comparison with classical Alzheimer disease , 2007, Acta Neuropathologica.

[117]  H. Budka,et al.  The Spectrum of Tau Pathology in Human Prion Disease , 2013 .

[118]  Clifford R. Jack,et al.  Argyrophilic grains: A distinct disease or an additive pathology? , 2008, Neurobiology of Aging.

[119]  Y. Hirayasu,et al.  Accumulation of phosphorylated TDP-43 in brains of patients with argyrophilic grain disease , 2009, Acta Neuropathologica.

[120]  J. Hodges,et al.  Clinical phenotypes in autopsy-confirmed Pick disease , 2011, Neurology.

[121]  K. Dewar,et al.  The MAPT H1 haplotype is associated with tangle-predominant dementia , 2012, Acta Neuropathologica.