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Comment & Response
April 2016

Understanding Conflicting Neuropathological Findings

Author Affiliations
  • 1Institute of Clinical Neurobiology, Vienna, Austria
JAMA Neurol. 2016;73(4):479-480. doi:10.1001/jamaneurol.2015.4879

To the Editor In their editorial, Salloway and Sperling,1 when commenting on the article by Monsell et al,2 use the term neuritic amyloid plaques, which, according to the current definitions of senile plaques, is incorrect and confusing. It is well documented that senile plaques have different appearances (see the article by Mirra et al3). Amyloid plaques (diffuse, primitive, and classic) differ from “neuritic plaques.” The latter, according to the National Alzheimer’s Coordinating Center’s Neuropathologic Data Set coding guidebook,4 are defined as plaques with argyrophilic, thioflavin S-positive, or tau-positive dystrophic neurites with or without dense β-amyloid cores. A 4-level rating was dichotomized into none or sparse (minimal plaques) vs moderate or frequent. Diffuse β-amyloid plaque frequency also was graded using the Consortium to Establish a Registry for Alzheimer’s Disease plaque template.2