Primary age-related tauopathy (PART): a common pathology associated with human
aging 
   Lead Investigator:    Pete Nelson
   Institution      :    U Kentucky
   E-Mail           :    pnels2@uky.edu
   Proposal ID      :    467


   Publications:


1  Crary JF, Trojanowski JQ, Schneider JA, Abisambra JF, Erin L. Abner P, Alafuzoff I, Arnold SE, Attems J, Beach TG, Bigio EH, Cairns NJ, Dickson DW, Gearing M, Grinberg LT, Hof PR, Hyman BT, Jicha GA, Jellinger K, Kovacs GG, Knopman DS, Kofler J,  Kukull WA , Mackenzie IR, Masliah E, McKee AC, Montine TJ, Murray ME, Neltner JH, Santa-Maria I, Seeley WW, Serrano-Pozo A, Shelanski ML, Stein TD, Takao M, Thal DR, Toledo JB, Troncoso JC, Vonsattel JP, 3rd CLW, Wisniewski T, Woltjer RL, Yamada M, Nelson PT
   Primary age-related tauopathy (PART): a common pathology associated with human aging
   Journal Article  Acta Neuropathol,128:755-766,2014,PMC4257842

   PUBLISHED





   Proposal Description:
   We recommend a new term, "primary age-related tauopathy" (PART), to describe a pathology that is commonly observed in the brains of aged individuals. Many autopsy studies have reported brains with neurofibrillary tangles (NFT) that are indistinguishable from those of Alzheimer's disease (AD), in the absence of amyloid (A??) plaques. For these "NFT+/A??-" brains, for which formal criteria for AD neuropathologic changes are not met, the NFT are mostly restricted to structures in the medial temporal lobe, basal forebrain, brainstem, and olfactory areas (bulb and cortex). Symptoms in persons with PART usually range from normal to amnestic cognitive changes, with only a minority exhibiting profound impairment. Because cognitive impairment is often mild, existing clinicopathologic designations, such as "tangle-only dementia" and "tangle-predominant senile dementia", are imprecise and not appropriate for most subjects. PART is almost universally detectable at autopsy among elderly individuals, yet this pathological process cannot be specifically identified pre-mortem at the present time. Improved biomarkers and tau imaging may enable diagnosis of PART in clinical settings in the future. Indeed, recent studies have identified a common biomarker profile consisting of temporal lobe atrophy and  tauopathy without evidence of A?? accumulation. For both researchers and clinicians, a revised nomenclature will raise awareness of this extremely common pathologic change while providing a conceptual foundation for future studies. Prior reports that have elucidated features of the pathologic entity we refer to as PART are discussed, and working neuropathological diagnostic criteria are proposed.