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National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach
Montine TJ, Phelps CH, Beach TG, Bigio EH, Cairns NJ, Dickson DW, Duyckaerts C, Frosch MP et al.. Acta neuropathologica, 2011-11-20
Topic: Amyloid, tau and blood-test diagnosis
We present a practical guide for the implementation of recently revised National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease (AD). Major revisions from previous consensus criteria are: (1) recognition that AD neuropathologic changes may occur in the apparent absence of cognitive impairment, (2) an "ABC" score for AD neuropathologic change that incorporates histopathologic assessments of amyloid β deposits (A), staging of neurofibrillary tangles (B), and scoring of neuritic plaques (C), and (3) more detailed approaches for assessing commonly co-morbid conditions such as Lewy body disease, vascular brain injury, hippocampal sclerosis, and TAR DNA binding protein (TDP)-43 immunoreactive inclusions. Recommendations also are made for the minimum sampling of brain, preferred staining methods with acceptable alternatives, reporting of results, and clinico-pathologic correlations.
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APA 7th
Montine, T. J., Phelps, C. H., Beach, T. G., Bigio, E. H., Cairns, N. J., Dickson, D. W., et al. (2012). National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach. Acta neuropathologica. https://doi.org/10.1007/s00401-011-0910-3
Vancouver
Montine TJ, Phelps CH, Beach TG, Bigio EH, Cairns NJ, Dickson DW, et al. National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach. Acta neuropathologica. 2012. doi:10.1007/s00401-011-0910-3. PMID: 22101365.
BibTeX
@article{montine2012-22101365,
author = {Montine, T. J. and Phelps, C. H. and Beach, T. G. and Bigio, E. H. and Cairns, N. J. and Dickson, D. W. and Duyckaerts, C. and Frosch, M. P. and others},
title = {{National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease: a practical approach}},
journal = {Acta neuropathologica},
year = {2012},
doi = {10.1007/s00401-011-0910-3},
pmid = {22101365},
url = {https://doi.org/10.1007/s00401-011-0910-3}
}
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Key findings
- Recommendations also are made for the minimum sampling of brain, preferred staining methods with acceptable alternatives, reporting of results, and clinico-pathologic correlations.
Why it matters
These guidelines give a practical way to assess Alzheimer's brain changes in examined brain tissue, using an "ABC" score that combines amyloid β deposits (A), the stage of neurofibrillary tangles (B) and neuritic plaques (C), along with recommendations on brain sampling, staining and reporting. They also recognise that Alzheimer's brain changes "may occur in the apparent absence of cognitive impairment", and they set out more detailed ways to record common co-existing conditions such as Lewy body disease, vascular brain injury, hippocampal sclerosis and TDP-43 inclusions. This is a standard for examining brain tissue, not a test for living patients or a treatment.
Study details
- Evidence strengthLow
How this study scored 64/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Acta neuropathologica) |
| Journal's citation record | 3 / 4 | Acta Neuropathologica: journal h-index 287 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 2,848 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 178.0 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 6 / 6 | Cited 41.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 6 / 6 | Cited by 202 other studies in this library |
| Still being cited | 4 / 4 | Cited 801 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Bradley T. Hyman: h-index 190 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multicenter collaboration | 3 / 3 | OpenAlex lists 18 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22101365) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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