Home › Research › Brain tissue and pathology
Neuropathological stageing of Alzheimer-related changes
Heiko Braak, Eva Braak. Acta Neuropathologica, 1991-09-01
Topic: Amyloid, tau and blood-test diagnosis
Researchers examined brains obtained at autopsy from nondemented and demented individuals to study extracellular amyloid deposits and intraneuronal neurofibrillary changes. They found that while amyloid deposits were of limited significance for staging, neurofibrillary tangles and neuropil threads exhibited a characteristic distribution pattern. This pattern permitted the differentiation of six neuropathological stages.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Braak, H., & Braak, E. (1991). Neuropathological stageing of Alzheimer-related changes. Acta Neuropathologica. https://doi.org/10.1007/bf00308809
Vancouver
Braak H, Braak E. Neuropathological stageing of Alzheimer-related changes. Acta Neuropathologica. 1991. doi:10.1007/bf00308809. PMID: 1759558.
BibTeX
@article{braak1991-1759558,
author = {Braak, Heiko and Braak, Eva},
title = {{Neuropathological stageing of Alzheimer-related changes}},
journal = {Acta Neuropathologica},
year = {1991},
doi = {10.1007/bf00308809},
pmid = {1759558},
url = {https://doi.org/10.1007/bf00308809}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- The distribution pattern and packing density of amyloid deposits turned out to be of limited significance for differentiation of neuropathological stages.
- Neurofibrillary tangles and neuropil threads, in contrast, exhibited a characteristic distribution pattern permitting the differentiation of six stages.
- The hallmark of the two isocortical stages (stages V-VI) was the destruction of virtually all isocortical association areas.
Why it matters
Using brains examined after death, this study found that the spread of tangle-type changes inside nerve cells ("neurofibrillary tangles and neuropil threads") follows a set pattern that can be divided into six stages, while the spread and density of amyloid deposits were "of limited significance" for staging. In the last two stages (V-VI), virtually all of the brain's outer association areas were destroyed. It is a way to grade how far the changes have gone in brain tissue, not a test or a treatment.
Study details
- Evidence strengthLow
How this study scored 58/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 56 of the 97 points we could judge it on, which is 58 out of 100.
| 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 | 1991 — older than 20 years, still counted |
| 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 16,174 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 437.1 citations a year over 37 year(s) since 1991 |
| Impact for its field and year | 5 / 6 | Cited 33.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 6 / 6 | Cited by 821 other studies in this library |
| Still being cited | 4 / 4 | Cited 2,471 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Eva Braak: h-index 67 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 1759558) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 56 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 56 of the 97 points we could judge it on is 58 out of 100. |
| Total | 58 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
821 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Brain tissue and pathology
Also in Brain tissue and pathology
124 studies in the library are filed under Brain tissue and pathology with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Brain tissue and pathology hub.