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date: 24 February 2021

Abstract and Keywords

Neuropathological examination is a key component in determining accurate diagnoses in both the postmortem and surgical settings. Postmortem analyses are necessary for clinicopathological correlation and for determination of frequent comorbid and subclinical pathologies, and neurosurgical specimens are increasingly important for molecular analysis and diagnosis of tumors, which inform treatment choices and prognosis. Neurodegenerative pathologies involve multiple and distinct brain regions, are age-dependent, and frequently co-occur. Well-developed staging systems have been developed for tau, β-amyloid, and Lewy pathologies and are used to establish threshold criteria for pathological diagnoses. The precise role of a given pathology on cognitive impairment will vary depending on pathological stage, comorbid pathology, and other factors such as cognitive reserve. A complete neuropathological workup for neurodegenerative disease requires the examination of multiple well-preserved regions with histochemical and immunohistochemical techniques optimized for paraffin embedded tissue. On the other hand, modern molecular techniques often require fresh or frozen tissue for accurate quantification of genetic and protein alterations. Overall, performing a complete neuropathological workup for accurate diagnoses and maintaining research quality tissue can be mutually beneficial and complementary processes.

Keywords: adult cognitive disorders, neuropathological evaluation, diagnosis, neurodegenerative pathologies, dementing disorders, comorbid pathologies, neuropathology, brain tumors, paraneoplastic encephalitis

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