TY  - JOUR
AU  - Attems, Johannes
AU  - Toledo, Jon B.
AU  - Walker, Lauren
AU  - Gelpi, Ellen
AU  - Gentleman, Steve
AU  - Halliday, Glenda
AU  - Hortobagyi, Tibor
AU  - Jellinger, Kurt
AU  - Kovacs, Gabor G.
AU  - Lee, Edward B.
AU  - Love, Seth
AU  - McAleese, Kirsty E.
AU  - Nelson, Peter T.
AU  - Neumann, Manuela
AU  - Parkkinen, Laura
AU  - Polvikoski, Tuomo
AU  - Sikorska, Beata
AU  - Smith, Colin
AU  - Grinberg, Lea Tenenholz
AU  - Thal, Dietmar R.
AU  - Trojanowski, John Q.
AU  - McKeith, Ian G.
TI  - Neuropathological consensus criteria for the evaluation of Lewy pathology in post-mortem brains: a multi-centre study
JO  - Acta neuropathologica
VL  - 141
IS  - 2
SN  - 1432-0533
CY  - Heidelberg
PB  - Springer
M1  - DZNE-2021-00342
SP  - 159 - 172
PY  - 2021
AB  - Currently, the neuropathological diagnosis of Lewy body disease (LBD) may be stated according to several staging systems, which include the Braak Lewy body stages (Braak), the consensus criteria by McKeith and colleagues (McKeith), the modified McKeith system by Leverenz and colleagues (Leverenz), and the Unified Staging System by Beach and colleagues (Beach). All of these systems use semi-quantitative scoring (4- or 5-tier scales) of Lewy pathology (LP; i.e., Lewy bodies and Lewy neurites) in defined cortical and subcortical areas. While these systems are widely used, some suffer from low inter-rater reliability and/or an inability to unequivocally classify all cases with LP. To address these limitations, we devised a new system, the LP consensus criteria (LPC), which is based on the McKeith system, but applies a dichotomous approach for the scoring of LP (i.e., äbsent" vs. "present") and includes amygdala-predominant and olfactory-only stages. α-Synuclein-stained slides from brainstem, limbic system, neocortex, and olfactory bulb from a total of 34 cases with LP provided by the Newcastle Brain Tissue Resource (NBTR) and the University of Pennsylvania brain bank (UPBB) were scanned and assessed by 16 raters, who provided diagnostic categories for each case according to Braak, McKeith, Leverenz, Beach, and LPC systems. In addition, using LP scores available from neuropathological reports of LP cases from UPBB (n = 202) and NBTR (n = 134), JT (UPBB) and JA (NBTR) assigned categories according to all staging systems to these cases. McKeith, Leverenz, and LPC systems reached good (Krippendorff's α ≈ 0.6), while both Braak and Beach systems had lower (Krippendorff's α ≈ 0.4) inter-rater reliability, respectively. Using the LPC system, all cases could be unequivocally classified by the majority of raters, which was also seen for 97.1
KW  - Autopsy
KW  - Brain: pathology
KW  - Brain Mapping
KW  - Consensus
KW  - Humans
KW  - Lewy Bodies: pathology
KW  - Lewy Body Disease: classification
KW  - Lewy Body Disease: diagnosis
KW  - Lewy Body Disease: pathology
KW  - Observer Variation
KW  - Reproducibility of Results
LB  - PUB:(DE-HGF)16
C6  - pmid:33399945
C6  - 33399945
C2  - pmc:PMC7847437
DO  - DOI:10.1007/s00401-020-02255-2
UR  - https://pub.dzne.de/record/154752
ER  -