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NEUROLOGY 1991;41:479
© 1991 American Academy of Neurology

The Consortium to Establish a Registry for Alzheimer's Disease (CERAD)

Part II. Standardization of the neuropathologic assessment of Alzheimer's disease

S. S. Mirra, MD, A. Heyman, MD, D. McKeel, MD, S. M. Sumi, MD, B. J. Crain, MD, PhD, L. M. Brownlee, BChE, MD, F. S. Vogel, MD, J. P. Hughes, MS, G. van Belle, PhD, L. Berg, MD and participating CERAD neuropathologists

Veterans Administration Medical Center and Emory University School of Medicine (Drs. Mirra and Brownlee), Atlanta, GA; Duke University Medical Center (Drs. Heyman and Crain), Durham, NC; Washington University (Drs. McKeel and Berg), St. Louis, MO; and the University of Washington (Drs. Sumi and Vogel, J.P. Hughes, and Dr. van Belle), Seattle, WA.

The Neuropathology Task Force of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) has developed a practical and standardized neuropathology protocol for the postmortem assessment of dementia and control subjects. The protocol provides neuropathologic definitions of such terms as "definite Alzheimer's disease" (AD), "probable AD," "possible AD," and "normal brain" to indicate levels of diagnostic certainty, reduce subjective interpretation, and assure common language. To pretest the protocol, neuropathologists from 15 participating centers entered information on autopsy brains from 142 demented patients clinically diagnosed as probable AD and on eight nondemented patients. Eighty-four percent of the dementia cases fulfilled CERAD neuropathologic criteria for definite AD. As increasingly large numbers of prospectively studied dementia and control subjects are autopsied, the CERAD neuropathology protocol will help to refine diagnostic criteria, assess overlapping pathology, and lead to a better understanding of early subclinical changes of AD and normal aging.

Address correspondence and reprint requests to Dr. Suzanne S. Mirra, VA Medical Center (113), Department of Pathology and Laboratory Medicine, 1670 Clairmont Road, Decatur, GA 30033.

Supported by NIA # AG06790. Dr. Mirra's work is also supported by Veterans Administration Merit Award # 5747-4.

Received September 5, 1990. Accepted for publication in final form October 1, 1990.

* See Acknowledgments on page 485.




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J. L. Holton, S. A. Schneider, T. Ganesharajah, S. Gandhi, C. Strand, P. Shashidharan, J. Barreto, N. W. Wood, A. J. Lees, K. P. Bhatia, et al.
Neuropathology of primary adult-onset dystonia
Neurology, February 26, 2008; 70(9): 695 - 699.
[Abstract] [Full Text] [PDF]

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 NeurologyHome page
J. A. Schneider, Z. Arvanitakis, W. Bang, and D. A. Bennett
Mixed brain pathologies account for most dementia cases in community-dwelling older persons
Neurology, December 11, 2007; 69(24): 2197 - 2204.
[Abstract] [Full Text] [PDF]

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 J Geriatr Psychiatry NeurolHome page
J. A. Levy and G. J. Chelune
Cognitive-Behavioral Profiles of Neurodegenerative Dementias: Beyond Alzheimer's Disease
J Geriatr Psychiatry Neurol, December 1, 2007; 20(4): 227 - 238.
[Abstract] [PDF]

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 Arch NeurolHome page
S. E. Counts, B. He, S. Che, M. D. Ikonomovic, S. T. DeKosky, S. D. Ginsberg, and E. J. Mufson
{alpha}7 Nicotinic Receptor Up-regulation in Cholinergic Basal Forebrain Neurons in Alzheimer Disease
Arch Neurol, December 1, 2007; 64(12): 1771 - 1776.
[Abstract] [Full Text] [PDF]

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 Am. J. Pathol.Home page
M. M.M. Wilhelmus, I. Otte-Holler, J. J.J. van Triel, R. Veerhuis, M. L.C. Maat-Schieman, G. Bu, R. M.W. de Waal, and M. M. Verbeek
Lipoprotein Receptor-Related Protein-1 Mediates Amyloid- -Mediated Cell Death of Cerebrovascular Cells
Am. J. Pathol., December 1, 2007; 171(6): 1989 - 1999.
[Abstract] [Full Text] [PDF]

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 J. Neurol. Neurosurg. PsychiatryHome page
Z. Walker, E. Jaros, R. W H Walker, L. Lee, D. C Costa, G. Livingston, P. G Ince, R. Perry, I. McKeith, and C. L E Katona
Dementia with Lewy bodies: a comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy
J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1176 - 1181.
[Abstract] [Full Text] [PDF]

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 Am. J. Neuroradiol.Home page
J. Huang, R.P. Friedland, and A.P. Auchus
Diffusion Tensor Imaging of Normal-Appearing White Matter in Mild Cognitive Impairment and Early Alzheimer Disease: Preliminary Evidence of Axonal Degeneration in the Temporal Lobe
AJNR Am. J. Neuroradiol., November 1, 2007; 28(10): 1943 - 1948.
[Abstract] [Full Text] [PDF]

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 NeurologyHome page
F. Barkhof, T. M. Polvikoski, E.C.W. van Straaten, R. N. Kalaria, R. Sulkava, H. J. Aronen, L. Niinisto, S. Rastas, M. Oinas, P. Scheltens, et al.
The significance of medial temporal lobe atrophy: A postmortem MRI study in the very old
Neurology, October 9, 2007; 69(15): 1521 - 1527.
[Abstract] [Full Text] [PDF]

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 J. Neurol. Neurosurg. PsychiatryHome page
K. L Brickell, J. B Leverenz, E. J Steinbart, M. Rumbaugh, G. D Schellenberg, D. Nochlin, T. H Lampe, I. E Holm, V. V. Deerlin, W. Yuan, et al.
Clinicopathological concordance and discordance in three monozygotic twin pairs with familial Alzheimer's disease
J. Neurol. Neurosurg. Psychiatry, October 1, 2007; 78(10): 1050 - 1055.
[Abstract] [Full Text] [PDF]

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 BrainHome page
A. Lockhart, J.R. Lamb, T. Osredkar, L.I. Sue, J.N. Joyce, L. Ye, V. Libri, D. Leppert, and T.G. Beach
PIB is a non-specific imaging marker of amyloid-beta (A{beta}) peptide-related cerebral amyloidosis
Brain, October 1, 2007; 130(10): 2607 - 2615.
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 AM J ALZHEIMERS DIS OTHER DEMENHome page
F. D. Sajan, F. Martiniuk, D. L. Marcus, W. H. Frey II, R. Hite, E. Z. Bordayo, and M. L. Freedman
Apoptotic Gene Expression in Alzheimer's Disease Hippocampal Tissue
American Journal of Alzheimer's Disease and Other Dementias, September 1, 2007; 22(4): 319 - 328.
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 BrainHome page
V. Bogaerts, S. Engelborghs, S. Kumar-Singh, D. Goossens, B. Pickut, J. van der Zee, K. Sleegers, K. Peeters, J.-J. Martin, J. Del-Favero, et al.
A novel locus for dementia with Lewy bodies: a clinically and genetically heterogeneous disorder
Brain, September 1, 2007; 130(9): 2277 - 2291.
[Abstract] [Full Text] [PDF]

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 Am. J. Pathol.Home page
W. Yang, R. L. Woltjer, I. Sokal, C. Pan, Y. Wang, M. Brodey, E. R. Peskind, J. B. Leverenz, J. Zhang, D. P. Perl, et al.
Quantitative Proteomics Identifies Surfactant-Resistant {alpha}-Synuclein in Cerebral Cortex of Parkinsonism-Dementia Complex of Guam but Not Alzheimer's Disease or Progressive Supranuclear Palsy
Am. J. Pathol., September 1, 2007; 171(3): 993 - 1002.
[Abstract] [Full Text] [PDF]

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 NeurologyHome page
W. Jagust, B. Reed, D. Mungas, W. Ellis, and C. DeCarli
What does fluorodeoxyglucose PET imaging add to a clinical diagnosis of dementia?
Neurology, August 28, 2007; 69(9): 871 - 877.
[Abstract] [Full Text] [PDF]

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 NeurologyHome page
G. Li, E. B. Larson, J. A. Sonnen, J. B. Shofer, E. C. Petrie, A. Schantz, E. R. Peskind, M. A. Raskind, J.C.S. Breitner, and T. J. Montine
Statin therapy is associated with reduced neuropathologic changes of Alzheimer disease
Neurology, August 28, 2007; 69(9): 878 - 885.
[Abstract] [Full Text] [PDF]

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 Arch NeurolHome page
V. M. Van Deerlin, E. M. Wood, P. Moore, W. Yuan, M. S. Forman, C. M. Clark, M. Neumann, L. K. Kwong, J. Q. Trojanowski, V. M.-Y. Lee, et al.
Clinical, Genetic, and Pathologic Characteristics of Patients With Frontotemporal Dementia and Progranulin Mutations
Arch Neurol, August 1, 2007; 64(8): 1148 - 1153.
[Abstract] [Full Text] [PDF]

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 BrainHome page
P. A. Kempster, D. R. Williams, M. Selikhova, J. Holton, T. Revesz, and A. J. Lees
Patterns of levodopa response in Parkinson's disease: a clinico-pathological study
Brain, August 1, 2007; 130(8): 2123 - 2128.
[Abstract] [Full Text] [PDF]

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 BrainHome page
D. R. Williams, J. L. Holton, C. Strand, A. Pittman, R. de Silva, A. J. Lees, and T. Revesz
Pathological tau burden and distribution distinguishes progressive supranuclear palsy-parkinsonism from Richardson's syndrome
Brain, June 1, 2007; 130(6): 1566 - 1576.
[Abstract] [Full Text] [PDF]

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 Am. J. Pathol.Home page
X. Zhu, J. Avila, G. Perry, and M. A. Smith
Treating the Lesions, Not the Disease
Am. J. Pathol., May 1, 2007; 170(5): 1457 - 1459.
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 J. Neurol. Neurosurg. PsychiatryHome page
R McNeill, G M Sare, M Manoharan, H J Testa, D M A Mann, D Neary, J S Snowden, and A R Varma
Accuracy of single-photon emission computed tomography in differentiating frontotemporal dementia from Alzheimer's disease
J. Neurol. Neurosurg. Psychiatry, April 1, 2007; 78(4): 350 - 355.
[Abstract] [Full Text] [PDF]

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 Arch NeurolHome page
R. M. Liscic, M. Storandt, N. J. Cairns, and J. C. Morris
Clinical and Psychometric Distinction of Frontotemporal and Alzheimer Dementias
Arch Neurol, April 1, 2007; 64(4): 535 - 540.
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 BrainHome page
J. L. Whitwell, C. R. Jack Jr, J. E. Parisi, D. S. Knopman, B. F. Boeve, R. C. Petersen, T. J. Ferman, D. W. Dickson, and K. A. Josephs
Rates of cerebral atrophy differ in different degenerative pathologies
Brain, April 1, 2007; 130(4): 1148 - 1158.
[Abstract] [Full Text] [PDF]

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 J. Biol. Chem.Home page
M. Kim, L. B. Hersh, M. A. Leissring, M. Ingelsson, T. Matsui, W. Farris, A. Lu, B. T. Hyman, D. J. Selkoe, L. Bertram, et al.
Decreased Catalytic Activity of the Insulin-degrading Enzyme in Chromosome 10-Linked Alzheimer Disease Families
J. Biol. Chem., March 16, 2007; 282(11): 7825 - 7832.
[Abstract] [Full Text] [PDF]

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M. S. Forman, E. J. Mufson, S. Leurgans, D. Pratico, S. Joyce, S. Leight, V. M.-Y. Lee, and J. Q. Trojanowski
Cortical biochemistry in MCI and Alzheimer disease: Lack of correlation with clinical diagnosis
Neurology, March 6, 2007; 68(10): 757 - 763.
[Abstract] [Full Text] [PDF]

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 J Geriatr Psychiatry NeurolHome page
G. A. Marshall, L. A. Fairbanks, S. Tekin, H. V. Vinters, and J. L. Cummings
Early-Onset Alzheimer's Disease Is Associated With Greater Pathologic Burden
J Geriatr Psychiatry Neurol, March 1, 2007; 20(1): 29 - 33.
[Abstract] [PDF]


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