Page 71 - Memora anual Fundación CIEN 2017

3. SCIENTIFIC ACTIVITY
3.2.3. Department of Neuropathology
Neuropathology of neurodegenerative disorders is a
specialty in continuous progress with capacity for
contrasting clinical judgment and performance of
any diagnostic test, including the most recent bio-
markers, with the final diagnosis that is still neuropa- damental element in the process of classifying de-
thology ("gold standard"). However, in the field of
basic research, neuropathology plays an additional
role, providing critical information about the mole-
cular components of the characteristic lesions of
each disease, the pathogenic mechanisms and the
potential biomarkers.
The post-mortem neuropathological findings obser-
ved in donations of brain tissue from patients with
neurodegenerative diseases, especially in the case
of dementias, have allowed to know in recent de-
cades the epidemiological reality of these diseases
in the population, and among other evidences,
have revealed the high prevalence of combined
pathology (Alzheimer's pathology, Vascular patho-
logy and Lewy pathology, mainly).
The neuropathology of dementia landscape has
dramatically changed in recent years. The incorpo-
ration to the neuropathological diagnosis of new an-
tibodies for immunostaining and new molecular
techniques has helped establishing the boundaries
and internal heterogeneity of entities such as
dementia with Lewy bodies and frontotemporal
dementia, and has also led to the discovery of new
entities in this area (DFT-TDP. DFT-FUS, etc.). The neu- NED researchers, as well as in the neuropathological
ropathological study of an increasing number of pa-
tients with neurodegenerative pathology has
allowed identifying new genetic causes of these di-
seases, thus helping to define new molecular targets
for possible therapeutic approaches. In addition, the
definition of diagnostic criteria from large series of
brains (in biobanks of neurological tissue or brain
banks) has allowed us to address the problem of
combined and mixed pathology, specifically regar-
ding Alzheimer's disease. The evolution of the diag-
nostic criteria themselves (e.g. the new criteria for
the diagnostic classification of Alzheimer's disease
proposed by the National Institute of Aging - Alzhei-
mer's Association, 2012) and molecular techniques
are converting the histological diagnosis into an fun-
mentias, definitive or quasi-definitive in some cases,
but partial or probabilistic in many others. As repea-
tedly demonstrated in clinical-pathological sessions,
made possible in most cases thanks to the donation
of brain tissue by patients or their families and the
close collaboration of clinicians, the final classifica-
tion of a case requires the integration of all clinical,
neuroradiological, neuropathological and molecu-
lar information, when available.
A need for dementia research is the availability of well-
diagnosed, classified and long-term preserved brain
tissue. Brain banks (biobanks of neurological sam-
ples) respond to this need, and the CIEN Foundation
has one of the main brain banks in the country, the
CIEN Tissue Bank (BT-CIEN, for its acronym in Spanish).
Neuropathology also provides significant support for
studies based on animal models of neurological di-
seases, both for the histological evaluation of trans-
genic animals and for the search for natural models
of the disease. The Department of Neuropathology
of the CIEN Foundation participates regularly in the
histological evaluation of animal models of different
neurodegenerative diseases developed by CIBER-
study of elderly mammals of the Madrid Zoo.
Department activities
The core activity of the UIPA’s Department of Neuro-
pathology corresponds to the BT-CIEN, both to its or-
ganizational and logistical components as well as the
neuropathological diagnostic work and the mana-
gement of biological samples.
CIEN Foundation Annual Report 2017 / 71