Iacono Diego, Geraci-Erck Maria, Peng Hui, Bouffard John Paul
Neuropathology Research, Biomedical Research Institute of New Jersey (BRInj);
Neuropathology Research, Biomedical Research Institute of New Jersey (BRInj).
J Vis Exp. 2016 Dec 18(118):54602. doi: 10.3791/54602.
Neuropathologists, at times, feel intimidated by the amount of knowledge needed to generate definitive diagnoses for complex neuropsychiatric phenomena described in those patients for whom a brain autopsy has been requested. Although the advancements of biomedical sciences and neuroimaging have revolutionized the neuropsychiatric field, they have also generated the misleading idea that brain autopsies have only a confirmatory value. This false idea created a drastic reduction of autopsy rates and, consequently, a reduced possibility to perform more detailed and extensive neuropathological investigations, which are necessary to comprehend numerous normal and pathological aspects yet unknown of the human brain. The traditional inferential method of correlation between observed neuropsychiatric phenomena and corresponding localization/characterization of their possible neurohistological correlates continues to have an undeniable value. In the context of neuropsychiatric diseases, the traditional clinicopathological method is still the best possible methodology (and often the only available) to link unique neuropsychiatric features to their corresponding neuropathological substrates, since it relies specifically upon the direct physical assessment of brain tissues. The assessment of postmortem brains is based on brain cutting procedures that vary across different neuropathology centers. Brain cuttings are performed in a relatively extensive and systematic way based on the various clinical and academic contingencies present in each institution. A more anatomically inclusive and symmetric bi-hemispheric brain cutting methodology should at least be used for research purposes in human neuropathology to coherently investigate, in depth, normal and pathological conditions with the peculiarities of the human brain (i.e., hemispheric specialization and lateralization for specific functions). Such a method would provide a more comprehensive collection of neuropathologically well-characterized brains available for current and future biotechnological and neuroimaging techniques. We describe a symmetric bi-hemispheric brain cutting procedure for the investigation of hemispheric differences in human brain pathologies and for use with current as well as future biomolecular/neuroimaging techniques.
神经病理学家有时会因需要大量知识才能对那些已要求进行脑尸检的患者所描述的复杂神经精神现象做出明确诊断而感到畏惧。尽管生物医学科学和神经影像学的进步彻底改变了神经精神领域,但它们也产生了一种误导性观念,即脑尸检仅具有确认价值。这种错误观念导致尸检率急剧下降,进而减少了进行更详细、广泛的神经病理学研究的可能性,而这些研究对于理解人脑众多未知的正常和病理方面是必要的。观察到的神经精神现象与其可能的神经组织学关联的相应定位/特征之间的传统相关性推断方法仍然具有不可否认的价值。在神经精神疾病的背景下,传统的临床病理方法仍然是将独特的神经精神特征与其相应的神经病理底物联系起来的最佳方法(而且通常是唯一可用的方法),因为它特别依赖于对脑组织的直接物理评估。对死后大脑的评估基于不同神经病理学中心各不相同的脑切片程序。根据每个机构存在的各种临床和学术情况,以相对广泛和系统的方式进行脑切片。至少应将一种在解剖学上更具包容性和对称性的双半球脑切片方法用于人类神经病理学的研究目的,以便连贯地深入研究人脑的正常和病理状况以及其特殊性(即特定功能的半球特化和偏侧化)。这样一种方法将提供更全面的、神经病理学特征明确的大脑集合,可供当前和未来的生物技术和神经影像学技术使用。我们描述了一种对称双半球脑切片程序,用于研究人脑病理学中的半球差异,并用于当前以及未来的生物分子/神经影像学技术。