TATIANA FOROUD & TOM MONTINE - ppmi-info.org...Jun 03, 2018 · TATIANA FOROUD & TOM MONTINE....
Transcript of TATIANA FOROUD & TOM MONTINE - ppmi-info.org...Jun 03, 2018 · TATIANA FOROUD & TOM MONTINE....
PPMI PATHOLOGY CORETATIANA FOROUD &
TOM MONTINE
Pathology Core Infrastructure
Indiana University Pathology Core
Stanford University Pathology Core
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PPMI PATHOLOGY CORE OVERVIEW
Plan Brain Donation
Introduction to Participant
Brain Collection
NeuropathEvaluation
SpecimenRepository
Site Coordinators are the Key!• Provide talking points for site
coordinators and stress their important role in helping with engagement– Contribution to understanding PD
progression– No additional cost to subject– Post mortem report provided to family
Pathology Core Referral
PPMI Site Referrals to Pathology Core
2
9
8
38
1
4
7
150
31
17
23
12
52
13
0
0
0
0 20 40 60 80 100 120 140 160
(1) Rochester(120) Cleveland
(154) Banner(18) U Penn(2) Columbia
(23) UCSD(32) Emory
(34) IND(40) Boston
(57) UAB(6) Oregon(7) Baylor(73) UCSF
(86) Beth Israel(196) Boca Raton
(12) Parkinson's Institute(96) Seattle
Subject Count
Site
Pending Amend 12 approval: (19) University of South Florida, (28) JHU, (88) NWU
PPMI Subject Referrals by Arm
28
56
1
5
9
21
5
2
35
91
4
12
18
64
11
5
0 10 20 30 40 50 60 70 80 90 100
Genetic Cohort PD
Genetic Cohort Unaffected
Genetic Registry PD
Genetic Registry Unaffected
HC
PD
Prodromal
SWEDD
Incomplete Complete
PPMI Pathology Core UpdatePPMI Site Referral to PPMI Path Core
(n=367)
PPMI Path Core: Contacts Subject, explains Core (n= 367) Not yet successfully
contacted (n=52) & Request delayed planning (n=16)
Decline/lost to f-up
(n=54)Subject sent IC and CRF (paper/electronic)
(n=245)
Completed IC and CRF received (n=135)
IC pending completion; reminder sent every 3
weeks (n=110)
Brain removal plan in place and documented(n=127)
Still planning (n=8)
Planning Challenges
• Finding removal specialists with 24/7 coverage to help with <8 hr removal goals
• Coordinating donations for subjects enrolled in multiple donations programs
• Identifying subjects who might have already donated to other brain banks
Brain Donation• Three PPMI subjects have samples at
Stanford University– One individual was planned by PPMI Pathology
Core and brain was successfully obtained– Two individuals had planned for donation prior
to the establishment of the PPMI Pathology Core
• Tissue/slides from recipient brain banks transferred to Stanford
– Preliminary evaluation of one case completed• ClinicoPathologic Case (CPC) conference to be
scheduled
Goals for the Coming Year• Annual confirmation with PPMI participants who
have a plan in place• Continue to receive referrals from US PPMI sites• European and International PPMI site expansion
– Establish harmonized IHC staining protocol across international sites
– Neuropathology evaluation to be performed at either international site with data transfer to Stanford or at Stanford
• Finalize plans for data transfer with LONI– Pathology slide images (Stanford University)– Pathology specimen catalog (Indiana University)
Case 2018-01• 80 yo woman with history of
movement disorder and cognitive impairment
• Brain – 1370 gm– Mild cerebral cortical atrophy– Enlarged lateral ventricles– Moderate atrophy of hippocampus– Moderate pallor of SN and LC
Anti-Amyloid B (6E10) IHC, Cerebellum
Anti-PHF-tau IHC; BA17
H&E/LFB; Substantia Nigra
Anti-P129 alpha-Synuclein IHC; DMN X
Anti-P129 alpha-Synuclein IHC; BA9
Anti-P129 alpha-Synuclein IHC; amygdala
PPMI Case 2018-01• High Level AD Neuropathologic Change
– A3, B3, C3– CAA (grade 2/3)
• Neocortical LB Disease– DMNX, SN, anterior cingulate gyrus, BA9– Amygdala
• No evidence of:– Microinfarcts– Hippocampal sclerosis– TDP-43 cytoplasmic inclusions