ABSTRACT

Diagnostic brain biopsies are not often performed in cases of progressive dementia. This is despite the commonest cause of the condition, Alzheimer’s disease (AD), requiring microscopic examination of the brain for confirmation of the diagnosis. There seem to be several principal reasons for the sparing use of cerebral biopsy for the diagnosis of AD. If treatment for AD is developed that is effective but not cheap or trouble-free the demand for a biopsy diagnosis of AD may increase, unless a specific test of a less invasive type is developed in the meantime. In most of the studies reporting on the use of cerebral biopsy for the diagnosis of AD, this diagnosis was based on the presence of both senile plaques and neurofibrillary tangles in the sample of neocortex removed. Progress is, however, now being made in developing such criteria for the autopsy diagnosis of AD, where the number of cases available for study is large.