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01-01-2016 | Consensus Paper

Aging-related tau astrogliopathy (ARTAG): harmonized evaluation strategy

Authors: Gabor G. Kovacs, Isidro Ferrer, Lea T. Grinberg, Irina Alafuzoff, Johannes Attems, Herbert Budka, Nigel J. Cairns, John F. Crary, Charles Duyckaerts, Bernardino Ghetti, Glenda M. Halliday, James W. Ironside, Seth Love, Ian R. Mackenzie, David G. Munoz, Melissa E. Murray, Peter T. Nelson, Hitoshi Takahashi, John Q. Trojanowski, Olaf Ansorge, Thomas Arzberger, Atik Baborie, Thomas G. Beach, Kevin F. Bieniek, Eileen H. Bigio, Istvan Bodi, Brittany N. Dugger, Mel Feany, Ellen Gelpi, Stephen M. Gentleman, Giorgio Giaccone, Kimmo J. Hatanpaa, Richard Heale, Patrick R. Hof, Monika Hofer, Tibor Hortobágyi, Kurt Jellinger, Gregory A. Jicha, Paul Ince, Julia Kofler, Enikö Kövari, Jillian J. Kril, David M. Mann, Radoslav Matej, Ann C. McKee, Catriona McLean, Ivan Milenkovic, Thomas J. Montine, Shigeo Murayama, Edward B. Lee, Jasmin Rahimi, Roberta D. Rodriguez, Annemieke Rozemüller, Julie A. Schneider, Christian Schultz, William Seeley, Danielle Seilhean, Colin Smith, Fabrizio Tagliavini, Masaki Takao, Dietmar Rudolf Thal, Jon B. Toledo, Markus Tolnay, Juan C. Troncoso, Harry V. Vinters, Serge Weis, Stephen B. Wharton, Charles L. White III, Thomas Wisniewski, John M. Woulfe, Masahito Yamada, Dennis W. Dickson

Published in: Acta Neuropathologica | Issue 1/2016

Abstract

Pathological accumulation of abnormally phosphorylated tau protein in astrocytes is a frequent, but poorly characterized feature of the aging brain. Its etiology is uncertain, but its presence is sufficiently ubiquitous to merit further characterization and classification, which may stimulate clinicopathological studies and research into its pathobiology. This paper aims to harmonize evaluation and nomenclature of aging-related tau astrogliopathy (ARTAG), a term that refers to a morphological spectrum of astroglial pathology detected by tau immunohistochemistry, especially with phosphorylation-dependent and 4R isoform-specific antibodies. ARTAG occurs mainly, but not exclusively, in individuals over 60 years of age. Tau-immunoreactive astrocytes in ARTAG include thorn-shaped astrocytes at the glia limitans and in white matter, as well as solitary or clustered astrocytes with perinuclear cytoplasmic tau immunoreactivity that extends into the astroglial processes as fine fibrillar or granular immunopositivity, typically in gray matter. Various forms of ARTAG may coexist in the same brain and might reflect different pathogenic processes. Based on morphology and anatomical distribution, ARTAG can be distinguished from primary tauopathies, but may be concurrent with primary tauopathies or other disorders. We recommend four steps for evaluation of ARTAG: (1) identification of five types based on the location of either morphologies of tau astrogliopathy: subpial, subependymal, perivascular, white matter, gray matter; (2) documentation of the regional involvement: medial temporal lobe, lobar (frontal, parietal, occipital, lateral temporal), subcortical, brainstem; (3) documentation of the severity of tau astrogliopathy; and (4) description of subregional involvement. Some types of ARTAG may underlie neurological symptoms; however, the clinical significance of ARTAG is currently uncertain and awaits further studies. The goal of this proposal is to raise awareness of astroglial tau pathology in the aged brain, facilitating communication among neuropathologists and researchers, and informing interpretation of clinical biomarkers and imaging studies that focus on tau-related indicators.

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Title: Aging-related tau astrogliopathy (ARTAG): harmonized evaluation strategy
Authors: Gabor G. Kovacs
Isidro Ferrer
Lea T. Grinberg
Irina Alafuzoff
Johannes Attems
Herbert Budka
Nigel J. Cairns
John F. Crary
Charles Duyckaerts
Bernardino Ghetti
Glenda M. Halliday
James W. Ironside
Seth Love
Ian R. Mackenzie
David G. Munoz
Melissa E. Murray
Peter T. Nelson
Hitoshi Takahashi
John Q. Trojanowski
Olaf Ansorge
Thomas Arzberger
Atik Baborie
Thomas G. Beach
Kevin F. Bieniek
Eileen H. Bigio
Istvan Bodi
Brittany N. Dugger
Mel Feany
Ellen Gelpi
Stephen M. Gentleman
Giorgio Giaccone
Kimmo J. Hatanpaa
Richard Heale
Patrick R. Hof
Monika Hofer
Tibor Hortobágyi
Kurt Jellinger
Gregory A. Jicha
Paul Ince
Julia Kofler
Enikö Kövari
Jillian J. Kril
David M. Mann
Radoslav Matej
Ann C. McKee
Catriona McLean
Ivan Milenkovic
Thomas J. Montine
Shigeo Murayama
Edward B. Lee
Jasmin Rahimi
Roberta D. Rodriguez
Annemieke Rozemüller
Julie A. Schneider
Christian Schultz
William Seeley
Danielle Seilhean
Colin Smith
Fabrizio Tagliavini
Masaki Takao
Dietmar Rudolf Thal
Jon B. Toledo
Markus Tolnay
Juan C. Troncoso
Harry V. Vinters
Serge Weis
Stephen B. Wharton
Charles L. White III
Thomas Wisniewski
John M. Woulfe
Masahito Yamada
Dennis W. Dickson
Publication date: 01-01-2016
Publisher: Springer Berlin Heidelberg
Published in: Acta Neuropathologica / Issue 1/2016
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI: https://doi.org/10.1007/s00401-015-1509-x

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Aging-related tau astrogliopathy (ARTAG): harmonized evaluation strategy

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