The Quarterly INS Webinar Series in partnership with the Dementia Special Interest Group (SIG)
An Introduction to Neurodegenerative Pathology for Neuropsychologists
About the Webinar
Autopsy remains the gold standard for diagnosis of neurodegenerative disease. Neurodegeneration is defined as the progressive loss of selectively vulnerable neurons in specific anatomic networks, thus leading to neuronal death and cognitive impairment. Neurodegenerative diseases are therefore characterized by the clinical phenotype (e.g. a dementia syndrome), anatomic patterns of atrophy or vulnerability, and pathology at cellular and molecular levels. Is there concordance between clinical manifestations of disease and the underlying pathology that causes symptoms? If so, what are the anatomic targets and molecular fingerprints of specific neurodegenerative diseases? The evaluation of postmortem pathology underlying dementia is thus critical for understanding the substrates of disease, developing disease-specific biomarkers, and retrospectively identifying antemortem clinical features reliable for early diagnosis. A major challenge that impedes these developments, however, is the heterogeneity of pathologies underlying dementia syndromes and old age. This lecture will review the scientific literature on clinicopathologic relationships in focal dementia syndromes like dementia of the Alzheimer’s type, Primary Progressive Aphasia (PPA), and behavioral variant Frontotemporal Dementia (bvFTD). It will also introduce participants to underlying pathologic features of unique elderly individuals, known as “SuperAgers”, who appear to resist neurodegeneration. The overarching theme is that the relationship between cognitive phenotype during life and underlying pathology at death is not absolute but probabilistic. In the clinic and in the laboratory, the neuropsychologist can benefit from a nuanced view of the postmortem factors that contribute to vulnerability versus resistance in the field of neurodegeneration.
- Better describe cognitive phenotypes of dementia syndromes and their anatomic and pathologic vulnerabilities
- Compare and contrast pathologic features of common neurodegenerative diseases
- Apply an understanding of clinicopathologic relationships to the practice of clinical neuropsychology
Dr. Gefen is an academic clinical neuropsychologist with an interest in neurodegenerative disorders and trajectories of aging (both abnormal and successful). She received her PhD in clinical neuropsychology from Northwestern University, Feinberg School of Medicine and completed an APA-accredited internship at Harvard Medical School/MGH. Dr. Gefen returned to Northwestern to complete a post-doctoral fellowship in clinical neuropsychology and neurodegenerative neuropathology. She currently directs the Laboratory for Translational Neuropsychology supported by funding from the NIA/NIH (R01AG062566) at Feinberg School of Medicine at Northwestern, which bridges antemortem clinical features of dementia with postmortem microscopic neuropathology found at autopsy. She is the Assistant Director of the Clinical Core of the NIA-funded (P30) Alzheimer’s Disease Research Center (ADRC) housed within the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease. Her clinical work is focused on the neuropsychological characterization of dementia syndromes and other age-related disorders. Dr. Gefen is passionate about mentorship, teaching, and collaboration-and bringing neuropsychologists-in-training into the wet lab.
To obtain information about how to receive 1.0 hour of CE credit for this webinar please visit the INS website.