We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Brain Infarction and the Clinical Expression of Alzheimer Disease

Suzanne S. Mirra, MD; Marla Gearing, PhD
JAMA. 1997;278(2):113. doi:10.1001/jama.1997.03550020045022.
Text Size: A A A
Published online


To the Editor.  —We were intrigued by the findings of Dr Snowdon and colleagues1 in the prospective study of elderly nuns that fewer neuropathologic lesions of Alzheimer disease (AD), especially neurofibrillary tangles (NFTs), apparently resulted in dementia in individuals with concomitant lacunar infarcts than in individuals with pure AD. These observations prompted us to examine the frequency of neocortical NFTs in AD cases with and without concomitant infarcts. We reviewed data on 201 autopsy cases derived from dementia subjects clinically diagnosed as having AD enrolled in the longitudinal multicenter study, CERAD (Consortium to Establish a Registry for Alzheimer's Disease). The cases, contributed by 20 participating medical centers, were assessed using standard clinical and neuropathologic batteries. Neuropathologic assessment included semiquantitative ratings of senile plaques and NFTs in multiple regions of neocortex; levels of certainty of the neuropathologic diagnosis of AD were determined using an algorithm based on age-related neocortical plaque


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.