Neuropathology
Neuropathology is the study of disease of nervous system tissue, usually in the form of either small surgical biopsies or whole-body autopsies. Neuropathologists usually work in a department of anatomic pathology, but work closely with the clinical disciplines of neurology, and neurosurgery, which often depend on neuropathology for a diagnosis. Neuropathology also relates to forensic pathology because brain disease or brain injury can be related to cause of death. Neuropathology should not be confused with neuropathy, which refers to disorders of the nerves themselves (usually in the peripheral nervous system) rather than the tissues. In neuropathology, the branches of the specializations of nervous system as well as the tissues come together into one field of study.
Methodology[edit]
The work of the neuropathologist consists largely of examining autopsy or biopsy tissue from the brain and spinal cord to aid in diagnosis of disease.[1] In addition to brain and spinal cord, tissues of the eyes, nerves, muscles, and tumors are examined. A biopsy is usually requested after a mass is detected by radiologic imaging, the imaging in turn driven by presenting signs and symptoms of a patient. CT and MRI scans are also used to discover lesions in the patient. As for autopsies, the work of the neuropathologist is to make post-mortem diagnosis of diseases such as dementia, Parkinson's disease and other conditions that affect the central nervous system. Tissue samples are researched within the lab for diagnosis, and in forensic investigations to clarify the cause of death.
Biopsies can also consist of the skin. Epidermal nerve fiber density testing (ENFD) is a more recently developed neuropathology test in which a punch skin biopsy is taken to identify small fiber neuropathies by analyzing the nerve fibers of the skin. This pathology test is becoming available in select labs as well as many universities; it replaces the traditional sural nerve biopsy test as less invasive. It is used to identify painful small fiber neuropathies.
Neuropathologists work in hospital labs and clinics, universities, or with the government depending on the situation. They often do not work with patients but only with medical professionals or other officials behind the scene. They research using information given to them by other neurologists and/ or physicians. Neuropathologists may also research in coroner's or morgue offices for forensic projects. The ultimate goal of neuropathologists is to find the medical issue and then formulate a timeline in which to cure the patient's tissue.
Prominent historical and current figures[edit]
Santiago Ramon y Cajal is considered one of the founders of modern neuroanatomy. Alois Alzheimer, the person after whom Alzheimer's disease is named, is considered an important early contributor to the field.
There are many neuropathologists around the world who have made important clinical and research contributions toward our understanding of diseases that specifically affect the brain (degenerative diseases, multiple sclerosis, stroke, brain tumors, trauma and neuromuscular diseases). The majority are members of the International Society of Neuropathology (ISN). For neuropathologists practicing within the United States of America please refer to the Membership Directory available through the American Association of Neuropathologists (AANP) website. There are also Membership Directories available for many of the neuropathology societies that exist in other specific countries and/or regions of the world (British, European, Canadian... etc.).
Progress[edit]
A European Board Examination in Neuropathology which emphasizes the importance of proper training in the neurosciences is currently being established (www.euro-cns.org). The most recent international congress of neuropathology was held in Tokyo, Japan, in September 2018.
Journals[edit]
Academic neuropathology is served by several specialist neuropathology journals. Acta Neuropathologica is the neuropathology journal with the highest impact factor.[3] Some journals are sponsored by national or international neuropathology associations: Brain Pathology is the official journal of the International Society of Neuropathology, Neuropathology & Applied Neurobiology is sponsored by the British Neuropathological Society, the Journal of Neuropathology & Experimental Neurology is the official journal of the American Association of Neuropathologists (AANP) and "Neuropathology" is the official journal of the Japanese Society of Neuropathology.