Interpretation of neuropathological lesions: Its limitations in medico-legal experts’ reports

Piercecchi-Marti, Marie-Dominique; De Paula, Andre Maues; Gavaudan, Gilles; Bartoli, Christophe; Pelissier-Alicot, Anne-Laure; Leonetti, Georges; Pellissier, Jean-François

doi:10.1016/j.forsciint.2009.07.010

« Previous Next »Forensic Science International
Volume 194, Issue 1 , Pages e1-e3, 30 January 2010

Interpretation of neuropathological lesions: Its limitations in medico-legal experts’ reports

Marie-Dominique Piercecchi-Marti
- Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, 27 Bd Jean Moulin, 13005 Marseille, France
- Corresponding author at: Service de Médecine Légale, Faculté de Médecine, 27, boulevard Jean Moulin, F-13385 Marseille Cedex 5, France. Tel.: +33 4 91 38 78 63; fax: +33 4 91 92 33 31.
Andre Maues De Paula
- Service d’Anatomie Pathologique et de Neuropathologie, CHU Timone, 264 rue Saint-Pierre, 13005 Marseille, France
Gilles Gavaudan
- Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, 27 Bd Jean Moulin, 13005 Marseille, France
Christophe Bartoli
- Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, 27 Bd Jean Moulin, 13005 Marseille, France
Anne-Laure Pelissier-Alicot
- Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, 27 Bd Jean Moulin, 13005 Marseille, France
Georges Leonetti
- Service de Médecine Légale et Droit de la Santé, Faculté de Médecine, CHU Timone, 27 Bd Jean Moulin, 13005 Marseille, France
Jean-François Pellissier
- Service d’Anatomie Pathologique et de Neuropathologie, CHU Timone, 264 rue Saint-Pierre, 13005 Marseille, France

Received 15 January 2008; received in revised form 28 April 2009; accepted 15 July 2009. published online 30 October 2009.

Abstract

Aggressive or paradoxical behaviour may reflect an organic dementia. The most frequent is Alzheimer's disease, which results from an abnormal structural conformation of tubulin-associated protein (tau) and beta-amyloid protein that, respectively, aggregate in certain neurons as intracellular neurofibrillary tangles (NFTs) and in the extracellular environment as senile plaques.

These lesions progress in the brain tissue according to the stages described by Braak and Braak. Staging of neurofibrillary pathology has proven anatomical and clinical correlation, which can be used in a medico-legal procedure. We report two cases demonstrating discrepancies between anatomical and clinical features, which should encourage medical expert to prudence when interpreting neuropathological reports.

Keywords: Alzheimer's disease, Dementia, Neuropathology, Medico-legal psychiatry