{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:35:17Z","timestamp":1789176917269,"version":"build-2803163510"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"Department of Veteran Affairs","doi-asserted-by":"crossref","award":["CX002342"],"award-info":[{"award-number":["CX002342"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006309","name":"American Parkinson Disease Association","doi-asserted-by":"publisher","award":["IR526-MN242.114"],"award-info":[{"award-number":["IR526-MN242.114"]}],"id":[{"id":"10.13039\/100006309","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01AG054008"],"award-info":[{"award-number":["R01AG054008"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["RF1NS095252"],"award-info":[{"award-number":["RF1NS095252"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["P30AG066514"],"award-info":[{"award-number":["P30AG066514"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01AG062348"],"award-info":[{"award-number":["R01AG062348"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K01AG070326"],"award-info":[{"award-number":["K01AG070326"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01NS142076"],"award-info":[{"award-number":["R01NS142076"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Rainwater Charitable Foundation, CurePSP Pathway","award":["685-2023-06"],"award-info":[{"award-number":["685-2023-06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Neuropathologic features diagnostic of parkinsonian disorders infrequently occur in isolation; hyperphosphorylated tau (p-tau) and amyloid plaques are often observed in combination with \u03b1-synuclein deposition. Co-pathologies in neurodegenerative diseases are now recognized as the norm rather than an exception, but existing neuropathological assessment tools do not capture the complexity of concurrent co-pathologies. Characterization of this co-pathology is critical, as it has the potential to identify synergistic mechanisms. We developed a hierarchical cytoarchitectural classification system, which we applied to an autopsy series of military veterans with parkinsonism (n\u2009=\u200926), focusing on Lewy and neurofibrillary pathologies. We defined co-pathology as Type A (co-morbid), Type B (co-regional), Type C (co-cellular), or Type D (co-aggregate). The regional distributions of each co-pathology subtype were assessed using double-label immunohistochemistry in the frontal cortex, hippocampal formation, and midbrain. The frontal cortex demonstrated only subtypes A-C (no co-aggregates), whereas the midbrain and hippocampus showed all subtypes of copathology (A-D). In summary, we show marked differences in the prevalence and levels of mixed \u03b1-synuclein and tau pathology in this cohort. Our classification system has the potential to be applied broadly for the study of co-pathology in neurodegenerative disorders.<\/jats:p>","DOI":"10.1093\/jnen\/nlaf137","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T13:18:08Z","timestamp":1763731088000},"page":"525-536","source":"Crossref","is-referenced-by-count":1,"title":["A novel hierarchical framework elucidating regional differences in \u03b1-synuclein and tau co-pathology in military veterans with parkinsonism"],"prefix":"10.1093","volume":"85","author":[{"given":"Victoria G","family":"Flores Almazan","sequence":"first","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia F","family":"Laborc","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"De Sanctis","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma L","family":"Thorn","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalilah F","family":"Quintana Mora","sequence":"additional","affiliation":[{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Neurology, James J. 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Peters Veterans Affairs Medical Center , Bronx, NY,","place":["United States"]},{"name":"Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily Yu-Chia","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Ronald M. 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Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Glenn Biggs Institute for Alzheimer\u2019s & Neurodegenerative Diseases, University of Texas Health Science Center , San Antonio, TX,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth H","family":"Walker","sequence":"additional","affiliation":[{"name":"Neuropathology Brain Bank & Research CoRE, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Neurology, James J. 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Loeb Center for Alzheimer\u2019s Disease, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]},{"name":"Department of Artificial Intelligence & Human Health, Icahn School of Medicine at Mount Sinai , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2026052217345887500_nlaf137-B1","doi-asserted-by":"crossref","first-page":"1498756","DOI":"10.3389\/fnagi.2024.1498756","article-title":"Global, regional, national epidemiology and trends of Parkinson\u2019s disease from 1990 to 2021: findings from the Global Burden of Disease Study 2021","volume":"16","author":"Luo","year":"2024","journal-title":"Front Aging Neurosci"},{"key":"2026052217345887500_nlaf137-B2","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1038\/42166","article-title":"\u03b1-Synuclein in Lewy bodies","volume":"388","author":"Spillantini","year":"1997","journal-title":"Nature"},{"key":"2026052217345887500_nlaf137-B3","first-page":"124","volume-title":"Contribution \u00e0 L\u2019\u00e9tude de L\u2019anatomie Pathologique du Locus Niger de S\u0153mmering Avec Quelques D\u00e9ductions Relatives \u00e0 la Pathog\u00e9nie des Troubles du Tonus Musculaire et de la Maladie de Parkinson","author":"Tr\u00e9tiakoff","year":"1919"},{"key":"2026052217345887500_nlaf137-B4","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1136\/jnnp.51.6.745","article-title":"The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson\u2019s disease","volume":"51","author":"Gibb","year":"1988","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2026052217345887500_nlaf137-B5","first-page":"2012;2:a00925","article-title":"Parkinson\u2019s disease and parkinsonism: neuropathology","author":"Dickson","journal-title":". 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