{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:17:26Z","timestamp":1787015846299,"version":"build-2736575974"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropathology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Alzheimer's disease (AD) is the leading cause of dementia in the elderly, marked by abnormal protein buildup (beta\u2010amyloid and tau) resulting in neuronal loss, especially in the medial temporal lobe and other limbic regions. The presence of transactive response DNA binding protein 43 (TDP\u201043) immunoreactive inclusions in medial temporal lobe regions has also been associated with neuroimaging changes in limbic regions. It has been proposed that hypometabolism in limbic regions on [\n                    <jats:sup>18<\/jats:sup>\n                    F] fluorodeoxyglucose positron emission tomography (FDG\u2010PET) in a patient with a slowly evolving amnestic syndrome may be a signature of the presence of TDP\u201043. In this context, we observed an 86\u2010year\u2010old Caucasian female with dementia characterized by a slowly evolving amnestic syndrome, along with focal medial temporal atrophy evident on MRI and hypometabolism in limbic regions on FDG\u2010PET. The patient subsequently died and underwent an autopsy. We performed detailed neuroimaging and digital neuropathological analyses of the hippocampal subfields to better understand the relationship between clinico\u2010imaging findings and histopathology. In addition to TDP\u201043, we identified three other pathological processes in the medial temporal lobe: sequestosome\u20101\/p62, argyrophilic grain disease (AGD), and primary age\u2010related tauopathy (PART). Hippocampal subfield volumes and rates of atrophy were no different from those of matched healthy controls, except for the atrophy rate in cornu ammonis 1 (CA1). Digital histopathology revealed the relative highest burden of pathology for p62, followed by TDP\u201043, AGD, and PART in CA1. Multiple pathological processes appear to have contributed to the hippocampal atrophy and hypometabolism in our patient with a slowly progressive amnestic syndrome.\n                  <\/jats:p>","DOI":"10.1111\/neup.70000","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T03:11:30Z","timestamp":1740021090000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Multiple Neuropathologies Underly Hippocampal Subfield Atrophy in a Case With a Slowly Progressive Amnestic Syndrome: Challenging the Notion of Pure\n                    <scp>LATE<\/scp>\n                    \u2010\n                    <scp>NC<\/scp>"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8876-8038","authenticated-orcid":false,"given":"Hossam","family":"Youssef","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota 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