DIMENSIONS Winter 2001


by Julie Cleveland

Dr. David Nochlin has been a neuropathologist in the University of Washington (UW) Department of Pathology since 1986. Neuropathology is the branch of medicine that examines tissue specimens related to the nervous system including the brain, spinal cord, nerves and muscle. The majority of work that neuropathologists do is to examine specimens that come from the operating room, such as a sample from a patient who is having surgery because of a brain tumor. The neuropathologist examines the lesions under the microscope, and presents a medical description of those lesions. Neuropathologists also perform autopsies, to examine the brain after a patient dies. The diagnosis of degenerative neurological diseases, such as dementia, is confirmed by autopsy. One obvious change in the brain that occurs with all types of dementia is atrophy, or shrinkage of the brain. "However," states Dr. Nochlin "atrophy can be caused by many diseases, so we have to find the microscopic lesions that pertain to each individual disease. In Alzheimer's disease (AD) we look for neuritic plaques and neurofibrillary tangles; in Pick's disease we look for Pick bodies and Pick cells; in Cruetzfeld-Jacob disease we look for spongiform changes."

Dr. Nochlin conducts the neuropathological diagnostic assessment for four major studies being conducted at the UW: The Alzheimer's Disease Research Center's Core C longitudinal study (Dr. Murray Raskind, P.I.) and familial AD project (Dr. Thomas Bird, P.I.), the KAME project on Asian Americans with dementia, and the ADRP Alzheimer's Disease Patient Registry (Dr. Eric Larson, P.I. for both studies). About 115-120 brains are examined every year including referrals from community pathologists of approximately three brains per week. In their studies, Dr. Nochlin and his colleagues discovered that familial (early onset) AD and sporadic (late onset) AD have the same pathology. The main difference is related to the age of onset of the disease; typically, the younger the patient's age of onset, the greater the amount of neuritic plaques and neurofibrillary tangles found upon examination.

The aspect Dr. Nochlin enjoys most about his work is finding differences in every brain he examines. Different types of dementia have different pathologies, and even among patients with the same type of dementia, there are differences between patients. Dr. Nochlin states, "Even if the dementia is very severe, where the brain is riddled with plaques and tangles, it's greatly variable from area to area from frontal, to parietal, to temporal, to occipital."

Dr. Nochlin received his M.D. from the National Autonomous University of Mexico in 1972. The following year, he moved to the U.S., and has been a physician here for 27 years. He likes to keep informed about international news especially what is happening in his native country of Mexico. Every year he makes a month-long trip to Mexico City to visit his relatives. When not at work, Dr. Nochlin is a self-proclaimed "home-body," and enjoys reading, watching TV and movies, and exercising.

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