Neuropathology through the ages
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Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 1 of 20
Reflections
Neuropathology through the ages
My life between neurology and neuropathology
Kurt A. Jellinger1
1
Institute of Clinical Neurobiology, Vienna, Austria
Address for correspondence:
Kurt A. Jellinger · Institute of Clinical Neurobiology · Alberichgasse 5/13 · A-1150 Vienna · Austria
kurt.jellinger@univie.ac.at
Additional resources and electronic supplementary material: supplementary material
Submitted: 12 August 2020 · Accepted: 12 August 2020 · Copyedited by: Katy Lawson · Published: 27 August 2020
Keywords: Neuropathology, Clinical neurology, Vienna, Personal reflections
Introduction enced by my late mother, my beloved wife Elisa-
beth, colleagues, patients, friends, and students
When the editors of Free Neuropathology, whom I met during my professional and private life.
Werner and Tibor, approached me about writing an
autobiography for the journal, similar in scope to This essay is intended to encourage young col-
Sam Ludwin’s excellent piece two years ago [1], I leagues to not concentrate exclusively on experi-
confess that I had reservations about writing an mental neuropathology without also considering
autobiography, because I never wanted to talk the practical part of the neurosciences since there
about myself. However, after a lengthy hesitation is an urgent need to inspire young neurologists to
and eager discussions with my wife and my former pursue a double career as both a clinician and neu-
scholar and friend, Hans Lassmann, I realized with a roscientist in order to promote progress in the neu-
certain degree of doubt that, on the threshold of rosciences.
age 90 years, I could perhaps provide some
thoughts about the bridges between clinical neu- Why the appeal of clinical neurology
rology and neuropathology for those who might be and neuropathology?
interested in the experiences of an old neuroscien-
tist. There are three principal reasons to try to uni-
Thus, in lieu of concentrating on my career as fy these two closely connected fields of neurosci-
neuropathologist, I wish to instead write about my ence. First and foremost is the aim to help patients
life in the context of unifying these intrinsically suffering from disorders of the nervous system by
linked but disparate areas within the rapidly pro- trying to make an early diagnosis, provide effective
gressing scientific world: neurology and neuropa- treatment, and promote preventive measures.
thology. This long, and not always easy, path Second, is the ongoing need to apply ever-evolving
through the wide field of practical and theoretical basic scientific approaches to diseases of the nerv-
neuroscience, as well as other interests, was influ- ous system in order to support the clinical neurolo-
Copyright: © 2020 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the Creative Commons license is provided, and any changes
are indicated. The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 2 of 20
gist in elucidating the pathogenesis of disorders After Austria's “Anschluss” to the German
afflicting their patients. Neuropathology should be Reich, I attended a public primary school in Vienna
pursued not just for its own sake but to aid the and later, during World War II, a public secondary
clinician with the mutual goal to improve diagnoses school (Realgymnasium, also in Vienna), where I
and enable successful therapeutic strategies for received basic education in languages, natural sci-
many hitherto incurable disorders. Lastly, there is ences, geography, and history. In 1943, to escape
inherent fascination and fulfillment in using our from air raids on the city, many children were sent
knowledge to elucidate the structure and function to live with farmers in the Batschka, then southern
of the nervous system in the healthy and diseased Hungary, now Serbia. Once there, we had a won-
human individual. derful and peaceful time, though the atrocity of
witnessing the pogroms of Jewish people was never
Based on this knowledge, the neuropa- far from sight or mind.
thologist is able to elucidate much of the back-
ground of disorders of the nervous system using On our way home we passed the then peace-
immunohistochemical, molecular, biological, and ful city of Budapest, which I would see again during
ultrastructural methods not only in autopsy mate- the Hungarian revolution in 1956. Once returned to
rial but also tissues from living patients, including Vienna, in 1944, we had to change school buildings
biopsies, cerebrospinal fluid, and blood. Often, due to bombing damages. Air raids were still so
these images are comparable to modern art (Fig. frequent that I often did not make it home in the
1). The selective and interdisciplinary application of evenings but had to instead seek shelter along the
these methods may enable the neuropathologist to way.
not only make a reasonable diagnosis of many,
though not all, disorders of the nervous system but In September of 1944, we lost our home due
may also provide insight into the complex pathoge- to an air raid and had to wait for a new flat. Around
netic cascades that are responsible for the onset this time, I attended one of the last performances
and progression of such disorders. In this respect, of Schiller's Wallenstein trilogy of plays featuring
the neuropathologist is privileged to act as both a the famous actor Werner Krauss in the Vienna
physician and a basic scientist. Burgtheater. Soon afterwards, all theaters were
closed. On April 13, 1945, during the battle be-
This retrospective will consider highlights and tween German and Russian armies in the city of
drawbacks in my 63 years of life between clinical Vienna, I had my first medical “experience” by
neurology, neuropathology, and private activities. cleaning up brain tissue of Russian soldiers who
Given my many years of work and limited space were killed by the projectile from a German tank.
herein, may my friends, scholars, colleagues, and After my father died in a Russian POW camp in
co-workers excuse that I regrettably could not con- 1947, my mother and I were left alone to overcome
sider all of them in this review. the difficult times after the end of the war. She
worked in her former profession as a dressmaker
Early life and schooling and I became tutor of children.
In 1949, I graduated high school summa cum
I was born May 28, 1931 in Vienna, as the only laude. In that final year, our class contained 18
child to Rosa and Alois Jellinger, both with roots boys and, when we had our final exams, I got excel-
from Upper Austria and Moravia (near Olomouc). lent marks (Fig. 2). After graduation, our class, led
My father was an official in the government of by our Latin teacher, traveled to Rome and Naples,
Lower Austria; my mother, a trained dressmaker, where we enjoyed arts, cuisine, and life in Italy. To
was a housewife. In the prewar years, I had a won- this day, I remain grateful to my many teachers
derful and well-kept childhood filled with summer who encouraged me to liberally approach history
vacations in the beautiful surroundings of Vienna and natural sciences. Years later, one of my favorite
and in the idyllic countryside, while in the city there high school teachers became a patient in my clinic
were increasing tensions, poverty, and changes in with myasthenia gravis, which we treated with
the political atmosphere. I remember Kurt success. Over the years, my classmates and I met
Schuschnigg's radio speech of March 11, 1938, with several times at reunions to remember and discuss
his concluding sentence “May God protect Austria,” previous experiences. The last meeting was 2009 to
after which my father commented, “This will be the celebrate the 50th anniversary of our graduation.
beginning of the end.”
Free Neuropathology 1:25 (2020) Kurt A. Jellinger doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 3 of 20 Fig. 1. (A) MS-like autoimmune encephalitis after repeated subcutaneous injections of lyophilized calf brain cells in male aged 51 years with hemi-Parkinson syndrome. Left hemisphere with prominent periventrivular demyelinated lesion and multiple demyelinated plaques in cortex and subcortical nuclei. From [2] (B) EM image of focal (core) plaque in hippocampus showing dense accumulation of thick amyloid fiber bundles, surrounded by dystrophic neuritic endings and hyperintense structure of myelinated axon. (x 4000). Photo: K.A. Jellinger. (C) Major histopathological changes in Alzheimer’s disease. (C1) Amyloid deposits in the neuropil (plaques) and vascula- ture (CAA) (congo red stain). (C2) Neuritic plaque with dystrophic neurites (Bodian stain). (C3) Neurofibrillary tangles (large arrows) and neuropil threads (small arrows) (Bodian stain). From [3].
Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 4 of 20
Medical school and beyond “Promotio sub auspiciis Praesidentis rei publicae,”
the highest possible distinction for academic
In 1949, I entered the Medical Faculty of the achievements in Austria, in medicine since the end
University of Vienna, where the circumstances of of World War II. In the meantime, I worked as guest
medical education were made far more difficult doctor without salary in the Franz Josef Hospital in
due to the sequelae of the war. For example, we Vienna, within the department of Internal Medicine
worked in the anatomy theater in winter with and Surgery, directed by Prof. Herbert Kraus, later
glassless windows and without warm water. De- chairman of the first Department of Neurosurgery
spite this, and with eight of us were working on a of Vienna Medical School. On April 14, 1956, I was
corpse, we succeeded thanks to the influence of promoted to Doctor of Medicine “sub auspiciis
our professor, Alfred Gisel, a wonderful teacher praesidentis rei publicae,” which I received in the
and enthusiastic anatomist, who, in addition, was uniform of an officer of the Austrian Red Cross (Fig.
medical chief of the Austrian Red Cross. 3).
The curriculum had basic subjects like anato- Hospital years and first experiences
my, chemistry, physics, and physiology for 2 years,
followed by 3 years of theoretical and practical In 1956, once the Soviet army left Budapest
training, beginning with pathological anatomy, subsequent to the bloody uprising of the Hungarian
physiology, pharmacology, and clinical specialties. people, I went with a Red Cross convoy to deliver
Most of our teachers were outstanding, some of medical supplies and blood bottles to the liberated
them scientists of high reputation, such as: Prof. H. citizens of Budapest. We were lucky to return to
Tuppy, chemistry (Nobel Price candidate); Prof. F.T. Vienna before the Russian army reconquered Bu-
Brücke, pharmacology; Prof. G. Schubert, physiolo- dapest.
gy; and Prof. H. Chiari, head of pathological anato- I enjoyed clinical medicine but my major in-
my. During my studies, and despite regular grants, I terest was neuropathology. On January 5, 1957, I
supported myself with work as a paramedic for began as a postdoctoral fellow (wissenschaftliche
physically disabled people, as a tutor for children Hilfskraft) at the Neurological Institute (NI) a.k.a.
and students, and as a writer of short stories for Obersteiner Institute of the Vienna Medical School
newspapers and magazines. headed by Hans Hoff, who was also chairman of
Our clinical teachers were very dedicated and the neuropsychiatric clinic. Founded by Heinrich
regularly organized seminars and clinical practi- Obersteiner in 1882 as a box that was subsequently
cums, but the majority of teaching was much less expanded by Obersteiner's personal expenses, the
practical but more formal and didactic than in the NI became the first interdisciplinary institute of
new curricula. In December 1955, I finished my neurosciences and was visited by many scientists
medical studies, but had to wait for my graduation from Japan, the USA, and other countries.
due to administrative delay since mine was the first
Fig. 2. Our graduation class 1949 together with H.R. Klieba, principal of the Realgymnasium Wien VIII, and Dr. Seifert, our class teacher.
KJ second left in the first row.
Free Neuropathology 1:25 (2020) Kurt A. Jellinger
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Training progress
During the following years, I was trained by
Franz Seitelberger, an internationally renowned
neuropathologist with particular interest in meta-
bolic and neurodegenerative diseases of the nerv-
ous system, who later became dean and rector of
the University of Vienna. I was in charge of brain
autopsies (600 to 1000 per year) and diagnostic
workup of neurosurgical biopsies.
My early scientific work concerned acute de-
myelinating encephalitis following injections of
lyophilized calf brain cells in a patient suffering
from Parkinson's disease (PD) [2] (Fig. 1a). This
particular case, which closely resembled those of
patients who received rabies vaccinations in Japan,
was later re-published as acute autoimmune de-
Fig. 3. Promotion to Doctor of Medicine 1956 in the uniform of myelinating encephalitis [4]. Other projects includ-
a Red Cross officer, with Dr. Heinrich Drimmel, Federal Minis- ed studying the neuropathological side effects of
ter of Education and Science.
the 1958 influenza epidemic and the neuropathol-
ogy of Spring-Summer (tick-borne) encephalitis in
Obersteiner edited a series of publications under Austria, which we described in detail.
the title “Arbeiten aus dem Obersteinerschen Insti-
tut” and books about basic neuroanatomy and In parallel to my work at the NI, I underwent
pathology. Together with the Edinger Institute in specialization in neurology and psychiatry as a
Frankfurt, the NI became one of the leading centers guest doctor at the University Clinic of Neurology
of neurosciences in the world until the beginning of and Psychiatry in Vienna, headed by Hans Hoff,
World War II, when it was directed by Oskar Gagel, between January 1958 and December 1963. Among
an experienced neurooncologist. The NI, together my tutors were Klara Weingarten, an excellent clin-
with the Institute of Histology, occupied the first ical neurologist, and Franz Gerstenbrand, later
floor in a building of preclinical institutes, next to chairman of the Clinic of Neurology, Medical Uni-
the general hospital of the Vienna Medical School versity Innsbruck. We examined patients, both
(Allgemeines Krankenhaus/AKH). Parts of this area clinically and neuropathologically, with chronic
had been bomb-damaged during the war. coma or apallic syndrome (now unresponsive
wakefulness syndrome) following head injury and
My first venture into neuropathology was to those who suffered hypoxic brain damage and
save and reorganize the large collection of slides found a close relationship between the pattern of
that included material from major brain diseases. It brainstem lesions due to intracranial pressure, the
was through this work that I learned the basics of state of consciousness, and clinical outcome.
neuroanatomy and neuropathology. The NI had a
huge library, originally compiled by Obersteiner In addition to hospital work, I was assistant to
himself, which was a treasure trove of rare and Prof. Hoff's lectures in neurology, which was often
antique books, including an original edition of difficult since he wanted the patients' histories and
Thomas Willis' “Circulus arteriosus cerebri,” one of clinical statuses to be in exact accordance with his
the first descriptions of brain vasculature. In 1958, neurology book. I also heard lectures by Prof. Her-
Prof. Franz Seitelberger became director of the NI bert Reisner, an excellent neurologist and psychia-
(Fig. 4). In the same year, I met and immediately trist, who later became chairman of the Clinic of
fell in love with Elisabeth, a beautiful and clever girl Neurology of the University of Vienna. After train-
aged 21 years, born in Brno (then CSSR), who stud- ing in neurology, I worked in the Division of Psychi-
ied English, Russian, and history of arts. We attend- atry, where I got experience in all kinds of psychiat-
ed theaters, operas, concerts, and frequently met ric disorders. On free weekends, I worked as a vol-
in the university library. Elisabeth and I married on untary health officer with the Red Cross.
August 17, 1960.
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On January 1st, 1960, I was promoted from Vienna Medical University, chaired by Hans Chiari,
assistant to consultant (Oberarzt) at the NI. I stud- where I performed general autopsies and brain
ied encephalitis and myelitis following poliomyelitis cutting. I detected the first case of clinically-
vaccination and movement disorders (progressive suspected Creutzfeldt-Jakob disease (CJD), which I
pallidum atrophy and striatonigral degeneration) “stole” in order to study it histologically, with the
with Erwin Neumeyer, who unfortunately died consequence that I was dismissed from the
early. In 1961, Elisabeth and I attended the Interna- morgue. This was the end of my training in general
tional Congress of Neuropathology in Munich pathology, but the relations with this department
where we met all the top scientists in this field. In remained excellent. Between 1963 and 1974, I ad-
1962, after a lecture on chronic vascular myelopa- ditionally worked two afternoons each week as
thy at the 25th Reunion Neurologique in Paris, I chief of the outpatient service of the Anton Proksch
became Membre associé à titre ètranger (associate Institute, a therapy facility for alcoholism and ad-
foreign member) of the French Neurology Associa- diction, in order to supplement my low salary as a
tion. During that time, many excellent neuroscien- university assistant. With Wichard Kryspin-Exner,
tists visited the NI and lectured there, such as Hugo later chairman of the Department of Psychiatry,
Spatz, Hans Jacob, Wilhelm Krücke, chief of the Medical University of Innsbruck, a number of pa-
Max Planck Institute of Brain Research in Frankfurt, pers about the course and prevention of alcoholism
Webb Haymaker, chief of the Armed Forces Insti- were published.
tute of Pathology (AFIP), and Ludo van Bogaert of
Bunge Institute in Antwerp, Belgium, for whom I Full-time neuropathology
had the honor of translating his lectures. A number
of postdocs and research fellows, particularly from In the following years, in addition to routine
Japan, were trained in the NI, such as Mansori postmortem neuropathology and diagnostic biopsy
Tomonaga, Professor at Tokyo University (his work, I examined vascular spinal cord pathology
charming wife was a wonderful soprano singer), and commented on Zülch's vascular “borderline
Riki Okeda (who counted cells in the pons during zones.” Other subjects included spinal cord injuries,
the the night while listening to classical music), and in particular, cervical hyperextension trauma with
many others (see [5]). It was an exciting time in the vascular complications. In January 1963, I earned
international neuroscience community! board certification as specialist (Facharzt) in neu-
Between February and August 1963, I worked rology and psychiatry and returned as a full-time
part-time as guest at the Institute of Pathology, consultant to the NI.
Fig. 4. Briefing with Prof. F. Seitelberger (left) and Dr. H. Hoff (right) in the Neurological Institute, 1958.
Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 7 of 20
In 1965, a postmortem study of a series of an-
oxic-vascular brain lesions resulting from complica-
tions of open heart surgery caused quite an outcry
in the surgical community, but, as a consequence,
the incidence of complications was reduced due to
changed modalities and techniques in cardiac and
vascular surgery. At the International Congress of
Neuropathology in Zurich, I gave a lecture on the
neuropathology of coma and postcomatose en-
cephalopathies. Then, I began experimental studies
of spinal cord vasculature in cats and other animals,
working together with the neurosurgeon Heinrich
Brenner in the experimental laboratory of the de-
partment of surgery. These studies, together with
large human postmortem material, were the basis
for my PhD thesis “Zur Onkologie und Pathologie
der Rückenmarksdurchblutung” (“On the oncology Fig. 5. Brain Cutting with (left to right) Hans Lassmann, Gernot
and pathology of spinal cord blood circulation”), Wöber (neurosurgeon), KJ, and Georg Spiel (later pediatric
neurologist) in the Neurological Institute, 1966. Note the nu-
published in 1966 by Springer Verlag Wien. On Jan-
merous fixed brains in the glass jars in the back.
uary 19, 1966, I was granted the Venia Legendi
(Dozentur, lecturer) in neurology, neuroanatomy,
and neuropathology, and became chief of the Divi- In 1970, invited by M. Mossakowski, head of the
sion of Neuropathology of the NI Vienna. In addi- Polish Academy of Sciences, I lectured about vari-
tion to routine diagnostic work, I lectured about ous neuropathological subjects in Warsaw, Poznao,
general and specific neuropathology, and per- and Kraków, and was impressed by the lifestyle of
formed regular brain cutting sessions for students the political upper class. At the 6th International
and colleagues who were interested in neuropa- Congress of Neuropathology in Paris, where I spoke
thology (Fig. 5). In the same year I received the about delayed radiation lesions of the spinal cord,
Kardinal Innitzer Award for Promotion of Medical Elisabeth and I were overwhelmed by the charm of
Research. France's capital. In Verona, the neuropathology of
the “apallic syndrome” after head trauma was pre-
Atypical encephalitides and spinal cord circu- sented. In the same year, Seitelberger and Igor
lation disorders were presented at the 1st meeting Klatzo, from the NIH, Bethesda, USA, organized an
of the CSSR Neuropathology meeting in Prague in international symposium on axons and axonal flow,
September 1966, where Prof. Bednar, chairman of where I discussed neuroaxonal dystrophy in hu-
die Institute of Pathology of Prague Medical School, mans.
was a charming host. 1967, with W. Sturm, a series
of radiation injuries of the cervical spinal cord with In October 1971 Herbert Budka joined us and
relation to the applied radiation doses was pub- became my assistant for more than three years.
lished. At that time of progressing international We shared routine diagnostic neuropathology.
congresses, publications and oral presentations Herbert recently described the situation and fur-
were increasingly presented in English, and I pub- ther fate of the NI, and became director of the Clin-
lished many articles in Acta Neuropathologica, ical Institute of Neurology, the successor of the NI
founded in 1961 by Franz Seitelberger, who was after its transfer to the Allgemeine Krankenhaus
editor-in-chief until 1987. (see [5]). In 1972, I lectured in Baltimore, Kansas
City (J.J. Kepes' invitation), and New York.
The focus of clinical work and research were
brain tumors, which were discussed in weekly clini- Heinz Regele, later chief of pathology in Linz,
co-pathological conferences with the Department and I observed peculiar things that were described
of Neurosurgery. Tumor cell imprints for rapid di- later by others. This included, in patients with brain
agnosis were introduced, which were confirmed by death, finding cerebellar material around the cervi-
histology with up to 95% concordance. cal and thoracic spinal cord, which dropped down
as sequelae of cerebellar incarceration due to in-
creased intracerebral pressure, later reported as a
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characteristic finding in brain death (vita reducta). formalin to be examined in the NI, an acute train
With Lothar Kucsko, a highly experienced stop resulted some brains falling out of the sacks. I
pathologist and heavy smoker, a postmortem was almost arrested as a suspected mass murderer
transorbital puncture of the brain in a patient with but the awful smell of formalin explained the reali-
clinically-suspected CJD was performed. Under the ty.
electron microscope, I saw ruptured cell mem-
branes, which I initially interpreted as postmortem Later career
artifact, but Peter Lampert from the AFIP published
these findings as typical lesions in CJD [6] - so we In 1973, I was offered the position of chairman
were too late! of the Division of Neuropathology at the Institute
In the course of routine examination of brain of Pathology in Zürich, but as I was number two on
tumor biopsies, I detected a large B cell lymphoma the list, Reinhard Friede was instead appointed. In
in the parietal lobe of a famous conductor. Erwin February 1974, I was offered the position of profes-
Deutsch, chairman of the Department of Internal sor and chairman of the Department of Neuropa-
Medicine, did not believe in my diagnosis, since thology at the Medical University Düsseldorf, Ger-
whole body examination did not show any malig- many, which after 2 years of unsuccessful negotia-
nancy. So I sent slides to Harry Zimmerman, chair- tions and for family reasons, I had to decline. Wolf-
man of neuropathology at Montefiore Hospital in gang Wechsler, then at the Max Planck Institute at
New York, one of the world’s best neuropa- Cologne, got this position which he held until his
thologists and mentor to generations of neuropa- retirement in 1998.
thologists, who confirmed my diagnosis. This pa- In 1975, in collaboration with Andras Guseo, a
tient survived for more than 12 years. Autopsy young neurologist from Székesfehérvár, Hungary
revealed a generalized immunocytoma, but no and guest in the NI, the patterns of inflammatory
tumor residual in the brain. Together with Harry perivascular infiltrates and their impact on the type
and Seitelberger, in 1974, an international sympo- and prognosis of multiple sclerosis were published.
sium on malignant lymphomas of the central nerv- This was the beginning of a fruitful cooperation
ous system (CNS) in Vienna was organized, where with the group of Hans Lassmann, then chief of the
experts discussed the classification of primary lym- Neuroimmunology Division of the Austrian Acade-
phomas of the CNS. my of Sciences and later of the Department of Neu-
In 1972, traumatic vascular diseases of the roimmunology at the Institute for Brain Research in
spinal cord were reviewed for the Handbook of Vienna. In the same year, together with Felicia
Clinical Neurology. With T. Radaszkiewicz, an excel- Slowik, a young neurooncologist from Budapest
lent expert in lymphomas who unfortunately died and guest in the NI, a large collection of biopsy and
too soon, a large collection of primary and second- autopsy-proven meningiomas was examined with
ary lymphomas of the CNS was published. In 1973, impact on the histological specificities and prognos-
Hanno Bernheimer, Oleh Hornykiewicz (who died tic relevance of various subtypes.
May 26, 2020), Walther Birkmayer, Franz Seitel- In between, I was offered the position of head
berger, and I published a highly-cited paper (cur- of the division of Neuropathology at Miami School
rently 3,005 citations) about dopamine in the syn- of Medicine, FL. On this occasion, Elisabeth and I
dromes of Parkinson and Huntington. It was one if toured through the USA and I lectured at various
the first studies that correlated the neuropatholog- universities. We got a deep impression about the
ical findings in the striatonigral system (semiquanti- way of living in the USA, which differed considera-
tative assessment of neuronal loss in substantia bly from ours. A few months later I was offered the
nigra) and the biochemical data (dopamine and its position of head of the Division of Neuropathology
metabolites) in a large number of autopsy cases [7]. at Case Western Medical School of Medicine,
During my time at the NI and afterwards, I ex- Cleveland, OH (successorship of R. Friede). Howev-
tended brain autopsy service to several institutions er, due to personal and family reasons, I declined
outside of Vienna, including the neurological hospi- all these positions.
tal in Linz. Since I had no car, I traveled by train. Since it was impossible to get an independent
Once, on the return trip to Vienna, while transport- position in Vienna,, I finally decided to accept the
ing sacks with freshly-dissected brains soaked with position as Head of the Department of Neurology
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at Lainz Hospital, one of the oldest municipal and completed my first crew. Kothbauer later had to
teaching hospitals in Vienna. It was built between leave the department. Within a few years, I finally
1908 and 1913 together with a large geriatric cen- gathered a crew of 12 neurologists, most of them
tre on the occasion of the 60th anniversary of Em- becoming excellent clinicians. For the neuropatho-
peror Franz Josef's regency and was equipped with logical lab, Mrs. Veronika Rappelsberger followed
all facilities of modern medicine. During Julius Tan- me from the NI. Without her help, I would never
dler's time, a famous anatomist and counselor of have been able to do my routine work and research
health of the City of Vienna, Lainz Hospital became in neuropathology. I had to perform brain autop-
“a second university.” In 2006 it was fused with the sies and biopsies for the whole hospital and geriat-
nearby Neurological Hospital Rosenhügel as a neu- ric center and biopsies for a large neurosurgical
rological center and is currently named Clinic Hietz- department. Since I received no funding from the
ing. city, I had to pay my lab assistant from my own
pocket. The chief of the neurochemistry lab was
On October 12, 1976, I was appointed chief of Peter Riederer, an experienced neurochemist who
the department of Neurology and became director had graduated from the Technical University Vien-
of the Ludwig Boltzmann Institute of Clinical Neu- na and, since 1971, had worked together with Wal-
robiology in January 1977, as successor of Walter ter Birkmayer in the Ludwig Boltzmann Institute
Birkmayer, one of the “fathers” of research in PD. (LBI) of Neurochemistry, the predecessor to the LBI
The Ludwig Boltzmann Society, named after the of Clinical Neurobiology. Later, a number of stu-
Austrian physicist Ludwig Boltzmann, was founded
dents and postdocs joined us.
1960 as an Austrian network of specialized research
institutes in the fields of medicine, humanities, and In addition to my new double functions, in
social sciences, all of which were sponsored by the 1976, I was appointed editor-in-chief of Acta Neu-
City of Vienna and the Austrian government. In ropathologica, after having acted as supplementary
2002, the society was reorganized and the number editor for several years. Between 1976 and 1981 I
of institutes greatly reduced. also edited the series “Current Topics in Neuropa-
thology” with selected papers from meetings of the
So, one career ended and a new area of neu- Austrian Society of Neuropathology. In total, I edit-
roscience began, although many within the Vienna
ed or co-edited 10 books.
neurological community reacted with skepticism
whether a neuropathologist would be able to man- With Peter Riederer, Wolf-Dieter Rausch, a
age a new clinical department. And, indeed, the dedicated post-doc who is currently Professor of
beginning was difficult. The department had 75 Neurochemistry at the Veterinary University of
beds, part of them still occupied by geriatric pa- Vienna, Paul Kruzik, and others, we examined the
tients, a waterbed ward, two trained nurses, and biochemistry of hepatic encephalopathy and the
some auxiliary personnel but only a minimum of mode of action of L-deprenyl in the human CNS.
technical equipment. I had to find coworkers, some Peter left Vienna in 1986 and became Professor of
of whom needed a training position, which was not Neurochemistry and head of Clinical Neurochemis-
easy to organize. In addition to the clinical depart- try at the Psychiatric Clinic of Würzburg Medical
ment, which occupied the ground floor of the build- University until his retirement in 2008. We had a
ing, the histological and neurochemical labs on the successful scientific cooperation and became close
second floor had to be equipped and prepared for friends with him and his wife, Inge. Graduate engi-
functioning. neer Ildiko Wichart, a young neurochemist from
Budapest, also joined our group and worked with
My first coworkers from the previous neuro- us for many years even after her retirement.
geriatric department were M. Podiwinsky, an elder-
ly neuropsychiatrist, and Roda Weiss, a young Ar- In addition to clinical service, with 1,700 to
menian doctor born in Odessa and married to a 2,000 in-patients and an outpatient service with
Viennese lawyer. Soon afterwards, Herbert Flament more than 15,000 consultancies per year, our de-
and Hannes Schmidt, two young neurologists in partment had to perform the neurological and psy-
training from the nearby Rosenhügel hospital, and chiatric consultant service for the whole hospital
two specialists, Peter Kothbauer, nephew of the complex. The clinical crew published about brain
former Minister of Health, Ingrid Leodolter, and tumors, intramedullary metastases, and lympho-
Edith Sunder-Plassmann, wife of a neurosurgeon, mas; while the neurochemistry group wrote about
Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 10 of 20
neurotransmitters in metabolic encephalopathies, and is currently secretary of the World Federation
hepatic coma, brain infarcts, and deprenyl in the of Neurology.
human brain. In June 1976, I gave lectures about
CNS involvement by malignant lympho- Between 1975 and 1980, I wrote the chapter
mas/leukemias and radiation-induced lesions of the of pathology of the nervous system for several edi-
CNS in New York, Philadelphia, and Baltimore. In tions of the working book of pathology, edited by
1977, I received the award of the Vienna University J.H. Holzner, successor of M. Chiari as chief of pa-
Foundation, and in 1979 the Award of the Medical thology of the Vienna Medical University. In 1978,
Scientific Foundation of the City of Vienna. reviews about vascular tumors and malformations
were published, and lectures were given in New
We organized the first neurooncology group in York, Bethesda, and Washington (International
Vienna, in which the preoperative examinations Congress of Neuropathology). Again in collabora-
were done by my department, neurosurgery by the tion with Peter Riederer, the first Austrian-German
Hospital Rudolfstiftung (head H. Brenner), biopsy brain bank was organized and we collected a host
diagnosis, combined radiation, and polychemo- of neurodegenerative diseases, AD, PD, and normal
therapy according to the COMT scheme, and post- controls, all of which was later transferred to Pe-
operative care by our department. We introduced ter's lab in Würzburg. In 1980, with Filippo Gullotta,
modern CSF cytology, and studied cytological first chairman of the Department of Neuropatholo-
changes of gliomas caused by chemotherapy. The gy at Münster Medical School, Germany, and
clinical crew was organized in a way that everyone Miroslaw Mossakowski from Warsaw, the First
had their own specialty: clinical neurology (Edith European Congress of Neuropathology in Vienna
Sunder-Plassmann, Herbert Flament, Roda Weiss, was organized, bringing together many neuropa-
Andrea Vass, Maria Grisold, Dieter Volc); and neu- thologists in our city.
rophysiology (Rembert Vollmer, Wolfgang Grisold).
With Alexander Meng, son of a Chinese professor In the following years, many new associates
of pediatrics and a Viennese mother, and a special- joined our group. Christian Bancher was active in
ist in acupuncture and Traditional Chinese Medi- both clinical and neuropathological research, with a
cine (TCM), a successful multidisciplinary pain clinic focus on neurodegenerative and senile brain dis-
eases, and Werner Paulus, a postdoc from Germa-
was organized.
ny, worked on brain tumors, lymphomas, and iron
Later, we performed the first biomarker and ferritin in PD brains. He later became chairman
screenings (total tau and β-amyloid-42) in CSF for of the Department of Neuropathology at Münster
the early diagnosis of Alzheimer disease (AD). The Medical School and editor-in-chief of Acta Neuro-
department got the first transmission Zeiss EM 9 pathologica until 2019, and is the current editor-in-
microscope in a city hospital, transferred from the chief of Free Neuropathology since 2020.
LBI of Hematology (chief Alois Stacher, both an
experienced hematologist and dedicated politi- My working day was full and split. Often, in
cian). the mornings, I went to pick up fresh brains from
the nearby mortuary and carried them over the
In 1978, our neurochemistry group studied yard to the laboratory to dissect them for the brain
the activity of tyrosine hydroxylase (TH), the key bank, with one half being deep frozen for neuro-
enzyme of the dopaminergic system in the brain chemistry and the other fixed in formalin for histo-
and adrenal medulla. We found that the TH activity logical examination. The first part of the day was
was not only reduced in the striatonigral system by dedicated to clinical work and, after the morning
up to 90% but also in the adrenal medulla by about conference with my coworkers, I went on clinical
74% [8], a fact that questioned later research about rounds twice a week and every Saturday. In be-
transplantation of adrenal glands in patients with tween, I saw patients in the outpatient department
PD and would go on to save billions of dollars. or had conferences with other clinicians or neuro-
scientists. Meals were eaten together with doctors
In the background of this research, a laborato- and nurses in the kitchen of the ward. The after-
ry for muscle diseases and electromyography was noons were dedicated to neuropathology, brain
opened with Wolfgang Grisold, one of the best cutting, and sign out (about 700 brains per year), or
clinical neurologists and neurophsiologists. He later research in the EM lab (Fig. 1b). In addition, I pre-
became chief of the Neurology Department of pared a catalogue of all in-patients and their diag-
Franz Josef Hospital, the LBI for Neurooncology,Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 11 of 20
noses on cards intended to be computerized later, no computers or internet and I often read articles
which unfortunately was not possible at that time. I and proofs during bathing in our home, the journal
routinely read the letters of dismission (discharge) caused some tension in our private life.
of patients, since all of my associates had to pre-
pare these letters spontaneously – “trust is good Many of the clinical and clinicopathological
but control is better.” This usually lasted until night. presentations were performed together with
Besides the clinic and the institute, I ran a small members of my team, in particular with Wolfgang
private praxis once or twice a week, together with Grisold, one of the best neurologists I ever met,
Elisabeth, who was an ideal and helpful companion, Dieter Volc, later chief of the Parkinson service in a
loved by most of our patients. In addition, I served private clinic, and Mrs. Elisabeth Kienzl, student of
the Technical University Vienna and one of my best
as court-certified expert witness for insurance
companies or courts. So, my clinical duties were as assistants in the laboratory. With Andreas Rett, an
broad as my scientific interests, which suited me experienced neuropediatrist, a large number of
very well and was tolerated by Elisabeth with great brain malformations were studied. Franz Seitel-
patience. berger, Dawna Armstrong, an outstanding pediatric
neuropathologist from Houston, Texas, and I were
International activities: the roaring among the first to extensively study the morpholo-
gy and neurochemistry of Rett syndrome. In 1985, I
eigthies attended workshops in Baltimore and Bethesda,
and was regularly invited to the annual meeting of
In 1980, I was invited to speak by Prof.
the British Neuropathological Society. In addition to
Hoshino, chairman of the Department of Neurosur-
neurodegenerative disorders, the morphology and
gery, Teikyo University, Tokyo, one of the founders
biochemistry of schizophrenia was studied with my
of high dose irradiation of brain tumors. In addition
cousin Eberhart Gabriel, director of the Vienna
to lecturing, I reclassified the tumor collection of
Psychiatric Otto Wagner Hospital and renowned
this department. During my 3-week stay in Japan, I
historian in psychiatry.
got deep insights into the Japanese lifestyle, cul-
ture, and cuisine, not only in big cities but also in In 1986, I edited the book “Therapy of Malig-
the countryside. Also around this time, I presented nant Brain Tumours” (Springer Verlag, Vienna), in
holoprosencephaly and agenesis of the corpus cal- which international experts reviewed pathology,
losum at the meeting of the American Association imaging, neurosurgery, radiation, and chemothera-
of Neuropathology in Vancouver, Canada. py of brain neoplasms. Between 1986 and 1999, I
published chapters about neurodegenerative dis-
In 1982, together with F. Seitelberger, and H.
eases, brain tumors, and spinal circulation disor-
Lassmann, the 9th International Congress of Neu-
ders in the book series “Neurology in Clinic and
ropathology in Vienna was organized, one of the
Practice” and, in 1987, about pallidal degeneration
most important meetings of this specialty in Vienna
in the “Handbook of Neurology.” In September
that was visited by about 700 specialists from all
1986, Elisabeth and I visited Stockholm for the 10th
over the world. At a meeting about advances in
International Congress of Neuropathology, where I
neurotraumatology in Milan, October 1982, I pre-
presented Rett syndrome and changes of subcorti-
sented brain stem involvement in blunt head inju-
cal nuclei in AD and PD. We were overwhelmed by
ries and Elisabeth and I were welcomed by our
this charming city and the hospitality of its citizens.
Italian colleagues and we thoroughly enjoyed their
In September 1986 I attended the workshop “Histo-
hospitality and the flair of the city.
logical Classification of Tumors of the Nervous Sys-
Again with Peter Riederer, metabolic brain tem” in Houston, Texas, which initiated a new clas-
diseases, Dopa and tryptamine binding, selegiline sification of brain neoplasms (Fig. 6). In May 1988, I
effects, and lisuride in the treatment of PD were participated in the preparation of the 11th Interna-
studied, thus broadening my experience beyond tional Congress of Neuropathology 1990 in Kyoto
neuropathology. At a 1984 symposium on Parkin- and gave lectures in Tokyo, Sendai, and Niigata,
sonism in Bermuda, I was impressed by this won- where Elisabeth and I were hosted by Professor
derful island. Between clinical work, congresses, Iikuta, head of the Institute of Brain Research in
routine neuropathology, and publishing scientific Niigata and his wonderful wife, who spoke perfect
papers, my editorial work for Acta Neuropathologi- English. Here, we saw the other side of the Japa-
ca occupied much of my private time. Since we had nese island (Figs. 7 and 8).Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 12 of 20
Fig. 6. Brain Tumor meeting in Houston, Texas, 1988, with (left
to right) Lucien Rubinstein, KJ, Lucy Rosko and Paul Kleihues. Fig. 8. Neuropathology and hospitality in Niigate, 1988.
In March 1989, we had a wonderful Austrian
Neuroscience Winter Meeting at Kitzbühel, and in More work, more congresses
April 1989 I discussed Lewy bodies at a Parkinson
symposium in Chicago. The pathology of Parkinson In April 1990, I participated in The WHO Meet-
syndrome was published in the Handbook of Exper- ing on Histological Classification of Tumors of the
imental Pharmacology, edited by Donald Calne, a CNS, organized by my friend Paul Kleihues, chair-
pioneer of PD research. Between 1989 and 1991, man of neuropathology in Zürich and later director
Felicia Slowik, a highly experienced neurooncologist of the WHO International Agency for Research on
in Budapest worked with me on hemangiopericy- Cancer in Lyon, France. Werner Paulus and I, to-
tomas, the ultrastructure of malignant lymphomas, gether with 25 other distinguished brain tumor
and cerebral sarcomas. With Werner Paulus, the experts, participated in the meeting of the Blue
neuropathological basis of different clinical sub- Book’s Classification of Brain Tumours. The 2nd
groups of PD and their clinical relevance were stud- edition followed in 1993, the 3rd edition in 1997,
ied. In 1991, I received the City of Vienna Prize for and another in 2000, following a meeting in Lyon in
Medical Sciences. The next year, together with E. 1997, where I also participated. In its update, reti-
Kienzl and Emin Sofic, now professor of pharma- tled “Pathology and Genetics of Tumours of the
cology, Faculty of Sciences, University of Sarajevo, Nervous System,” edited by P. Kleihues and W.
selective increase of iron in the SN of PD and Cavanee, with Werner Paulus, malignant lympho-
changes in the iron-melanin complex in the SN of mas, histiocytic tumors, and melanotic lesions were
PD brains with X-ray microanalysis were studied reviewed. In August 1990, I presented primary cer-
and presented at the Meeting of the Canadian As- ebral lymphomas at the International Cancer Con-
sociation of Neuropathology, September 1992 in gress in Hamburg, and in September 1990, Elisa-
Toronto, Canada. beth and I visited the 12th International Congress
of Neuropathology in Kyoto, where we were hosted
by Prof. Yonezawa, who is not only an excellent
neuropathologist but also a gourmet and friend of
the good life. Further highlights were the 5th World
Congress of Biological Psychiatry in Florence in June
1991, where I presented pathomorphological as-
pects of schizophrenia, and the 10th International
Symposium of Parkinson's Disease in Tokyo in Oc-
tober 1991. At the Paneuropean Congress of Neu-
rology in Vienna, December 1991, the results of the
Vienna Longitudinal Study of Dementia were pre-
sented, which showed correlations between cogni-
tive impairment and quantitative Alzheimer pa-
Fig. 7. Visit to Yashiko Shrine Hiigata, May 1988 with Prof. thology.
Kreutzberg and Prof. Ikuta.Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 13 of 20
With Christian Bancher, the neuropathology of ety of Psychopharmacology from 1994 to 2000;
progressive supranuclear palsy (PSP) was reviewed member of the FSN study group of neuropathology
in a book edited by Irene Litvan and Yves Agid. At from 1987 to 2000; vice president of the Austrian
this time, the clinical department was fully devel- Alzheimer Society from 1997 to 2002; president of
oped and successful, including a new laboratory for the Viennese Association of Psychiatry and Neurol-
ultrasound examination of the cerebral vascula- ogy in 1986/87; and president of the Austrian Soci-
ture. Upon the 80th anniversary of Lainz Hospital, a ety of Neurology and Psychiatry from 1990-1992.
Festschrift was published in 1993 that documented From 1994 to 2000, I was a member of a commit-
the progress of our department. In April 1993, the tee reporting on neuroscience in Austria, on behalf
neuropathology and classification of PSP was dis- of the Austrian Ministry of Sciences. Based on these
cussed in Bethesda, MD, and I received the Eloise data, a national program for neuroscientific re-
Troxel Memorial Grant of the Society for Progres- search for Austria was prepared in 1966, coordi-
sive Supranuclear Palsy, Baltimore, MD. nated by the LBI of Clinical Neurobiology as a basis
for Austria's entry into the European Union.
At meetings in Tokyo in April 1994, I lectured
on new developments in AD and the pathogenesis With increasing age, I became member and
of PD. A further highlight was the 12th Internation- honorary member of national and international
al Congress of Neuropathology in Toronto in Sep- scientific societies, including the American, British,
tember 1994, where our group presented new data German, Hungarian, and Austrian Societies of Neu-
about cell death detected by DNA fragmentation ropathology, the German Societies of Neurology
and phospholipids in the Alzheimer brain. In 1994, and Pathology, the Austrian Neuroscience Associa-
together in a working group of Hans Lassmann, tion, honorary member of the Austrian and German
pathogenetic problems of multiple sclerosis were Parkinson Societies, the Scientific Commission of
studied. That same year, with Werner Paulus, ad- the German Hirnliga, among many others. During
vances in the pathology of primary CNS lymphomas these years, I reviewed articles for multiple nation-
was also studied. A number of neurodegenerative al and international journals and became editor or
disorders, like PSP, multiple system atrophy (MSA), member of the editorial board of many of them.
and corticobasal degeneration (CBD) were studied
in cooperation with an international group headed The great adventure: first Austrian
by Irene Litvan, now at University of California, San
Diego, USA.
neurologist in central China
In 1995, Christian Bancher and I described the In March 1996, a delegation from the Austrian
neurofibrillary predominant form of senile demen- Society of Neurology was invited by the Chinese
tia, a rare subtype with low APOE ε4 genotype, Ministry of Health to visit medical institutions and
which recently was renamed primary age-related hospitals in China. This included 6 persons: Hans
tauopathy (PART) [9]. In 1995, the pathology of and Jutta Lassmann, Alexander Meng, Christian
AIDS encephalopathy and, together with Herbert's Bancher, Barbara Zeman, and myself. The tour was
group, the neuropathology and diagnostic criteria organized and guided by Mrs. Zhou Quin, program
of CJD and other spongiform prion diseases were officer of the Department of International Coopera-
studied. In October 1995, I attended the Workshop tion of the Chinese Ministry of Health (Fig. 9).
on Dementia with Lewy bodies (DLB) in Newcas-
We visited China from March 31 to April 14,
tle/Tyne, a dementing disorder hardly known at
1996. In Beijing, we were informed about the
that time, and the guidelines for its diagnosis were
health organization in the People’s Republic of Chi-
published in the journal “Neurology” in 1996.
na. During the weekend, we visited the Great Wall,
the Ming graves, and the Imperial Palace. We then
Organizations and committees toured the neurological clinics of Beijing Hospital
and of Capital Medical College, the two largest
Through the years, I was elected to various na- hospitals in the city, where Hans and I gave lectures
tional and international scientific organizations and about multiple sclerosis (MS) and PD. We flew to
committees. I served as vice president of the Inter- Chengdu, the capital of Sichuan, the largest prov-
national Society of Neuropathology between 1981 ince of China, where we visited the Medical College
and 1984; was chairman of the EU working group for Traditional Chinese Medicine, which consisted
from 1996 to 1999; secretary of the European Soci-Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 14 of 20
of traditional and Westernized parts, the first spe- volved in the scandal about the euthanasia of hand-
cializing in acupuncture and other traditional icapped children in the Vienna psychiatric institu-
methods. tion “Am Spiegelgrund” during Nazi times, and I
was asked to take over his LBI for the research of
malformations of the CNS, located in the Psychiat-
ric Hospital Baumgartner Höhe, which was now
combined with the LBI of Clinical Neurobiology.
While the formalin-fixed brains of these children
were stored in the cellar of the Institute of Pathol-
ogy of this hospital, blocks of those brains had been
secretly stored somewhere in the premises of these
former LBIs and I had the difficult task to find these
materials from the archives so that they may be
buried in a special memorial, which took place in
2002. This required much time to locate the specif-
ic material, to which I never had access before,
Fig. 9. First delegation of Austrian neurologists in central China,
while other specimens had been stored in the ar-
with Hans Lassmann, KJ, Zhou Quin, Jutta Lassmann, Barbara chives of the NI (see [5]). This affair was discussed
Zeman, Christian Bancher (left to right). in the popular media and had unforeseen political
consequences, which hurt me, but I will not go into
We visited the largest herbal pharmacy of details.
China and were invited to an herb dinner. On April In 1996, together with Norbert Rösler, a post-
6, a Sino-Austrian Symposium on Neurosciences doc from Germany, the validity of CSF biomarkers
was organized in which lectures about MS, PD, and (total tau and Amyloid-β-42) in the diagnosis of AD
other topics were presented. By invitation of the was studied. Christian Bancher and I visited an Alz-
Minister of Health of Sichuan, we visited the Min heimer Congress in Osaka, Japan, and reported
river and the Buddhist grove sanctuaries in Bao- about the structural basis of dementia in AD and
dingshan and Beishan, which impressed us very PD. The next year was of great importance for the
much. After a short visit to Chongqing, a city with department and myself, since I had reached the
many respiratory diseases and lung cancers, we age of retirement from active service. However, my
traveled by ship down the Jangtze River to Wuhan contract was prolonged for an extra year, during
and visited the largest hospital of Hubei province, which we opened a stroke unit with 4 beds for sur-
which had modern technical equipment and many veillance and intensive treatment of patients with
German-trained professors. The journey on the acute stroke. Furthermore, Christian Bancher got
Jangtse River, with the three gorges, was one of the the lectureship (Dozentur) in neurology and neuro-
most impressive adventures in our life. pathology. In the years before, two other associ-
We experienced China's culture, landscape, ates, Rembert Vollmer (neurology and neurophysi-
and people, and passed the largest hydroelectric ology) and Wolfgang Grisold (neurology) had got
power station in China spanning the Yangtse River, their Dozentur.
which at that time was in construction and consid- On September 30, 1997, I retired from my po-
ered one of the most impressive technical projects. sition as director of the department of Neurology
For reasons of time, a visit to Shanghai was not at Lainz Hospital, but remained chief the LBI of
possible, and we returned to Vienna. In conclusion, Clinical Neurobiology, which was transferred to a
all of us were deeply impressed by the landscape, building in the Psychiatrical Otto Wagner Hospital.
the historical relics, culture, health institutions, life Together with my lab assistant, Mrs. Rappels-
in the countryside, and, in particular, by the friend- berger, I continued neuropathological routine work
ly hospitality of our Chinese colleagues. examining brains from a large psychiatric and geri-
atric hospital. Unfortunately, the archives of all the
Difficult times and new challenges in-patients during the last 22 years, including the
neuropathological protocols and brain material,
In 1996, the Ludwig Boltzmann Society decid- was not available any more.
ed to dismiss Heinrich Gross, who had been in-Free Neuropathology 1:25 (2020) Kurt A. Jellinger
doi: https://doi.org/10.17879/freeneuropathology-2020-2945 page 15 of 20
My successor was Dozent Manfred Schmid- whom a long-lasting and fruitful cooperation and
bauer, an excellent neurologist interested in neu- deep friendship began.
ropathology, book author, and painter. After the
fusion of Lainz Hospital with the nearby Neurologi- In 2000, I received the Burda Award of the
cal Hospital Rosenhügel, Schmidbauer had to suc- Austrian Parkinson Society. In the same year, I was
ceed the retired Gernot Schnabert as chief of both invited as guest professor at the Medical University
neurological departments. In addition, he contin- of Graz, where I lectured about many subjects of
ued routine neuropathology with focus on periph- clinical and theoretical neuropathology in the Clinic
eral nerve biopsies. He retired in 2016 and became of Neurology under chairmen Erwin Ott and later
Professor of Neurodegenerative Diseases at the Hans-Peter Hartung, now chairman of neurology in
Düsseldorf, Germany. It was a wonderful time in
Sigmund Freud Private University in Vienna. He was
succeeded by Christoph Baumgartner, a highly- the beautiful city of Graz and its surroundings,
qualified epileptologist. However, this marked the which I enjoyed very much. It was a leisure living
end of neuropathology, which I had initiated and compared to Vienna.
continued for 22 years. But I overcame this blow In 2000, we described cell death mechanisms
and continued scientific work. In addition to a small in PD and, in 2001, AIDS-related pathologies before
private praxis, I worked as a court-certified expert and after antiretroviral therapy. Since 2002, I
and still write second opinion expertises about helped the Pathological Bacteriological Institute of
difficult neurological problems. the Otto Wagner Hospital in the diagnostic workup
In October 1998, I presented data about of postmortem brains, mainly from elderly de-
movement disorders, malignant lymphomas, Lewy mented and non-demented individuals. I per-
body disease, and tangle dementia in New York, formed brain cuttings once a week, and instructed
Washington, Bethesda, and Montreal. At the 6th colleagues how to dissect brains, which were exam-
Conference on AD and related disorders, in Am- ined in the LBI. My trainee and friend Johannes
sterdam in July 1998, I described vascular dementia Attems, then assistant at the local Institute of Pa-
and its relation with AD and received the Alzheimer thology, examined the cases and we discussed
Obelisk (Fig. 10). them together between 2000 and 2008, thus giving
him an excellent basis for his future career and a
In 1999 and 2000, the foci of my interests fruitful cooperation resulting in a number of shared
were PD and related disorders, in particular MSA, publications. Since 2009, Johannes is Professor of
as well as mechanisms of neuronal cell death, in- Neuropathology and head of the brain bank at
cluding apoptosis. With Hallinah Baran, an experi- Newcastle University in England and, since recent-
enced neurochemist, later at the Veterinarian Uni- ly, editor-in-chief of Acta neuropathological as suc-
versity Vienna, we studied kynurenine metabolism cessor of Werner Paulus.
in AD, and with Christine Stadelmann, then assis-
tant in Lassmann's institute and now director of the In 2002, I received the prestigious award for
Institute of Neuropathology, University Göttingen, Meritorious Contribution to Neuropathology by the
we studied cell death mechanisms in neurodegen- American Association of Neuropathology, together
erative diseases. with S. Horoupian, Professor Emeritus at Stanford
University in the USA and Fusahiro IIkuta, director
At a traditional medicine symposium in Vien- of the Brain research center at Niigata University,
na, I discussed the basis and impact of acupuncture Japan. The laudation of my award was written by
in neurology. The same year, I was invited as guest Robert D. Terry, one of the most important neuro-
professor of neuropathology at the Medical Univer- pathologists of the 20th century and co-founder of
sity Innsbruck, where I gave block lectures and US Alzheimer research (Addendum). We met on
seminars for students and colleagues. Since the several occasions, including a visit to his home in
Innsbruck University had no neuropathology at that California approximately one year before his death
time, I examined a number of autopsy cases of rare in May 2017.
movement disorders, such as MSA and PSP. The
symposium was hosted by Prof. Werner Poewe,
chairman of Neurology, and Gregor Wenning, later
chief of the Division of Clinical Neurobiology, withYou can also read
