Subspecialty	Neuropathology
Gender	Male
E-mail	daniel.perl@mssm.edu
Education and Training	MD, S.U.N.Y., Downstate Medical Center
	M.D., Columbia University
	Residency, Anatomic Pathology, Yale-New Haven Hospital
	Residency, Pathology, Yale-New Haven Hospital
	Fellowship, Neuropathology, Yale-New Haven Hospital

Clinical Interests
Neuropathology dementia, nerve & muscle disease, neurotoxicology, and forensic neuropathology.

Education and Training	MD, S.U.N.Y., Downstate Medical Center
	M.D., Columbia University
	Residency, Anatomic Pathology, Yale-New Haven Hospital
	Residency, Pathology, Yale-New Haven Hospital
	Fellowship, Neuropathology, Yale-New Haven Hospital
Board Certification	Neuropathology

Subspecialty	Neuropathology
Board Certification	Neuropathology

Environmental Factors in Neurodegenerative Disease
The Experimental Neuropathology laboratory is involved in the study of the role of potential environmental factors in the pathogenesis/etiology of the neurodegenerative diseases commonly encountered in the elderly. Our current studies involve work on Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis (Lou Gehrig's disease). We were the first to identify the accumulation of aluminum in the neurofibrillary tangles of Alzheimer's disease and in amyotrophic lateral sclerosis/parkinsonism-dementia complex seen in high frequency among the natives of the island of Guam. In this work we employ highly precise and sensitive tissue microprobe techniques including laser microprobe mass analysis of LAMMA. Animal models of chronic neurotoxicity are also employed to understand mechanisms by which environmental factors may enter the central nervous system and produce chronic progressive neuronal degeneration. For example, we have found that certain organic aluminum compounds can gain widespread access to the central nervous system following intranasal exposure.

We are also involved in detailed descriptive studies to document the extent and distribution of various neuropathologic lesions in human brains which have been obtained at autopsy from patients affected by a wide range of neurodegenerative diseases. We are particularly interested in the extent of overlap between the morphologic changes encountered in what have been classically considered to be separate and distinct clinical disorders.

Akram A, Christoffel D, Rocher AB, Bouras C, Kovari E, Perl DP, Morrison JH, Hermann FR, Haroutunian V, Giannakopoulos P, Hof PR. Stereologic estimates of total spinophilin-immunoreactive spine number in Area 9 and the CA1 field: relationship with the progression of Alzheimer's disease. Neurobiol. Aging 2008; 29: 1296-1307.

Geser F, Winton MJ, Kwong LK, Xu Y, Xie SX, Igax LM, Garruto R, Perl DP, Galasko D, Lee VY, Trojanowski JQ. Pathological TDP-43 in parkinsonism-dementia complex and amyotrophic lateral sclerosis of Guam. Acta Neuropathol 2008; 115: 133-145.

Yang W, Woltjer RL, Sokal I, Pan C, Wang Y, Brodey M, Peskind ER, Leverenz JB, Zhang J, Perl DP, Galasko DR, Montine TJ. Quantitative proteomics identifies surfactant-resistant alpha-synuclein in cerebral cortex of parkinsonism-dementia complex of Guam but not Alzheimer's disease or progressive supranuclear palsy. Amer. J. Pathol. 2007; 171: 993-1002.

Perl DP, Olanow CW. The neuropathology of manganese-induced parkinsonism. J. Neuropathol. Exp. Neurol. 2007; 66: 675-682.

Esiri MM, Perl DP. Oppenheimer's Diagnostic Neuropathology, A Practical Manual, 3rd Edition. London, Hodder Arnold Press; pp1-566.

Perl DP. Aluminium exposure and the subsequent development of a disorder with features of Alzheimer's disease. J. Neurol. Neurosurg, Psychiat. 2006; 77: 811.

Beeri MS, Rapp M, Silverman JM, Schmeidler J, Grossman HT, Fallon JT, Purohit DP, Perl DP, Siddiqui A, Lesser G, Rosendorff C, Haroutunian V. Coronary artery disease is associated with Alzheimer's disease neuropathology in APOE 4 carriers. Neurology 2006; 66: 1399-1404.

Perl DP, Moalem S. Aluminum and Alzheimer's disease, a personal perspective after 25 years. J. Alz. Dis. 2006; 9: 291-300.

Rapp MA, Schnaider-Beeri M, Grossman HT, Sano M, Perl DP, Purohit DP, Gorman JM, Haroutunian V. Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Arch Gen Psychiatry 2006; 63: 161-167.

Winton MJ, JOYCE S, Zhukareva V, Pratico D, PERL DP, MD, Galasko D, CRAIG U, TROJANOWSKI JQ, LEE VY. Characterization of tau pathologies in gray and white matter of Guam parkinsonism-dementia complex. ACTA Neuropathol 2006; 111: 401-412.