(A) A coronal slice from the left cerebral hemisphere demonstrates ventricular dilatation with atrophy of the frontal lobe, caudate nucleus, and amygdala. In the midbrain, there is severe pallor of the substantia nigra (arrows). (B) Histological examination of the frontal lobe by hematoxylin and eosin staining shows thinning and spongiosis of the cortex. (C) Severe loss of pigmented neurons in the substantia nigra is confirmed with residual free neuromelanin in the neuropil (arrow and inset). (D) TDP-43 immunohistochemistry in the frontal lobe shows neurons with loss of the normal nuclear staining pattern and containing cytoplasmic inclusions (arrows and inset), in addition to scattered short neurites (arrowheads). (E,F) Argyrophilic grains in the subiculum are highlighted by immunohistochemistry for p62 (E) and four-repeat tau isoforms (F). Scale bar, 300 µm (B), 120 µm (C), 30 µm (C inset, D,E,F), and 20 µm (D inset).