Acta Neuropathologica

, 116:269

Glial cytoplasmic inclusions in neurologically normal elderly: prodromal multiple system atrophy?

Authors

  • Hiroshige Fujishiro
    • Departments of Pathology (Neuropathology) and NeuroscienceMayo Clinic College of Medicine
  • Tae-Beom Ahn
    • Departments of Pathology (Neuropathology) and NeuroscienceMayo Clinic College of Medicine
  • Roberta Frigerio
    • Department of NeurologyMayo Clinic
  • Anthony DelleDonne
    • Departments of Pathology (Neuropathology) and NeuroscienceMayo Clinic College of Medicine
  • Keith A. Josephs
    • Department of NeurologyMayo Clinic
  • Joseph E. Parisi
    • Department of Laboratory Medicine and PathologyMayo Clinic
  • J. Eric Ahlskog
    • Department of NeurologyMayo Clinic
    • Departments of Pathology (Neuropathology) and NeuroscienceMayo Clinic College of Medicine
Original Paper

DOI: 10.1007/s00401-008-0398-7

Cite this article as:
Fujishiro, H., Ahn, T., Frigerio, R. et al. Acta Neuropathol (2008) 116: 269. doi:10.1007/s00401-008-0398-7

Abstract

In this study, we used immunohistochemistry to screen for α-synuclein pathology in the brains of 241 individuals without clinical evidence of neurologic disease, and discovered 36 cases (15%) with incidental Lewy bodies (LBs) and one case, a 96-year-old woman (0.4%), with inclusions similar to those seen in multiple system atrophy (MSA), a non-familial neurodegenerative disorder characterized by parkinsonism, cerebellar ataxia and autonomic dysfunction and α-synuclein immunoreactive glial cytoplasmic inclusions (GCI). In a routine hospital autopsy series of 125 brains, we detected GCI in a neurologically normal 82-year-old man (0.8%). Both cases showed widespread GCI in the central nervous system, as well as a few neuronal cytoplasmic inclusions, but no neuronal loss or gliosis in vulnerable brain regions, including the substantia nigra, putamen, inferior olive and pontine base. Applying a recently proposed grading scale for MSA, the two cases showed pathology far below that detected in patients with clinically overt MSA, suggesting the possibility that these two individuals had preclinical MSA. The prevalence of clinically overt MSA is estimated to be about 4 per 100,000 persons (0.004%), which is far less than the frequency of GCI in this series (0.4–0.8%). Further studies are needed to determine if GCI in neurologically normal elderly represents prodromal MSA or a rare non-progressive age-related α-synucleinopathy.

Keywords

α-SynucleinClinicopathologicGlial cytoplasmic inclusionMultiple system atrophyPreclinical

Copyright information

© Springer-Verlag 2008