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Abundant neuritic inclusions and microvacuolar changes in a case of diffuse Lewy body disease with the A53T mutation in the α-synuclein gene

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Abstract

We report here a case of diffuse Lewy body disease with the A53T mutation in the α-synuclein gene. The proband presented at the age of 41 years with parkinsonism that was poorly responsive to levodopa. She subsequently developed cognitive impairment and moderate dementia, and died at the age of 50. Her father, paternal grandfather and uncle were all reported to have suffered from Parkinson’s disease. Staining of tissue sections from the proband’s brain with hematoxylin-eosin and α-synuclein antibodies showed small numbers of Lewy bodies in a few brain regions. This contrasted with large numbers of Lewy neurites and neuroaxonal spheroids in many brain regions. By electron microscopy, Lewy neurites consisted of abnormal filaments and dense granular material. Isolated filaments resembled those previously described in idiopathic Parkinson’s disease and dementia with Lewy bodies. They were decorated by antibodies specific for the N and C termini of α-synuclein, indicating the presence of the full-length protein. Nucleus accumbens and the lower layers in limbic areas of the cerebral cortex showed prominent vacuolation, with frequent clustering of microvacuoles around Lewy neurites. Nerve cell loss was most extensive in dorsal motor nucleus of the vagus nerve, substantia nigra and nucleus basalis of Meynert. Neurofibrillary tangles and senile plaques were not observed. However, in several brain regions, a few widely scattered tau-positive nerve cell bodies and neurites were present. By electron microscopy, Alzheimer-type paired helical and straight filaments were seen.

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Acknowledgements

We gratefully acknowledge C. Alyea, R. Richardson and B. Dupree for technical help, and B. Glazier and U. Küderli for photographic assistance. We thank P. Davies, M. Hasegawa and T. Iwatsubo for their kind gift of antibodies. This study was supported in part by PHS P30 AG10133.

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, Division of Neuropathology, Indiana University School of Medicine, Indianapolis, IN, 46202-5120, USA

    Keiji Yamaguchi, Jill R. Murrell & Bernardino Ghetti

  2. Department of Neurological Sciences and Pathology, Rush University Medical Center, Chicago, Illinois, USA

    Elizabeth J. Cochran & Kathleen M. Shannon

  3. Novartis Pharmaceuticals, Gaithersburg, Maryland, USA

    Mihael H. Polymeropoulos

  4. Medical Research Council Laboratory of Molecular Biology, Cambridge, UK

    R. Anthony Crowther & Michel Goedert

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  1. Keiji Yamaguchi
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  8. Bernardino Ghetti
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Correspondence to Bernardino Ghetti.

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Yamaguchi, K., Cochran, E.J., Murrell, J.R. et al. Abundant neuritic inclusions and microvacuolar changes in a case of diffuse Lewy body disease with the A53T mutation in the α-synuclein gene. Acta Neuropathol 110, 298–305 (2005). https://doi.org/10.1007/s00401-005-1042-4

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  • DOI: https://doi.org/10.1007/s00401-005-1042-4

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