Intracytoplasmic inclusion bodies of the thalamus and the substantia nigra,and Marinesco bodies in myotonic dystrophy: a quantitative morphological study

Summary Intracytoplasmic inclusion bodies of the thalamus and the substantia nigra, and Marinesco bodies have been studied in four patients with myotonic dystrophy (MyD), eight patients with other neurological diseases (control A), and eight patients without neurological diseases (control B). The percentages of the affected cells were calculated by dividing the number of neurons including intracytoplasmic inclusion bodies of the thalamus and the substantia nigra, and Marinesco bodies, by the total cell count in these respective regions. Statistical analyses were performed with regard to the frequency of these bodies by using Student'st test. There was a significantly higher incidence of intracytoplasmic inclusion bodies of the thalamus (13.2% versus 0.7%,P<0.001) and the substantia nigra (20.4% versus 2.7%,P<0.001), and Marinesco bodies (37.4% versus 4.1%,P<0.001) in patients with MyD than in controls A and B. From our observations, it is suggested that the presence with a high frequency, in combination, of these bodies is not an incidental finding but may have an intimate and important relationship with the pathogenesis of MyD, and may be a conspicuous and diagnostically important feature of MyD.Supported by Grant-in-Aid for Scientific Research from The Ministry of Education, Science and Culture     

Familial Neuroaxonal Dystrophy with Principal Lesions of Nigro-Pallido-Subthalamic Degeneration

Abstract: Clinico-neuropathological studies were conducted on three patients of a family with parkinsonism. The clinical features of these three cases included juvenile parkinsonism with subcortical dementia. Neuropatho-logical changes observed in common were the simple degeneration of the substantia nigra, globus pallidus and subthalamic nucleus, spheroid bodies in the reticular zone of the substantia nigra, intracytoplasmic deposits of an eosinophilic substance in the nerve cells of the locus caeruleus and a swelling of nerve cells of the thalamus and brainstem nuclei. In one of the cases, electron microscopy of the locus caeruleus demonstrated dense bodies scattering within meshes of tubules in the cytoplasm of nerve cells. All these findings led to the conclusion that the pathologic diagnosis was identified as familial neuroaxonal dystrophy with the principal lesions of nigro-pallido-subthalamic degeneration.     

Indices of oxidative stress and mitochondrial function in individuals with incidental Lewy body disease

Brain tissue from normal individuals with incidental Lewy bodies and cell loss in pigmented substantia nigra neurons (asymptomatic Parkinson's disease) and age-matched control subjects without nigral Lewy bodies was examined biochemically. There was no difference in dopamine levels or dopamine turnover in the caudate and putamen of individuals with incidental Lewy body disease compared to control subjects. There were no differences in levels of iron, copper, manganese, or zinc in the substantia nigra or other brain regions from the individuals with incidental Lewy body disease compared to those from control subjects. Similarly, ferritin levels in the substantia nigra and other brain areas were unaltered. There was no difference in the activity of succinate cytochrome c reductase (complexes II and III) or cytochrome oxidase (complex IV) between incidental Lewy body subjects and control subjects. Rotenone-sensitive NADH coenzyme Q₁ reductase activity (complex I) was reduced to levels intermediate between those in control subjects and those in patients with overt Parkinson's disease, but this change did not reach statistical significance. The levels of reduced glutathione in substantia nigra were reduced by 35% in patients with incidental Lewy body disease compared to control subjects. Reduced glutathione levels in other brain regions were unaffected and there were no changes in oxidized glutathione levels in any brain region. Altered iron metabolism is not detectable in the early stages of nigral dopamine cell degeneration. There may be some impairment of mitochondrial complex I activity in the substantia nigra in Parkinson's disease. The marked reduction in nigral reduced glutathione levels suggests this to be an important early change in the process of oxidative stress underlying Parkinson's disease.     

蛋白酶体抑制剂诱导大鼠黑质变性伴包涵体形成

目的 观察蛋白酶体抑制剂Lactacystin诱导大鼠黑质变性伴包涵体形成及运动行为学的改变,探讨蛋白酶体功能下降在帕金森病(PDl发病机制中的作用. 方法 24只SD大鼠采用随机数字表法分为kactacystin实验组和生理盐水组.每组12只,Lactacystin实验组将蛋白酶体抑制剂Lactacystin立体定向注射人大鼠左侧黑质致密部(SNc).生理盐水组注射等体积生理盐水;观察大鼠自主行为和阿朴吗啡(APO)诱导的旋转行为的改变;Nissl染色法观察SNc病理改变;免疫组化法观察SNc及纹状体酪氨酸羟化酶(TH)和SNc中α-共核蛋白的表达;透射电镜观察SNc超微结构的改变. 结果 Lactacystin实验组大鼠给药7 d后出现自发性活动减少、动作缓慢、震颤、且症状逐步加重.APO可诱导出向健侧的旋转运动;Nissl染色发现Lactacystin实验组左侧SNc神经元数量减少,尼氏体结构松散;免疫组化结果表明21 d后Lactacystin实验组左侧SNc出现变性,TH免疫阳性神经元数量减少,α-共核蛋白表达增强,纹状体内TH免疫阳性纤维数量减少;电镜观察到蛋白质聚集形成的包涵体. 结论 Lactacystin单侧SNc注射可以诱导大鼠黑质变性伴包涵体形成及大鼠行为改变.蛋白酶体功能下降可能在PD发病机制中起重要作用.     

Dendrite loss is a characteristic early indicator of toxin-induced neurodegeneration in rat midbrain slices

In rat brain substantia nigra catecholamine neurons in vitro, a sensitive indicator of excitatory amino-acid-induced damage is dendritic degeneration that precedes the loss of the cell body. The present study has shown that dendritic loss is not specific for excitatory amino acids and is an early indicator of neurodegeneration produced by numerous agents that initiate damage by different primary cellular actions. Rats were anesthetised by fluothane inhalation and killed, and the brain was rapidly removed. Three-hundred-micrometer-thick slices containing substantia nigra were incubated for 2 h at 35 degrees C in the presence or absence of kainic acid (50 microM), 1-methyl-4-phenylpyridinium ion (10 or 50 microM), ouabain (10 or 30 microM), 6-hydroxydopamine (10 or 100 microM), potassium cyanide (100 microM or 1 mM), or elevated extracellular potassium chloride (25, 50, or 100 mM). The slices were fixed and recut into thin sections (30 micrometer) and substantia nigra dopamine neurons were immunolabeled for tyrosine hydroxylase coupled to diaminobenzidine. Both the cell body and the extensive dendritic projections were immunolabeled. Each agent caused a similar pattern of toxicity including loss of tyrosine-hydroxylase-immunolabeled dendrites at lower concentrations and damage to, or disintegration of, the cell bodies at higher concentrations. For example, 100 microM potassium cyanide reduced the proportion of substantia nigra neurons which exhibited dendrites from 66 +/- 4% (SEM) in controls to 54 +/- 7%, without obvious changes in cell bodies. After 1 mM potassium cyanide, only 13 +/- 2% of substantia nigra neurons retained dendrites and cell bodies were shrunken or disintegrated. Loss of dendrites was also evident in substantia nigra neurons stained with cresyl violet or immunolabeled for microtubule-associated protein 2. The findings suggest that disruption of the dendritic arbor is an early indicator of neurodegeneration, irrespective of how this is initiated. The approach that we have developed may therefore prove valuable in investigating the mechanisms of degeneration of catecholamine neurons.     

Unbiased morphometrical measurements show loss of pigmented nigral neurones with ageing

This study used the dissector method to evaluate pigmented nigral neuronal loss in the substantia nigra pars compacta with age. Dissector counts can be used to estimate the absolute and accurate total neurone numbers. In addition, the area and diameter of the neuronal cell body was estimated by using a computerized morphometric analysis in a single section of the substantia nigra pars compacta. Brain samples from 26 people with an age range from 17 to 90 years were studied. A significant decrease in the total number of pigmented neurones (r=-0.83, P<0.001) and their density (r=-0.83, P<0.001) with age was found in the substantia nigra pars compacta. The number of pigmented neurones counted from a single section also showed an age-dependent decline (r=-0.76, P<0.001). According to the regression equations, the total number of pigmented neurones estimated by dissector counts decreased by 9.8% per decade and the neuronal density decreased by 7.4% per decade. The area of the neuronal cell body decreased by 3.2% per decade. This latter change corresponds to an approximate 4.4% decrease per decade in neuronal volume. These findings show that both the number of pigmented neurones and their size in the substantia nigra pars compacta decreases with age. However, the reductions in the total number of pigmented neurones are more dramatic than the reduction in neurone size with ageing.     

Idiopathic parkinsonism with lewy-type inclusions in cerebral cortex. A case report

Summary A case of idiopathic parkinsonism showed specific neuropathological findings, namely, the diffuse appearnces of intracytoplasmic inclusions of Lewytype in the cerebral cortex in addition to many Lewy bodies in the pigmented brain stem nuclei. The staining properties and the ultrastructure of the inclusions in the cerebral cortex had a strong resemblance to those of the Lewy bodies in the substantia nigra, though a few electron microscopical differences were observed. Almost all of these cortical inclusions were homogeneous or had an obscure core in their center, and they gave the impression of immature Lewy bodies.     

Marked microglial reaction in normal aging human substantia nigra: correlation with extraneuronal neuromelanin pigment deposits

Multiple reports have documented an age-related loss, estimated at about 10% per decade, of the pigmented neurons in the substantia nigra. This is associated with motor dysfunction, including bradykinesia, stooped posture and gait disturbance. As microglia are activated by cell death and neuromelanin pigment, we hypothesized that there should be a significant microglial reaction in normal aging human substantia nigra. Sections of substantia nigra from elderly subjects (N = 15; mean 81.3; SD 7.0) and younger subjects (N = 7; mean 30.3; SD = 8.7), all of which had no specific neurologically or neuropathologically defined disorders, were stained immunohistochemically for MHC Class II and the area occupied by microglia was quantified in substantia nigra pars compacta. All elderly subjects showed a pronounced microglial reaction in the substantia nigra, with frequent, intensely stained hypertrophic microglia, while immunoreactive nigral microglia were much less frequent in the younger subjects. Quantification showed that in older subjects, the percentage of substantia nigra area occupied by microglial bodies and processes was significantly greater than for younger subjects (mean 19.6 vs. 3.6; P = 0.005). Extraneuronal neuromelanin deposits were present in all the older subjects but were absent or rare in the younger subjects. The neuromelanin deposit abundance score in the older subjects correlated significantly with the area occupied by immunoreactive microglia. The marked microglial reaction in normal aging human substantia nigra, together with the previously reported 35–80% pigmented neuron loss, indicates the presence of a powerful pathologic process that may be additive with specific age-related neurodegenerative diseases, including Parkinson’s disease.     

Apolipoprotein E epsilon4 is associated with neuronal loss in the substantia nigra in Alzheimer's disease

Apolipoprotein E epsilon4 (ApoE epsilon4) is associated with an earlier age at onset of Alzheimer's (AD) and possibly Parkinson's disease, suggesting a general role for ApoE epsilon4 in neuronal plasticity. Among 31 prospectively assessed subjects with pathologically confirmed AD (without Lewy bodies), epsilon4+ subjects had a longer duration of disease (by 2.8 years, p = 0.04). Only cell loss in the substantia nigra (p = 0.002) was associated with epsilon4. Neither neurofibrillary tangles nor plaque counts were associated with epsilon4. Cell counts of pigmented neurons in single midbrain sections in epsilon4+ specimens were 72% of those in epsilon4- substantia nigra (p = 0.04). These findings confirm that cell loss in the substantia nigra is associated with epsilon4 in AD. Copyrightz1999S.KargerAG,Basel     

Long-term follow-up after stereotaxic basal ganglia surgery in parkinsonism. A neuroanatomical study of a case showing unusual postural disorders

A 60-year-old man who had Parkinson's disease for 25 years became unable to maintain the upright position of the trunk while standing or walking. Because of a loss of postural fixation, his trunk sank forward until his back was horizontal. Fifteen years before, a bifocal implantation of radioactive yttrium-90 had been performed by a stereotaxic procedure at the level of the globus pallidus (GP) and the ventrolateral thalamus, respectively on the right side. A second operation, 2 years later, had been made by electrocoagulation in the left ventrolateral thalamus. Postmortem examination showed the following features (a) neuronal cell loss in the pigmented nuclei of the brainstem with intracellular Lewy bodies and gliosis. These data corresponded with the usual pathology of idiopathic Parkinson's disease; (b) surgical lesions resulting from the previous stereotaxic operations in the right GP and the ventrolateral thalamus on both sides and (c) neuronal cell loss without gliosis in the right GP that was evident in regions spared by the surgical lesion. Moreover, these degenerative changes were particularly seen in the left GP, which was surgically unlesioned. The ansa lenticularis was demyelinated on both sides. These data might be consistent with a retrograde degenerative process affecting the pallidothalamic projections. Beside the role of the neuronal cell loss affecting the pars compacta of the substantia nigra (SN) in akinesia, the role of the lesions affecting the G.P. in the genesis of postural disorders is suggested.     

Brainstem pathology in DYT1 primary torsion dystonia

DYT1 dystonia is a severe form of young-onset dystonia caused by a mutation in the gene that encodes for the protein torsinA, which is thought to play a role in protein transport and degradation. We describe, for the first time to our knowledge, perinuclear inclusion bodies in the midbrain reticular formation and periaqueductal gray in four clinically documented and genetically confirmed DYT1 patients but not in controls. The inclusions were located within cholinergic and other neurons in the pedunculopontine nucleus, cuneiform nucleus, and griseum centrale mesencephali and stained positively for ubiquitin, torsinA, and the nuclear envelope protein lamin A/C. No evidence of inclusion body formation was detected in the substantia nigra pars compacta, striatum, hippocampus, or selected regions of the cerebral cortex. We also noted tau/ubiquitin-immunoreactive aggregates in pigmented neurons of the substantia nigra pars compacta and locus coeruleus in all four DYT1 dystonia cases, but not in controls. This study supports the notion that DYT1 dystonia is associated with impaired protein handling and the nuclear envelope. The role of the pedunculopontine and cuneiform nuclei, and related brainstem brainstem structures, in mediating motor activity and controlling muscle tone suggests that alterations in these structures could underlie the pathophysiology of DYT1 dystonia [corrected]     

Ultrastructural Relationship between Lewy Bodies and Pale Bodies Studied in Locus Ceruleus Neurons of a Non-Parkinsonian Patient

The Lewy body (LB) is a hallmark of Parkinson's disease (PD). The pale body (PB) also represents a characteristic intracytoplasmic alteration of the neurons of the substantia nigra and locus ceruleus of PD patients. We recently had the opportunity to study a non-parkinsonian patient (a 66-year-old man) who had numerous LBs and PBs in the neurons of the locus ceruleus. However, there was no evidence of neuronal loss in this region. We performed a detailed ultrastructural study of these inclusions for which multiple serial sections were used. Our results revealed that the constituent filamentous structures of the LBs and PBs were indistinguishable from each other, that transitions occasionally occurred between PBs and LBs, and that presynaptic structures entrapped in the cytoplasm were frequently present in the vicinity of both types of inclusion bodies. These findings suggest that PBs, at least those of the present type, actually represent early LBs. In addition, the entrapment of presynaptic structures by the cytoplasm of neurons of the locus ceruleus may indicate the existence of certain degenerative (or regressive) processes in these cells and that postsynaptic areas in particular, may have a role in PB and LB formation.     

A quantitative investigation of the substantia nigra in Huntington's disease

To elucidate the quantitative and topographical changes of neurons in the substantia nigra in Huntington's disease (HD), sections from 4 HD patients and 8 age-matched control subjects were stained with cresyl violet and the numbers and localization of pigmented and nonpigmented neurons in the substantia nigra were examined. This study revealed a decrease of about 40% (p less than 0.01 or p less than 0.05) in neuronal number and a shrinkage of both pigmented and nonpigmented neurons in the substantia nigra in HD. Pigmented neuron number was decreased markedly in the ventral cell group. Loss of the neurons occurred in the medial and lateral thirds, but relative sparing of the neurons was seen in the central part of the substantia nigra. In contrast, loss of nonpigmented neurons was relatively uniform in the substantia nigra although it was more severe in the central part. We conclude that a primary neuronal degeneration occurs in the substantia nigra in HD.     

Spino-olivo-ponto-cerebello-nigral atrophy with Lewy bodies and binucleated nerve cells: A case report

Summary In a 58-year-old male symptoms of Parkinsonism gradually predominated over cerebellar symptoms during a 7 1/2 years long period. The patient had no history of encephalitis nor of hereditary neurological disease. Neuropathological examination revealed changes of Parkinson's disease with Lewy bodies and spino-olivo-ponto-cerebellar atrophy. Binucleated nerve cells were found in the thalamus, the substantia nigra and Purkinje cell layer. The association of these two disease entities and the significance of binucleated neurons are discussed. It was thought that the changes in the two affected systems were primary and independent from each other and that the same unknown etiological process involved each individual system.     

Comparison of neuropathology in Parkinson's disease subjects with and without deep brain stimulation

Background : The aim of this postmortem study was to compare, in Parkinson's disease subjects with and without bilateral subthalamic nucleus deep brain stimulation (STN‐DBS), the loss of pigmented neurons within the substantia nigra and pathological alpha‐synuclein density within the SN and other brain regions. Methods : PD subjects were identified from the Arizona Study of Aging and Neurodegenerative Disorders database (STN‐DBS = 11, non‐DBS = 156). Pigmented neuron loss scores within the substantia nigra as well as alpha‐synuclein density scores within the substantia nigra and 9 other brain regions were compared, the latter individually and in summary as the Lewy body brain load score. Results : DBS subjects had higher alpha‐synuclein density scores within the substantia nigra, olfactory bulb, and locus ceruleus, as well as higher total Lewy body brain load scores when compared with non‐DBS subjects. No differences in substantia nigra pigmented neuron loss scores were found. Conclusions : STN‐DBS subjects tend to have higher alpha‐synuclein density scores, but do not have a differential loss of substantia nigra pigmented neurons. © 2016 International Parkinson and Movement Disorder Society     

Distribution and ultrastructural localization of torsinA immunoreactivity in the human brain

We have examined the distribution and ultrastructural localization of torsinA, the protein product of the TOR1A gene, in the normal adult human and Macaque brain. TorsinA immunoreactivity was visualized using a monoclonal antibody raised against a fusion protein encoding exon 4 of human torsinA. Western blot analysis of brain homogenates revealed a major species of about 39 kDa, consistent with the predicted size of glycosylated torsinA protein. By light microscopy, torsinA like-immunoreactivity was enriched in gray matter in all brain regions examined. Immunoreactivity was concentrated in the neuropil and immunopositive cell bodies were not observed. Structures particularly enriched in torsinA like-immunoreactivity included the cerebral cortex, the caudate-putamen, globus pallidus, the hippocampal formation, the thalamus, the substantia nigra and molecular cell layer of the cerebellar cortex. Cell bodies of pigmented dopamine neurons in the substantia nigra pars compacta were immunonegative. Biochemical fractionation of the human striata revealed a concentration of torsinA immunoreactivity in particulate fractions. Ultrastructural studies of the human and Macaque striata further revealed an association of torsinA immunostaining with small vesicles within axons and presynaptic terminals forming symmetric synapses. These ultrastructural studies are consistent with a pre-synaptic localization of torsinA protein in the adult striatum and are consistent with a role of torsinA in modulating striatal signaling, although the widespread localization of the protein suggests it probably also participates in signaling in other regions.     

Neuropathology of Parkinson's disease and related syndromes.

A progressive parkinsonian disorder predicts pathology in the substantia nigra and possibly elsewhere in the basal ganglia. Parkinson's disease is a manifestation of Lewy body disease, which is characterized by the association between Lewy bodies and cell degeneration in specific neuronal populations. Striatonigral degeneration is part of multiple system atrophy and is characterized by striatal and nigral degeneration without neuronal inclusion bodies, but glial inclusions have been described. Steele-Richardson-Olszewski disease is characterized by the globose neurofibrillary tangle and predominant brain stem pathology. Corticobasal degeneration shows similar midbrain pathology and a round, filamentous inclusion in the substantia nigra, not unlike the globose tangle, but there is also focal frontoparietal cortical atrophy. The combination of the distribution of degeneration and nerve cell morphology identify apparently distinct disorders, but most of the neuronal inclusions are not disease specific.     

Altered distribution of dopaminergic neurons in the brain of L1 null mice

Dopaminergic neurons of the mouse mesencephalon originate in the ventricular zone and migrate radially along radial glia then tangentially along nerve fibers that express the neural cell adhesion molecule L1 to form the substantia nigra (A9 group) and ventral tegmental area (VTA) (A10 group). The role of L1 in migration of dopaminergic neuronal precursors was investigated in L1 knockout mice by tyrosine hydroxylase (TH) immunostaining. An altered rostrocaudal distribution of dopaminergic neurons was observed within the substantia nigra and VTA of L1-minus mice. In L1-minus mice at postnatal day 0, TH-positive cells were present abnormally in the dorsomedial mesencephalon, suggesting impaired migration. Axons projecting from the substantia nigra to the caudate putamen also exhibited an abnormal targeting pattern. There was no evidence of dopaminergic cell loss in the mutant SN. Abnormal localization of dopaminergic neurons in L1-minus mice was also evident in the zona incerta of the thalamus (A13 group), and the arcuate (A12) and periventricular nucleus (A14) of the hypothalamus. Cell bodies and axons in the substantia nigra, VTA, and hypothalamus of wild type mouse embryos expressed L1. These results suggested that L1 plays an important developmental role in the organization of dopaminergic neuronal cell groups in the mesencephalon and diencephalon.     

鱼藤酮致大鼠脑内α-突触核蛋白的表达分布变化

目的 研究鱼藤酮所致的帕金森病大鼠的脑内α-突触核蛋白（α—synuclein,ASN）分布。方法 Wistar大鼠随机分成两组,分别给予鱼藤酮和／或溶剂（对照组）皮下注射,4周后取脑组织,对黑质部位HE染色,光镜下观察Lewy小体形态;对黑质、海马、纹状体等脑区进行酪氨酸羟化酶（tyrosine hydroxylase,TH）、ASN免疫组织化学染色。结果 在对照组大鼠脑内,ASN广泛分布于各脑区,尤其在皮质、纹状体、海马等纤维投射丰富的区域。鱼藤酮处理的大鼠脑中,黑质TH阳性多巴胺能神经元数目减少、纹状体区TH阳性纤维脱失,黑质部位可见Lewy小体样结构;ASN阳性染色在各个脑区均有增强但各个脑区增强程度不一,黑质部位神经元胞浆和胞核内均有ASN明显聚集,纹状体可见ASN聚集围绕在细胞周围。海马部位偶见ASN在胞浆中点状聚集,胞核中无明显改变。结论 在鱼藤酮皮下注射导致的帕金森病大鼠的脑内,ASN在多个脑区中表达增加,而在黑质纹状体部位聚集最为明显,蛋白分布由多巴胺能神经元的突触末端向胞浆和胞核扩展。