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

Hiroshige Fujishiro, Tae Beom Ahn, Roberta Frigerio, Anthony DelleDonne, Keith Anthony Josephs, Joseph E Parisi, J. Eric Ahlskog, Dennis W Dickson

Research output: Contribution to journalArticle

34 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)269-275
Number of pages7
JournalActa Neuropathologica
Volume116
Issue number3
DOIs
StatePublished - 2008

Fingerprint

Multiple System Atrophy
Inclusion Bodies
Neuroglia
Synucleins
Brain
Pathology
Lewy Bodies
Cerebellar Ataxia
Gliosis
Putamen
Parkinsonian Disorders
Substantia Nigra
Nervous System Diseases
Neurodegenerative Diseases
Autopsy
Central Nervous System
Immunohistochemistry

Keywords

  • α-Synuclein
  • Clinicopathologic
  • Glial cytoplasmic inclusion
  • Multiple system atrophy
  • Preclinical

ASJC Scopus subject areas

  • Clinical Neurology
  • Pathology and Forensic Medicine
  • Neuroscience(all)

Cite this

Glial cytoplasmic inclusions in neurologically normal elderly : Prodromal multiple system atrophy? / Fujishiro, Hiroshige; Ahn, Tae Beom; Frigerio, Roberta; DelleDonne, Anthony; Josephs, Keith Anthony; Parisi, Joseph E; Eric Ahlskog, J.; Dickson, Dennis W.

In: Acta Neuropathologica, Vol. 116, No. 3, 2008, p. 269-275.

Research output: Contribution to journalArticle

Fujishiro, Hiroshige ; Ahn, Tae Beom ; Frigerio, Roberta ; DelleDonne, Anthony ; Josephs, Keith Anthony ; Parisi, Joseph E ; Eric Ahlskog, J. ; Dickson, Dennis W. / Glial cytoplasmic inclusions in neurologically normal elderly : Prodromal multiple system atrophy?. In: Acta Neuropathologica. 2008 ; Vol. 116, No. 3. pp. 269-275.
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