Involvement of medullary regions controlling sympathetic output in Lewy body disease

Eduardo E. Benarroch, Ann M. Schmeichel, Phillip Anson Low, Bradley F Boeve, Paola Sandroni, Joseph E Parisi

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

We sought to determine the involvement of medullary regions controlling sympathetic output in pathologically confirmed diffuse Lewy body disease (LBD). We studied eight limbic or neocortical stage LBD and eight multiple system atrophy (MSA) cases, confirmed neuropathologically, and eight age-matched controls. Five of the LBD cases and all MSA cases had orthostatic hypotension. Serial 50-μm sections obtained from the medulla rostral to the obex were immunostained for tyrosine hydroxylase, tryptophan hydroxylase and α-synuclein. Analysis was focused on the ventrolateral medulla and medullary raphe nuclei. In LBD cases, there were Lewy bodies and neurites, as well as dystrophic neurons in the ventrolateral medulla, but the number of catecholaminergic and serotonergic neurons was not significantly reduced. All these groups were depleted in MSA. There were Lewy body pathology and dystrophic neurons in the raphe in all LBD cases. Cell numbers were reduced in both the raphe obscurus and raphe pallidus. Our findings suggest that, although LBD affects medullary autonomic areas, it does so less severely than MSA, particularly in the case of the VLM, which controls sympathetic outputs maintaining arterial pressure. In LBD, orthostatic hypotension may be due primarily to involvement of sympathetic ganglion neurons rather than ventrolateral medulla neurons.

Original languageEnglish (US)
Pages (from-to)338-344
Number of pages7
JournalBrain
Volume128
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Lewy Body Disease
Multiple System Atrophy
Lewy Bodies
Neurons
Orthostatic Hypotension
Synucleins
Tryptophan Hydroxylase
Serotonergic Neurons
Sympathetic Ganglia
Raphe Nuclei
Tyrosine 3-Monooxygenase
Neurites
Arterial Pressure
Cell Count
Pathology

Keywords

  • Autonomic failure
  • Raphe
  • Synucleinopathy
  • Ventrolateral medulla

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Involvement of medullary regions controlling sympathetic output in Lewy body disease. / Benarroch, Eduardo E.; Schmeichel, Ann M.; Low, Phillip Anson; Boeve, Bradley F; Sandroni, Paola; Parisi, Joseph E.

In: Brain, Vol. 128, No. 2, 02.2005, p. 338-344.

Research output: Contribution to journalArticle

Benarroch, EE, Schmeichel, AM, Low, PA, Boeve, BF, Sandroni, P & Parisi, JE 2005, 'Involvement of medullary regions controlling sympathetic output in Lewy body disease', Brain, vol. 128, no. 2, pp. 338-344. https://doi.org/10.1093/brain/awh376
Benarroch, Eduardo E. ; Schmeichel, Ann M. ; Low, Phillip Anson ; Boeve, Bradley F ; Sandroni, Paola ; Parisi, Joseph E. / Involvement of medullary regions controlling sympathetic output in Lewy body disease. In: Brain. 2005 ; Vol. 128, No. 2. pp. 338-344.
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