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The distribution of oligodendroglial inclusions in multiple system atrophy and its relevance to clinical symptomatology
Abstract
In this study a semiquantitative mapping of oligodendroglial cytoplasmic inclusions (GCIs), a feature of oligodendroglial degeneration in multiple system atrophy (MSA), was undertaken by means of a sensitive silver technique in 14 brains and 11 spinal cords of patients with various combinations of striatonigral degeneration, olivopontocerebellar atrophy and autonomic failure. The results show a system-bound extensive degeneration of interfascicular, perineuronal and perivascular oligodendrocytes. Oligodendroglial cytoplasmic inclusion-rich structures occur in the supra-segmental motor systems (primary motor and higher motor areas of cerebral cortex, 'pyramidal', 'extrapyramidal' and cortico-cerebellar systems), in the supraspinal autonomic systems and in their targets. In contrast, the visual and auditory pathways, olfactory structures, somatosensory systems, association and limbic cortical areas and subcortical limbic structures contain no or only a few GCIs. Comparison of the severity of oligodendroglial degeneration (GCI-density) with that of the neuronal alterations (neuronal cytoplasmic and nuclear inclusions, degenerated neuronal processes and loss of nerve cells) indicates a striking preponderance of oligodendroglial degeneration and that degeneration neither of axons, nor of neuronal cell bodies is a prerequisite of the development of GCIs. It also suggests that inclusion-bearing oligodendroglial degeneration may cause or contribute to the manifestation of clinical symptomatology in structures with GCI accumulation but without convincing neuronal alterations, i.e. cerebral motor cortical areas and reticular formation of the lower brainstem, both previously thought to be spared in MSA.
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“Moreover, the morphology of the GCIs (Fig. 3f, red channel) mimics the typical conical half-moon shape inclusions seen in the human disease [43].”
From Novel oligodendroglial alpha synuclein viral vector models of multiple system atrophy: studies in rodents and nonhuman primates (2017) · cites this paper as [43]
In the citing paper
“These inclusions were later described to be composed mainly of α-syn [43].”
From Novel oligodendroglial alpha synuclein viral vector models of multiple system atrophy: studies in rodents and nonhuman primates (2017) · cites this paper as [43]
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Neuropathology of autonomic dysfunction in synucleinopathies
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BackgroundAlpha-synuclein and transgenic mouse models
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Kawai, Y., Suenaga, M., Takeda, A., Ito, M., Watanabe, H., Tanaka, F., Kato, K., Fukatsu, H., Naganawa, S., Kato, T., et al. (2008) · Neurology · doi:10.1212/01.wnl.0000310413.04462.6a · Cited by 187
Neuropathology of multiple system atrophy: New thoughts about pathogenesis
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“Of note, some regions such as motor cortex, although histologically unremarkable, have a high density of GCIs, indicating that neurodegeneration is not a prerequisite for developing GCIs.(80) Furthermore, the SN, despite severe neuronal loss, usually shows a relatively low density of GCIs, and the association between…”
BackgroundInfluentialBooij, J., Tissingh, G., Winogrodzka, A., & van Royen, E. A. (1999) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590050374 · Cited by 174
“Multiple system atrophy is neuropathologically characterised by neuronal degeneration and gliosis in the caudate and putamen, globus pallidus, brain stem, cerebellum and spinal cord [73, 74].”
BackgroundMicroglial Activation Parallels System Degeneration in Multiple System Atrophy
Ishizawa, K., Komori, T., Sasaki, S., Arai, N., Mizutani, T., & Hirose, T. (2004) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/63.1.43 · Cited by 172
“It was suggested that GCI formation may be an early event of the disease and that GCIs tend to be less prominent in severely affected areas or in cases of long-standing duration (25, 41, 42).”
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“Significantly, one area that appears to distinguish a-syn immunolabeled from silverstained GCIs in the MSA brain is the hippocampal formation, since it was reported that this region was ‘‘free or nearly free’’ of silver-positive GCIs (42), while a-syn specific antibodies detected a high to moderate GCI density in the…”
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Self-citationInvolvement of vagal autonomic nuclei in multiple system atrophy and Lewy body disease
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Self-citationSpinocerebellar ataxia type 1 with multiple system degeneration and glial cytoplasmic inclusions
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“…neurodegenerative disorders are also associated with intracellular accumulation of α-syn, such as Multiple system atrophy (MSA) (Dickson et al., 1999; Papp & Lantos, 1994; Spillantini, 1999; Wakabayashi et al., 1998), AD (Hamilton, 2000; Iwai, 2000), and Gaucher disease (Mazzulli et al., 2011).”
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“Glial cytoplasmic inclusions (GCIs) were found in the frontal lobe, particularly in the supplementary motor, cingulate, primary motor and premotor cortices (Papp and Lantos, 1994).”
BackgroundResultInfluentialPatterns of abnormal motor cortex excitability in atypical parkinsonian syndromes
Kühn, A. A., Grosse, P., Holtz, K., Brown, P., Meyer, B.-U., & Kupsch, A. R. (2004) · Clinical Neurophysiology · doi:10.1016/j.clinph.2004.03.020 · Cited by 92
SLEEP AND DEGENERATIVE NEUROLOGIC DISORDERS
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“bodies in neurons and/or glial cells [46, 127] with the term encompassing diverse, but clinically overlapping entities, such as multiple system atrophy, PD, dementia with Lewy bodies (DLB), the LB variant of Alzheimer’s disease (LBVAD) and neurodegeneration with brain iron accumulation type 1 (NBIA I) [9, 13, 38, 45,…”
BackgroundStacpoole, S., Spitzer, S. O., Bilican, B., Compston, A., Káradóttir, R. T., Chandran, S., & Franklin, R. J. M. (2013) · Stem Cell Reports · doi:10.1016/j.stemcr.2013.09.006 · Cited by 91
Meissner, W. G., Traon, A. P., Foubert‐Samier, A., et al. (2020) · Movement Disorders · doi:10.1002/mds.28218 · Cited by 88
Abnormalities of the nucleus and nuclear inclusions in neurodegenerative disease: a work in progress
Woulfe, J. (2007) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2006.00819.x · Cited by 89
Multiple system atrophy with remarkable frontal lobe atrophy
Konagaya, M., Sakai, M., Matsuoka, Y., Konagaya, Y., & Hashizume, Y. (1999) · Acta Neuropathologica · doi:10.1007/s004010051008 · Cited by 88
“In MSA, involvement of the cerebral hemisphere, which is considered to be most resistant reticular formation [2, 10 ], has been reported in only a few cases [5, 16].”
Backgroundα-Synuclein impairs oligodendrocyte progenitor maturation in multiple system atrophy
May, V. E. L., Ettle, B., Poehler, A.-M., Nuber, S., Ubhi, K. K., Rockenstein, E. M., Winner, B., Wegner, M., Masliah, E., & Winkler, J. (2014) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2014.02.028 · Cited by 85
“Additionally, post mortem studies indicate a correlation of GCI load with neuronal degeneration (Ozawa, et al., 2004, Papp and Lantos, 1994) for striatonigral, Neurobiol Aging.”
BackgroundStemberger, S., Poewe, W., Wenning, G. K., & Stefanova, N. (2010) · Experimental Neurology · doi:10.1016/j.expneurol.2010.05.008 · Cited by 83
Dying-back oligodendrogliopathy: A late sequel of myelin-associated glycoprotein deficiency
Lassmann, H., Bartsch, U., Montag, D., & Schachner, M. (1997) · Glia · doi:10.1002/(sici)1098-1136(199702)19:2 · Cited by 87
Hanna, P. A., Jankovic, J. J., & Kirkpatrick, J. B. (1999) · Archives of Neurology · doi:10.1001/archneur.56.1.90 · Cited by 82
Wakabayashi, K., Ikeuchi, T., Ishikawa, A., & Takahashi, H. (1998) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(98)00018-5 · Cited by 81
Benarroch, E. E. (2009) · Neurology · doi:10.1212/wnl.0b013e3181a6b123 · Cited by 81
Davies, S. W., Turmaine, M., Cozens, B. A., Raza, A. S., Mahal, A., Mangiarini, L., & Bates, G. P. (1999) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.1999.0448 · Cited by 81
“…not to our knowledge been described in postmortem human HD, DRPLA, SBMA or SCA brain, although it is of interest that inclusions composed of a-synuclein have been reported in nuclei of oligodendrocytes in post-mortem brain in multiple system atrophy (Papp & Lantos 1994; Spillantini et al. 1998).”
Olfactory dysfunction in cerebellar ataxia and multiple system atrophy
Abele, M., Riet, A., Hummel, T. R., Klockgether, T., & W�llner, U. (2003) · Journal of Neurology · doi:10.1007/s00415-003-0248-4 · Cited by 81
Characteristics of the Dysarthria of Multiple System Atrophy
Kluin, K. J., Gilman, S., Lohman, M., & Junck, L. (1996) · Archives of Neurology · doi:10.1001/archneur.1996.00550060089021 · Cited by 80
Shiga, K., Yamada, K., Yoshikawa, K., Mizuno, T., Nishimura, T., & Nakagawa, M. (2005) · Journal of Neurology · doi:10.1007/s00415-005-0708-0 · Cited by 79
“The pallor of myelin, gliosis, and GCIs are also observed in internal capsule [12], possibly disrupting tissue integrity in that area.”
BackgroundPiao, Y.-S., Hayashi, S., Hasegawa, M., Wakabayashi, K., Yamada, M., Yoshimoto, M., Ishikawa, A., Iwatsubo, T., & Takahashi, H. (2001) · Acta Neuropathologica · doi:10.1007/s004010000292 · Cited by 78
“GCIs are present in oligodendroglial cells and widely distributed in the brains of affected patients [ 32 ].”
Ishizawa, K., Komori, T., Arai, N., Mizutani, T., & Hirose, T. (2008) · Neuropathology · doi:10.1111/j.1440-1789.2007.00855.x · Cited by 74
“The exact effect of GCIs or microglia on white matter and gray matter still remains to be understood in MSA.”
BackgroundInfluentialA novel grading scale for striatonigral degeneration (multiple system atrophy)
Wenning, G. K., Seppi, K., Tison, F., & Jellinger, K. A. (2002) · Journal of Neural Transmission · doi:10.1007/s007020200025 · Cited by 76
Tsuchiya, K., Ozawa, E., Haga, C., WATABIKI, S., Ikeda, M., Sano, M., Ooe, K., Taki, K., & Ikeda, K. (2000) · Acta Neuropathologica · doi:10.1007/s004010051173 · Cited by 73
Monza, D., Soliveri, P., Radice, D., Fetoni, V., Testa, D., Caffarra, P., CARACENI, T., & Girotti, F. (1998) · Archives of Neurology · doi:10.1001/archneur.55.3.372 · Cited by 72
“Direct cortical involvement has also been found in MSA: the premotor areas show neural and oligodendroglial, basophilic, argyrophil, cytoplasmic inclusions that are relatively specific for this disease and point to a cortical origin of the motor disorganization in MSA.(49)”
BackgroundInfluential
Metadata
- Authors
- Papp, M. I., & Lantos, P. L.
- Affiliations
- Semmelweis University (HU)
- Corresponding author
- Papp, M. I.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 1994
- Volume
- 117
- Issue
- 2
- Pages
- 235-243
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2148569529
- Cited by
- 389
- References
- 0
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 5 · 2023: 7 · 2022: 10 · 2021: 16 · 2020: 19 · 2019: 10 · 2018: 10 · 2017: 15 · 2016: 4 · 2015: 12 · 2014: 20 · 2013: 12 · 2012: 10
- FWCI
- 8.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Brain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
- Keywords
- multiple system atrophy, oligodendrocyte degeneration, striatonigral degeneration, olivopontocerebellar atrophy, autonomic failure, motor cortex, reticular formation, brainstem, spinal cord, symptomatology, silver staining
- MeSH terms
- Aged, Atrophy, Autonomic Nervous System Diseases, Brain Diseases, Inclusion Bodies, Corpus Striatum, Female, Humans, Male, Middle Aged, Oligodendroglia, Olivopontocerebellar Atrophies, Substantia Nigra
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