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Glial cytoplasmic inclusions in neurologically normal elderly: prodromal multiple system atrophy?
Hiroshige Fujishiro1, Tae-Beom Ahn, Roberta Frigerio
1Department of Pathology (Neuropathology), Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
This study found alpha-synuclein pathology, including glial cytoplasmic inclusions (GCI) resembling preclinical multiple system atrophy (MSA), in a small percentage of neurologically normal elderly individuals. Further research is needed to understand if this represents early MSA or a benign age-related condition.
Area of Science:
- Neuroscience
- Neuropathology
- Aging
Background:
- Alpha-synucleinopathies, such as multiple system atrophy (MSA), are characterized by the accumulation of alpha-synuclein protein aggregates.
- Multiple system atrophy (MSA) is a sporadic neurodegenerative disorder affecting the autonomic nervous system, extrapyramidal system, and cerebellum.
Observation:
- Immunohistochemistry revealed incidental Lewy bodies (LBs) in 15% of 241 neurologically normal brains.
- Two cases (0.4% and 0.8%) in autopsy series showed widespread glial cytoplasmic inclusions (GCI) similar to MSA, but without significant neuronal loss or gliosis.
Findings:
- The observed GCI pathology in neurologically normal individuals was below the threshold for clinically overt MSA.
- The prevalence of GCI in this study (0.4-0.8%) is significantly higher than the estimated prevalence of clinically overt MSA (0.004%).
Implications:
- These findings suggest that GCI in elderly individuals may represent preclinical MSA or a distinct, non-progressive alpha-synucleinopathy.
- Further investigation is crucial to determine the clinical significance and progression of GCI in the absence of neurological disease.
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