Analysis of the adrenal gland is useful for evaluating pathology of the peripheral autonomic nervous system in lewy body disease.
Lewy body disease is defined as Lewy body-related neuronal degeneration involving the nigrostriatal system, limbic-neocortical system, and peripheral autonomic nervous system (PANS). We investigated whether the adrenal gland, which is evolutionarily related to sympathetic ganglia and is routinely examined in general autopsy, could be used to assess pathology of the PANS in Lewy body disease. Brains, spinal cords, and adrenal glands from 783 consecutive autopsy cases from a general geriatric hospital were examined immunohistochemically with antiphosphorylated alpha-synuclein antibodies and routine staining. Parkinson disease (PD) with dementia and dementia with Lewy bodies (DLB) were defined using 1996 Consensus Guidelines for DLB and the secondary Lewy body-related alpha-synucleinopathy or amygdala variants using previously established criteria. Lewy body-related alpha-synucleinopathy was found in 207 (26.4%) of 783 cases, with 1 case solely in the adrenal gland. In all 18 PD cases with or without dementia and in 33 of 38 DLB cases, the adrenal gland was involved, but it was spared in all cases of amygdala variants. Our results indicate that the adrenal gland can provide useful information for evaluation of the PANS in Lewy body disease.
Fumimura
Yuichi
Y
Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Ikemura
Masako
M
Saito
Yuko
Y
Sengoku
Renpei
R
Kanemaru
Kazutomi
K
Sawabe
Motoji
M
Arai
Tomio
T
Ito
Genta
G
Iwatsubo
Takeshi
T
Fukayama
Masashi
M
Mizusawa
Hidehiro
H
Murayama
Shigeo
S
D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D001341:Autonomic Nervous System / Q000378:metabolism / Q000473:pathology*; D001344:Autopsy / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D020961:Lewy Body Disease / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism; D051844:alpha-Synuclein / Q000378:metabolism
D051844:alpha-Synuclein; D014446:Tyrosine 3-Monooxygenase