title: Analysis of the adrenal gland is useful for evaluating pathology of the peripheral autonomic nervous system in lewy body disease.
abstract: 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.
authors.affiliation: Department of Neuropathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Fumimura
authors.forename: Masako
authors.initials: M
authors.lastname: Ikemura
authors.forename: Yuko
authors.initials: Y
authors.lastname: Saito
authors.forename: Renpei
authors.initials: R
authors.lastname: Sengoku
authors.forename: Kazutomi
authors.initials: K
authors.lastname: Kanemaru
authors.forename: Motoji
authors.initials: M
authors.lastname: Sawabe
authors.forename: Tomio
authors.initials: T
authors.lastname: Arai
authors.forename: Genta
authors.initials: G
authors.lastname: Ito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwatsubo
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Mizusawa
authors.forename: Shigeo
authors.initials: S
authors.lastname: Murayama
mesh_terms: 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
chemical_list: D051844:alpha-Synuclein; D014446:Tyrosine 3-Monooxygenase