title: Degeneration of brainstem respiratory neurons in dementia with Lewy bodies.
abstract: BACKGROUND
  Respiratory dysfunction, including sleep disordered breathing, is characteristic of multiple system atrophy (MSA) and may reflect degeneration of brainstem respiratory nuclei involved in respiratory rhythmogenesis and chemosensitivity, including the pre-Bötzinger complex (preBötC), nucleus raphe pallidus (RPa), and nucleus raphe obscurus (ROb). However, impaired ventilatory responses to hypercapnia have also been reported in dementia with Lewy bodies (DLB), suggesting that these nuclei may also be affected in DLB.
  
  
  OBJECTIVE
  To determine whether there is involvement of the preBötC, RPa, and ROb in DLB.
  
  
  METHODS
  We applied stereological methods to analyze sections immunostained for neurokinin-1 receptor and tryptophan hydroxylase in neuropathologically confirmed cases of DLB, MSA, and controls.
  
  
  RESULTS
  Reduction of neuronal density occurred in all three nuclei in DLB, as well as in MSA. The magnitude of neuronal depletion in ROb was similar in DLB and MSA (49% versus 56% respectively, compared to controls, P < 0.05), but neuronal loss in the preBötC and RPa was less severe in DLB than in MSA (40% loss in preBötC of DLB, P < 0.05 and 68% loss in MSA, P < 0.0001, compared to controls; 46% loss in RPa of DLB, P < 0.05 and 73% loss in MSA P < 0.0001, compared to controls).
  
  
  CONCLUSIONS
  Medullary respiratory nuclei are affected in dementia with Lewy bodies but less severely than in multiple system atrophy. This may help explain differences in the frequency of sleep disordered breathing in these two disorders.
authors: Department of Neurology.
authors: Michael F
authors: MF
authors: Presti
authors: Department of Neurology.
authors: Ann M
authors: AM
authors: Schmeichel
authors: Department of Neurology.
authors: Phillip A
authors: PA
authors: Low
authors: Department of Neurology ; Division of Anatomical Pathology, Mayo Clinic, Rochester, MN.
authors: Joseph E
authors: JE
authors: Parisi
authors: Department of Neurology.
authors: Eduardo E
authors: EE
authors: Benarroch
mesh_terms: D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008526:Medulla Oblongata / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D009474:Neurons / Q000201:enzymology / Q000378:metabolism / Q000473:pathology*; D018040:Receptors, Neurokinin-1 / Q000378:metabolism; D012891:Sleep Apnea Syndromes / Q000150:complications; D014365:Tryptophan Hydroxylase / Q000378:metabolism; D051844:alpha-Synuclein / Q000378:metabolism
chemical_list: D018040:Receptors, Neurokinin-1; D051844:alpha-Synuclein; D014365:Tryptophan Hydroxylase
keywords: DLB; MSA; Pre-Bötzinger; medullary raphe; respiration