title: Distribution of α-synuclein in the spinal cord and dorsal root ganglia in an autopsy cohort of elderly persons.
abstract: BACKGROUND
  Lewy body-related α-synucleinopathy (LBAS, the abnormal accumulation of pathologic α-synuclein) is found in the central and peripheral nervous systems, including the spinal cord, dorsal root ganglia, and sympathetic ganglia, of Parkinson's disease patients. However, few studies have focused on the distribution of LBAS in the spinal cord, primary sensory neurons, and preganglionic sympathetic nerves.
  
  
  RESULTS
  We analyzed 265 consecutive subjects with LBAS who underwent autopsy at a general geriatric hospital. LBAS in the spinal cord was significantly associated with that in the lower brainstem regions that are directly connected to the spinal cord (i.e., the medullary reticular formation and locus ceruleus), but it was not associated with the olfactory bulb-amygdala system, which is not directly connected to the spinal cord, suggesting that the lower brainstem is a key structure regarding the spread of LBAS to the spinal cord. In the primary sensory neurons, most subjects with LBAS in the dorsal root ganglia had LBAS in the dorsal root, and all subjects with LBAS in the dorsal root also had LBAS in the dorsal horn, suggesting that LBAS spreads retrogradely from the axonal terminals of the dorsal horn to the somata of the dorsal root ganglia via the dorsal root. In the preganglionic sympathetic nerves, the LBAS in the sympathetic ganglia preceded that in the nucleus of the intermediolateral column of the thoracic cord, suggesting that LBAS spreads retrogradely through the preganglionic sympathetic nerves.
  
  
  CONCLUSIONS
  LBAS in the spinal cord was associated with the lower regions of the brainstem, but not with the olfactory bulb or amygdala. LBAS may spread centrifugally along the primary sensory neurons, whereas it may spread centripetally along the preganglionic sympathetic nerves.
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. Satsumakitten0120@gmail.com.|Department of Neurology, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan. Satsumakitten0120@gmail.com.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sumikura
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. msktakao@saitama-med.ac.jp.|Department of Neurology, Saitama Medical University International Medical Center, Hidaka-shi, Saitama, Japan. msktakao@saitama-med.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Takao
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. xauyda@hotmail.com.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hatsuta
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. huchoperryi@hotmail.co.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. nakanoy55@gmail.com.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Nakano
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. akikou@med.kitasato-u.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Uchino
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. s8076@nms.ac.jp.
authors.forename: Akane
authors.initials: A
authors.lastname: Nogami
authors.affiliation: Department of Laboratory Medicine, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo, Japan. yukosabbar@gmail.com.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Neurology, Osaka University Graduate School of Medicine, Suita-shi, Osaka, Japan. hmochizuki@neurol.med.osaka-u.ac.jp.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mochizuki
authors.affiliation: Department of Neuropathology (the Brain Bank for Aging Research), Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan. smurayam@bbarjp.net.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001344:Autopsy; D001921:Brain / Q000378:metabolism / Q000473:pathology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005727:Ganglia, Spinal / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D020961:Lewy Body Disease / Q000473:pathology; D008297:Male; D009474:Neurons / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales; D013116:Spinal Cord / Q000378:metabolism* / Q000473:pathology; D018709:Statistics, Nonparametric; D051844:alpha-Synuclein / Q000378:metabolism*
chemical_list: D051844:alpha-Synuclein