title: Lewy body pathology involves the olfactory cells in Parkinson's disease and related disorders.
abstract: BACKGROUND
  The "dual-hit" and propagation hypotheses of α-synuclein suggests that the olfactory cells of the olfactory epithelium are among the earliest sites of involvement in Parkinson's disease (PD). We investigated the olfactory epithelium in consecutive cases that had been registered with a brain bank.
  
  
  OBJECTIVE
  This study was undertaken to check the presence or absence of Lewy body pathology in olfactory cells.
  
  
  METHODS
  Thirty-six male and 11 female patients were examined, including eight with PD, two with dementia with Lewy bodies, 11 with incidental Lewy body disease, and 26 with no Lewy-related alpha-synucleinopathy. The olfactory epithelium was sampled by craniotomy followed by resection of the cribriform plate, which was fixed in formalin and decalcified with ethylenediaminetetra-acetate. Coronal paraffin-embedded sections of the plate were stained with hematoxylin and eosin or immunohistochemically stained with antibodies against phosphorylated α-synuclein to detect Lewy body pathology and neuronal markers of protein gene product 9.5, phosphorylated neurofilament, and tyrosine hydroxylase.
  
  
  RESULTS
  Lewy body pathology was detected in the olfactory cells of the olfactory epithelium in a single patient with incidental Lewy body disease and in six patients with PD, but it was not detected in patients who had dementia with Lewy bodies.
  
  
  CONCLUSIONS
  We detected Lewy body pathology in the olfactory epithelium in six of the eight patients with Parkinson's disease and in one patient with incidental Lewy body pathology.
authors.affiliation: Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.|Department of Neurology, Graduate School of Comprehensive Human Science, University of Tsukuba, Ibaraki, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Shioya
authors.affiliation: Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Terunori
authors.initials: T
authors.lastname: Sano
authors.affiliation: Departments of Neuropathology and Neurology, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan.|Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sumikura
authors.affiliation: Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Murata
authors.affiliation: Departments of Neuropathology and Neurology, Tokyo Metropolitan Institute of Gerontology, Itabashi, Tokyo, Japan.|Department of Neurology, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Murayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology*; D020961:Lewy Body Disease / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009831:Olfactory Mucosa / Q000473:pathology*; D010300:Parkinson Disease / Q000473:pathology*; D011984:Sensory Receptor Cells / Q000473:pathology*; D043222:Ubiquitin Thiolesterase / Q000378:metabolism; D051844:alpha-Synuclein / Q000378:metabolism
chemical_list: C482860:UCHL1 protein, human; D051844:alpha-Synuclein; D043222:Ubiquitin Thiolesterase
keywords: Braak stage; alpha-synuclein; amygdala; hyposmia; olfactory bulb