PMC5445132_01
Alpha-synuclein histopathology in patients 1 and 3. Case 1: alpha-synuclein aggregates consistent with glial cytoplasmic inclusions (GCI) in the white matter of basis pons [(A) x400]; isolated neuronal cytoplasm inclusions and GCI in the basis pons [(B) x400], numerous GCI in the white matter of cerebellum [(C) x400]; Case 3: Lewy body like intraneuronal and neuritic aggregates of alpha-synuclein in peripheral sympathetic ganglia (D,E), medulla oblongata (F), and substantia nigra (G). Original magnification [(D) x400; (E,F) x200].
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F1
Immunohistochemistry revealed numerous intracellular protein aggregates of alpha-synuclein in oligodendroglial cells, consistent with glial cytoplasmic inclusions, in the white matter of basis pons (Figure 1A), cerebellum (Figure 1B), mesencephalon, medulla oblongata, and to a lesser extent in the thalamus and basal ganglia. Neuronal cytoplasm inclusions and neurite inclusions were sparse and limited to the basilar pontine nuclei (Figure 1C). Immunostaining for alpha-synuclein revealed abnormal intracellular aggregates of the protein, consistent with Lewy or Lewy-like bodies and neuritis, in the peripheral sympathetic ganglia (Figures 1D,E), in the dorsal vagal nucleus (Figure 1F), locus coeruleus, brainstem reticular formation, and substantia nigra (Figure 1G) (Braak stage III).