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Washington University Experience | NEURODEGENERATION | Multiple Systems Atrophy (MSA) | 6H2 MSA (Case 6) Inferior Olive (ION) pSYN 2.jpg
Neurons of the inferior olivary nucleus showed neuronal cytoplasmic pSYN inclusions. (pSYN IHC) ---- Not shown: The substantia nigra shows severe neuronal loss and gliosis, accompanied by extracellular and phagocytosed pigment. GCIs are numerous throughout the midbrain, including the substantia nigra, red nucleus and crus cerebri. No Lewy bodies are seen. pSYN-immunoreactive GCIs are frequent in the central gray and white matter tracts of the spinal cord. ---- Primary neuropathologic diagnoses: Multiple system atrophy ;Alzheimer's Disease Neuropathologic Change ---- Neuro Diagnosis Comment: There is also neuropathologic evidence of AD consisting of BAP but not neuritic forms and only modest numbers of NFT. In the NIA-AA criteria this is ADNC of A3, B1, C1 which indicates only a low probability of AD cognitive impairment. This patient's parkinsonism is most likely explained by multiple system atrophy.
