51 research outputs found
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āPontinizationā of the medulla: two clinical case studies
The authors report 2 clinical cases of human brainstems where there is blurring of the boundary between the medulla and pons, leading to "pontinization" of the medull
Case records of the Massachusetts General Hospital. Case 39-2006. A 24-year-old woman with systemic lupus erythematosus, seizures, and right arm weakness.
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Nodular bilateral amygdala degeneration in demented individuals
Among more than 2050 brains in our Alzheimer disease brain banks we came across three brains with well demarcated indurated white-yellow nodules in the amygdalas. Microscopically, these nodules were composed of numerous lipid-laden macrophages located in the central region surrounded by an eosinophilic hyaline-like material with minimal reactive gliosis in the periphery. Neurons within these lesions had a normal appearance but were moderately decreased in number. Beta-amyloid, tau and alpha-synuclein immunostaining revealed no abnormal deposits within the nodules. The three patients had long histories of dementia (one linked to a presenilin-1 mutation). The neuropathological diagnoses were Alzheimer disease in two of them and an unclassified tauopathy with argyrophilic grains in the third
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A 44-year-old man with eye, kidney, and brain dysfunction
Retinal vasculopathy with cerebral leukodystrophy (RVCL) is a rare, autosomal dominant condition caused by mutations of the three-prime repair exonuclease-1 (TREX1). The phenotypic expressions range from isolated retinal involvement to varying degrees of retinopathy, cerebral infarction with calcium depositions, nephropathy, and hepatopathy. We report a case of RVCL caused by a novel TREX1 mutation. This patientās multisystem presentation, retinal involvement interpreted as āretinal vasculitisā, and improvement of neuroimaging abnormalities with dexamethasone led to the accepted diagnosis of a rheumatologic disorder resembling BehƧetās disease. Clinicians should consider RVCL in any patient with retinal capillary obliterations associated with tumefactive brain lesions or nephropathy
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TDP-43 Proteinopathy and Motor Neuron Disease in Chronic Traumatic Encephalopathy
Epidemiological evidence suggests that the incidence of amyotrophic lateral sclerosis is increased in association with head injury. Repetitive head injury is also associated with the development of chronic traumatic encephalopathy (CTE), a tauopathy characterized by neurofibrillary tangles throughout the brain in the relative absence of Ī²-amyloid deposits. We examined 12 cases of CTE and, in 10, found a widespread TAR DNA-binding protein of approximately 43 kd (TDP-43) proteinopathy affecting the frontal and temporal cortices, medial temporal lobe, basal ganglia, diencephalon, and brainstem. Three athletes with CTE also developed a progressive motor neuron disease with profound weakness, atrophy, spasticity, and fasciculations several years before death. In these 3 cases, there were abundant TDP-43āpositive inclusions and neurites in the spinal cord in addition to tau neurofibrillary changes, motor neuron loss, and corticospinal tract degeneration. The TDP-43 proteinopathy associated with CTE is similar to that found in frontotemporal lobar degeneration with TDP-43 inclusions, in that widespread regions of the brain are affected. Akin to frontotemporal lobar degeneration with TDP-43 inclusions, in some individuals with CTE, the TDP-43 proteinopathy extends to involve the spinal cord and is associated with motor neuron disease. This is the first pathological evidence that repetitive head trauma experienced in collision sports might be associated with the development of a motor neuron disease
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Ataxia, Dementia, and Hypogonadotropism Caused by Disordered Ubiquitination
In recent years, we have seen great advances in the elucidation of genetic causes of cerebellar ataxia, with newly identified genes regulating a wide spectrum of cellular functions, including intracellular signaling, tau regulation, and mitochondrial function.1 However, a genetic defect cannot be found in approximately 40% of patients with ataxia,1 including those in whom ataxia is associated with reproductive endocrine failure, a syndrome first reported by Gordon Holmes in 1908.2 Most patients with this syndrome have a hypogonadotropic condition, with defective secretion of gonadotropins by the pituitary gland.3-12 Strikingly, genes associated with ataxia have little functional overlap with genes associated with hypogonadotropic hypogonadism, which encode proteins involved in the biologic function of the neurons that secrete gonadotropin-releasing hormone (GnRH).13
A decade ago, we described a consanguineous family with a syndrome of cerebellar ataxia, dementia, and hypogonadotropic hypogonadism.12 Here we report the results of whole-exome and targeted sequencing performed to identify mutations that underlie the syndrome in this kindred and in unrelated patients
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Distribution of [1,2-3H]cholesterol in mouse brain after injection in the suckling period
Glutaraldehyde-carbohydrazide polymer (GACH) was used to embed olfactory tracts, trapezoid body, and sciatic nerves of 9-, 10-, and 49- day old mice 2 h, 24 h, and 6 wk (respectively) after the intraperitoneal administration of [1,2-3H]cholesterol. Greater than 94% of radioactive cholesterol was retained in the GACH-infiltrated brain 24 h or more after injection. The fine structural preservation of both central and peripheral nervous tissues was excellent. Quantitative analysis of electron microscope autoradiographs demonstrated that [1,2- 3H]cholesterol is limited to blood vessel walls and lumen within the central nervous system at 2 h and 6 wk postinjection, but neurons and neuropil also contain the labeled cholesterol. The thickest myelin sheaths in the adult mice appear to be uniformly labeled throughout their width. No relationship of the retained [1,2-3H]cholesterol to the node of Ranvier was found in the adult sciatic nerve
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