Olfactory bulb in multiple system atrophy

Kovács, Tibor; Papp, M; Cairns, Nigel J.; Khan, M. Nadeem; Lantos, Peter L.

doi:10.1002/mds.10466

Cited by 49 publications

(31 citation statements)

References 22 publications

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“…Isolated GCI were detected In the olfactory bulb (Fig. 3a), consistent with previous reports [16]. The basal ganglia had mild neuronal loss and gliosis with iron pigment in the lateral putamen.…”

Section: Neuropathologic Findings (Case 2)supporting

confidence: 90%

Glial cytoplasmic inclusions in neurologically normal elderly: prodromal multiple system atrophy?

et al. 2008

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In this study we used immunohistochemistry to screen for α-synuclein pathology in the brains of 241 individuals without clinical evidence of neurologic disease, and discovered 36 cases (15%) with incidental Lewy bodies (LBs) and one case, a 96-year-old woman (0.4%), with inclusions similar to those seen in multiple system atrophy (MSA), a nonfamilial neurodegenerative disorder characterized by parkinsonism, cerebellar ataxia and autonomic dysfunction and α-synuclein immunoreactive glial cytoplasmic inclusions (GCI). In a routine hospital autopsy series of 125 brains, we detected GCI in a neurologically normal 82-year-old man (0.8%). Both cases showed widespread GCI in the central nervous system, as well as a few neuronal cytoplasmic inclusions, but no neuronal loss or gliosis in vulnerable brain regions, including the substantia nigra, putamen, inferior olive and pontine base. Applying a recently proposed grading scale for MSA, the two cases showed pathology far below that detected in patients with clinically overt MSA, suggesting the possibility that these two individuals had preclinical MSA. The prevalence of clinically overt MSA is estimated to be about 4 per 100,000 persons (0.004%), which is far less than the frequency of GCI in this series (0.4%-0.8%). Further studies are needed to determine is GCI in neurologically normal elderly represents prodromal MSA or a rare non-progressive age-related α-synucleinopathy.

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Section: Neuropathologic Findings (Case 2)supporting

confidence: 90%

Glial cytoplasmic inclusions in neurologically normal elderly: prodromal multiple system atrophy?

et al. 2008

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“…Several studies have also suggested the lack of correlation between olfactory loss with duration or severity of the disease [27,29,30], which was confirmed by the present study. Studies that examined the correlation between pathological changes in the brain and results of olfactory tests suggested that olfactory dysfunction in MSA could be related to glial cytoplasmic inclusions in the olfactory bulb [31]. Another study examined the brain of patients with PSP at postmortem and identified neurofibrillary tangles and tau accumulation in the rhinencephalon, although only three of their patients had hyposmia [13].…”

Section: Discussionmentioning

confidence: 99%

The odor stick identification test for Japanese differentiates Parkinson's disease from multiple system atrophy and progressive supra nuclear palsy

et al. 2011

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BackgroundProgressive supranuclear palsy (PSP) and parkinsonian variant of multiple system atrophy (MSA-P) are clinically difficult to differentiate from idiopathic Parkinson's disease (PD), particularly in the early stages of the disease. Previous reports indicated that the olfactory function is relatively intact or slightly reduced in patients with PSP and MSA-P, suggesting that the odor stick identification test for Japanese (OSIT-J), which is a short and simple noninvasive test that is potentially useful clinically for detecting early-stage PD in Japan, may be useful in the differential diagnosis of early-stage PD from MSA-P and PSP. There is no information on the sensitivity and specificity of OSIT-J in the diagnosis of parkinsonian syndromes such as PSP and MSA-P.MethodsWe assessed the olfactory function using the OSIT-J test in 94 Japanese patients with idiopathic PD, 15 with MSA-P, 7 with PSP, and 29 age-matched control subjects.ResultsThe mean ± SD score of OSIT-J in patients with PD (4.4 ± 2.9) was significantly lower than in patients with MSA-P (8.7 ± 2.2, P < 0.0001), PSP (7.6 ± 2.2, P < 0.0057), and control subjects (10.5 ± 1.3, P < 0.0001). The area under the curve (AUC) of receiver operating characteristic (ROC) to discriminate PD from normal control using OSIT-J scores was 0.97 (95% confidence interval, 0.95-1.00), from MSA-P 0.87 (0.80-0.95), and from PSP 0.81 (0.66-0.96).ConclusionThe OSIT-J is a potentially useful clinical test not only for detection of olfactory deficit in PD but also for differentiating PD from MSA-P and PSP.

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“…In multiple system atrophy (MSA), glial cytoplasmatic inclusions may be present in the olfactory bulb [27,37]. However, most studies have found evidence of only a mild smell deficit [21,38,39,40 . ], and UPSIT scores are significantly higher than in PD [38].…”

Section: Multiple System Atrophymentioning

confidence: 99%