Sadao Katayama

CAG expansions in a novel gene for Machado-Joseph disease at chromosome 14q32.1

We have identified a novel gene containing CAG repeats and mapped it to chromosome 14q32.1, the genetic locus for Machado-Joseph disease (MJD). In normal individuals the gene contains between 13 and 36 CAG repeats, whereas most of the clinically diagnosed patients and all of the affected members of a family with the clinical and pathological diagnosis of MJD show expansion of the repeat-number (from 68–79). Southern blot analyses and genomic cloning demonstrates the existence of related genes. These results raise the possibility that similar abnormalities in related genes may give rise to diseases similar to MJD.

Serial diffusion-weighted imaging in MELAS

Abstract Clinical features of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) resemble those of cerebral infarcts, but the pathogenesis of infarct-like lesions is not fully understood. To characterise these infarct-like lesions, we studied two patients with MELAS using diffusion-weighted (DWI) MRI before and after stroke-like episodes and measured the apparent diffusion coefficient (ADC) in the new infarct-like lesions. These gave high signal on DWI and had much higher ADC than normal-appearing regions. The ADC remained high even 30 days after a stroke-like episode then decreased in lesions, with or without abnormality as shown by conventional MRI. We speculate that early elevation of ADC in the acute or subacute phase reflects vasogenic rather than cytotoxic edema. The ADC of the lesions, which disappeared almost completely with clinical improvement, returned to normal levels, which may reflect tissue recovery without severe damage. To our knowledge, this is the first study of DWI in MELAS.

Abnormal signals on proton density-weighted MRI of the superior cerebellar peduncle in progressive supranuclear palsy

Objective– To assess MRI signal abnormalities of the superior cerebellar peduncle (SCP) in progressive supranuclear palsy (PSP) patients. Material and methods– Signal changes were examined on proton density‐weighted images (PDWI) and on T2‐weighted images (T2WI) of SCP in 9 PSP patients, and findings were compared to those in 20 Parkinsons disease patients and 20 age‐matched control subjects. Results– We observed effacement or lack of clarity of the low signal on PDWI in SCP in 4 of 9 PSP patients, but not in any of the Parkinsons disease patients or control subjects. These signal changes were not observed on T2WI. Conclusions– The signal changes on PDWI may be a specific finding reflecting demyelination and gliosis of SCP in PSP. Our findings suggest that evaluation of SCP on PDWI may be helpful in the diagnosis of PSP patients.

A decrease in cerebral cortex intensity on T2-weighted with ageing images of normal subjects

Abstract To determine the change in intensity in the cerebral cortex on T2-weighted MRI with ageing, we reviewed the T2-weighted images of 83 normal subjects and measured the signal intensity in the cerebral cortex in 30 subjects randomly selected from them. Low-intensity areas were more common in the cerebral cortex of the aged. The intensity of different cortical regions varied, and the intensity in the temporal and parietal to be decreased with ageing. Presumably, this change of the intensity reflects senile changes, although low intensity is not evident in the temporal cortex because of its high basal intensity level.

Magnetization Transfer Measurements of Brain Structures in Patients with Multiple System Atrophy

To determine whether magnetization transfer imaging (MTI) demonstrates abnormalities in the brain structures of patients with multiple system atrophy (MSA), we examined 12 patients with clinically probable MSA and 11 control subjects. We calculated magnetization transfer ratios (MTRs) using region of interest analysis from MTI and assessed abnormal signal changes on T2-weighted images. MTRs of the base of the pons, middle cerebellar peduncle, putamen, and white matter of the precentral gyrus were significantly lower in the MSA patients than in the controls. Abnormal signal changes on T2-weighted images were observed in the base of the pons (n = 6), middle cerebellar peduncle (n = 7), and putamen (n = 7). MTRs of regions with abnormal signals were significantly lower than those of regions without abnormal signals and those in the controls. Even the MTRs of the regions without abnormal signals were lower than those in the controls. MTRs of the pyramidal tract, including white matter of the precentral gyrus, posterior limb of the internal capsule, cerebral peduncle, and base of the pons, were significantly lower in patients with pyramidal tract sign (n = 7) than in the controls. Patients with asymmetrical parkinsonism (n = 5) showed significantly lower MTRs in the putamen contralateral to the predominant side of parkinsonian symptoms than the ipsilateral side, although asymmetry of abnormal signal changes on T2-weighted images was not evident in more than half of those patients. This study showed that MTI demonstrates abnormalities in the brains of patients with MSA that seem to reflect underlying pathological changes and that the pathological changes detected by MTI seem to give rise to clinical symptoms. This study also showed that the abnormalities are detected more sensitively and over a larger area by MTI than by conventional magnetic resonance imaging.

Somatostatin increases intracellular Ca2+ concentration in cultured rat hippocampal neurons

Changes of intracellular Ca2+ concentration [( Ca2+]i) in response to somatostatin were measured in cultured rat hippocampal neurons on a single cell basis by fura-2 fluorometry. Somatostatin increased [Ca2+]i dose-dependently and this effect was completely blocked in either Ca2+-depleted medium or LaCl3-containing medium. In addition, omega-conotoxin GVIA completely inhibited the effect of somatostatin. Our results indicate that somatostatin receptors couple with N-type voltage-sensitive Ca2+ channels in cultured rat hippocampal neurons.

Decrease of neurons in the medullary arcuate nucleus of multiple system atrophy: quantitative comparison with Parkinson's disease and amyotrophic lateral sclerosis

The physiological functions of the medullary arcuate nucleus are supposed to be involved in autonomic cardioventilatory regulation, but neuropathological studies on neurodegenerative diseases have rarely reported about the arcuate nucleus. We quantitatively examined the neuronal density of the arcuate nucleus in patients with multiple system atrophy (MSA, n = 3), Parkinsons disease (PD, n = 3), amyotrophic lateral sclerosis (ALS, n = 2), and control subjects (n = 6), and statistically compared the findings in each group. Although the neuronal densities in PD and ALS patients were not different from that in the controls, MSA patients showed a marked depletion of neurons in the arcuate nucleus. The neuronal density (/mm2, mean +/- SEM) in the arcuate nucleus was 9.27 +/- 10.4 in MSA, and was significantly decreased (P < 0.05; Wilcoxon test), compared with that in control subjects (87.1 +/- 12.2). These results suggest that the lesioned arcuate nucleus is related to the pathogenesis of dysatonomia in MSA.

Mapping of somatostatin receptor localization in rat brain: Forebrain and diencephalon

Using quantitative in vitro receptor autoradiography, minute distributions of 125I-Tyr11-somatostatin (SS)-14 binding sites were investigated in the rat forebrain and diencephalon. In the cerebral cortex, there was a high density of receptors observed in layers V-VI and a low density in layers I-IV. The entorhinal cortex displayed the highest receptor density of the cerebral cortices. The olfactory system had a high SS receptor density. The anterior olfactory nucleus, nucleus of the lateral olfactory tract, medial habenular nucleus and the basolateral amygdaloid nucleus showed moderate densities. In the limbic system, the CA1 and subiculum regions had high receptor densities. More detailed observations revealed high receptor densities in the oriens, radiatum and lacunosum layers and a much lower density in the pyramidal cell layer. The caudate putamen and substantia nigra showed low receptor densities, while the claustrum displayed the highest density of receptors in the rat brain. These data were not consistent with those of previous studies using 125I-SS-28 and 125I-201-995, which had shown that the high receptor density area in the basolateral amygdaloid group was identified as the lateral amygdaloid nucleus, and that the pyramidal cell layer in the hippocampus showed high receptor densities.

Autopsy case of pure akinesia showing pallido‐nigro‐luysian atrophy

A 60‐year‐old man developed levodopa‐resistant pure akinesia. The patient gradually became more akinetic without accompanying gaze palsies, nuchal dystonia, or other parkinsonian features such as rigidity or tremor. At the age of 71, he died of bronchopneumonia. Neuropathologically, bilateral marked neuronal loss and gliosis were restrictedly observed in the globus pallidus, substantia nigra and corpus luysii, whereas mild gliosis without neuronal loss was found in the brain stem. With Gallyas‐Braak silver stain, numerous argyrophilic fibrous structures partly surrounding glial nuclei were observed in the three major affected regions. With Bodian stain, however, they were rarely recognized. The structures were partly positive for tau protein. Rare neurofibrillary tangles were found in the three areas and brain stem. They were relatively more numerous but still sparse in the hippocampus and the parahippocampus. The present case was diagnosed as having pallido‐nigro‐luysian atrophy based on two characteristic findings: (i) the distribution of lesions showing neuronal loss with gliosis; and (ii) significant presence of tau‐positive argyrophilic fibrous structures related to glia but with the absence of neurofibrillary tangles in the major affected regions and the brain stem. As our present case uniquely showed pure akinesia for the whole clinical course, it is noteworthy to report it here with a full neuropathological evaluation. In addition, a moderate number of diffuse plaques positive for β‐amyloid were distributed in the thalamus.

Slowly progressive L-DOPA nonresponsive pure akinesia due to nigropallidal degeneration: a clinicopathological case study

We report an autopsy case of a 51-year old man who showed slowly progressive pure akinesia: freezing phenomenon and festination during 21 years of illness without tremor, rigidity, upward gaze palsy, bradykinesia and dementia, which were not responded to L-DOPA clinically. Neuropathological findings revealed the circumscribed regions in the substantia nigra and middle portion of the internal globus pallidus (GPi), without neurofibrillary tangles, neuropil threads, and glial fibrillary tangles. So this case was clearly distinguished with progressive nuclear palsy and pallidonigroluisian atrophy. It was first reported to describe that L-DOPA nonresponsive pure akinesia can arise from nigopallidal atrophy.