DECREASE OF MEDULLARY CATECHOLAMINERGIC NEURONS IN MULTIPLE SYSTEM ATROPHY AND PARKINSONS-DISEASE AND THEIR PRESERVATION IN AMYOTROPHIC-LATERAL-SCLEROSIS
S. Kato et al., DECREASE OF MEDULLARY CATECHOLAMINERGIC NEURONS IN MULTIPLE SYSTEM ATROPHY AND PARKINSONS-DISEASE AND THEIR PRESERVATION IN AMYOTROPHIC-LATERAL-SCLEROSIS, Journal of the neurological sciences, 132(2), 1995, pp. 216-221
We investigated the number of tyrosine hydroxylase (TH)-immunoreactive
neurons in the C1 and A2 regions of the medulla, the sites of the bar
oreflex are, in 7 patients with multiple system atrophy (MSA), 8 with
Parkinson's disease (PD), 9 with amyotrophic lateral sclerosis (ALS),
and 12 age-matched normal subjects to analyze the relationship between
cardiovascular dysfunction and medullary catecholaminergic neurons. O
rthostatic hypotension (OH) was marked in all the MSA patients and mod
erate in three PD patients. Three of the five ALS patients who had bee
n on respirators showed lability of blood pressure; paroxysmal hyperte
nsion and nocturnal hypotension without compensatory tachycardia. All
the MSA patients showed extremely marked decrease of TH-immunoreactive
neurons in both the C1 and A2 regions. In the patients with Parkinson
's disease, numerous TH-immunoreactive neurons contained Lewy bodies t
hat were immunostained by antibody to TH. TK-immunoreactive neurons we
re decreased very markedly in the A2 regions of two patients with OH,
and three patients without OH showed fairly marked decreases in the C1
or A2 region. In contrast, the number of TH-immunoreactive neurons in
ALS was the same as in normal subjects. In MSA and some PD patients,
orthostatic hypotension may partly be due to the involvement of the me
dullary catecholaminergic neurons. The lability of blood pressure in A
LS probably is not related to the medullary catecholaminergic neurons.