{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:14:00Z","timestamp":1778800440011,"version":"3.51.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We aimed to investigate the frequency of multiple system atrophy (MSA) in a large number of forensic autopsies and characterize the pathological appearance of preclinical MSA. We investigated a series of 1930 brains from forensic autopsies. In addition to performing immunohistochemistry for phosphorylated \u03b1-synuclein, the levels of 3 autonomic nervous system markers (catecholaminergic, serotonergic, and cholinergic) were used to assess the peripheral nerve (heart and superior cervical ganglion) and medulla oblongata. The results were compared to those of healthy control and Parkinson disease (PD) cases. Four cases (0.21%) were identified as having MSA. Cases 1\u20133 were symptomatic, and Case 4 was incipient; that is, although no neuronal loss was evident, the cerebellar dentate nucleus exhibited marked grumose degeneration. Immunohistochemistry revealed a marked reduction in autonomic nervous system marker levels expressed in the medulla; this reduction was more prominent in the 3 symptomatic MSA cases than in the PD case. The opposite occurred for the peripheral nerve. Case 4 exhibited mild cholinergic nerve reduction. Two cases showed possible significant pathological changes in the heart. Grumose degeneration, few oligodendroglial cytoplasmic inclusions without neuronal loss, and less reduction of autonomic nervous tissue were more prominent in the preclinical case than in symptomatic cases.<\/jats:p>","DOI":"10.1093\/jnen\/nlac096","type":"journal-article","created":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T09:07:35Z","timestamp":1666948055000},"page":"965-974","source":"Crossref","is-referenced-by-count":3,"title":["Pathological Appearance of a Case of Preclinical Multiple System Atrophy: A Comparison With Advanced Cases"],"prefix":"10.1093","volume":"81","author":[{"given":"Keitaro","family":"Okada","sequence":"first","affiliation":[{"name":"Department of Legal Medicine, Faculty of Medicine, University of Toyama From the , Toyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, Faculty of Medicine, University of Toyama From the , Toyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shojiro","family":"Ichimata","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, Faculty of Medicine, University of Toyama From the , Toyama, Japan"},{"name":"Tanz Centre for Research in Neurodegenerative Disease, Krembil Discovery Tower, University of Toronto , Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology and Department of Medicine, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, Faculty of Medicine, University of Toyama From the , Toyama, Japan"},{"name":"Tanz Centre for Research in Neurodegenerative Disease, Krembil Discovery Tower, University of Toronto , Toronto, Ontario, Canada"},{"name":"Department of Laboratory Medicine and Pathobiology and Department of Medicine, University of Toronto , Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6921-1768","authenticated-orcid":false,"given":"Naoki","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine, Faculty of Medicine, University of Toyama From the , Toyama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"2024032523485273200_nlac096-B1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1056\/NEJMra1311488","article-title":"Multiple-system atrophy","volume":"372","author":"Fanciulli","year":"2015","journal-title":"N Engl J Med"},{"key":"2024032523485273200_nlac096-B2","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1212\/WNL.49.5.1284","article-title":"Incidence of progressive supranuclear palsy and multiple system atrophy in Olmsted County, Minnesota, 1976 to 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