RESEARCH: New findings on the neuropathology of multiple system atrophy.

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Auton Neurosci 2002 Feb 28;96(1):59-62

New findings on the neuropathology of multiple system

atrophy.

Benarroch EE.

Neurophysiological Laboratory, Department of

Neurology, Mayo Clinic, Rochester, MN 55905, USA.

benarroch.eduardo@...

Multiple system atrophy (MSA) provides a typical

example of the integrative role of the central

autonomic network in controlling cardiovascular,

respiratory, bladder and gastrointestinal functions.

There is increasing evidence that neurochemically

defined neuronal groups of the brainstem are

selectively affected in MSA to a much greater degree

than in Parkinson's disease. These include the

catecholaminergic neurons of the rostral ventrolateral

medulla (C1 group) which project to the

intermediolateral cell column and are involved in

modulation of sympathetic vasomotor outflow, and

noradrenergic neurons of the caudal ventrolateral

medulla (A1 group) projecting to the magnocellular

nuclei of the hypothalamus and regulating vasopressin

(AVP) release. Loss of these groups of neurons may, at

least in part, explain the development of orthostatic

hypotension, baroreflex dysfunction, and impaired

reflex AVP release in response to hypotension. There

is preliminary evidence that cardiovagal neurons of

the ventrolateral portion of the nucleus ambiguus,

distinct from the branchimotor neurons of the compact

region, may also be affected in MSA. Loss of

cholinergic neurons in the medullary arcuate nucleus,

considered by some to be the homologous to the central

chemosensitive region of the ventral medullary

surface, may contribute to disturbances in automatic

ventilation, particularly during sleep, in patients

with MSA.

PMID: 11911503 [PubMed - in process]

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