Summary
Using stereological techniques we have estimated the volume density of melanin and counted the number of pigmented and non-pigmented neuronal cell bodies in the pars compacta of the substantia nigra of 12 autopsied patients with acquired immune deficiency syndrome (AIDS) who did not have inflammation or necrosis of the midbrain or clinical parkinsonism. The total number of neuronal cell bodies was 25% lower in AIDS (P<0.01) than in 12 age-matched controls, although the volume density of neuronal melanin did not differ from that of controls because the percentage of pigmented cell bodies was higher (P<0.01) and the cell bodies were more fully packed with melanin in AIDS. Also, the expected increase with age of the volume density of neuronal melanin (P<0.02) and the percentage of pigmented neurons (P<0.01) occurred in the controls but not in AIDS patients. Importantly, our histopathological examination showed unequivocal nigral degeneration with neuronal loss, small neuronal cell bodies packed with melanin, reactive astrocytosis and extra-cellular melanin in the AIDS patients but not in controls. Our study shows that a subclinical nigral degeneration is common in AIDS and could possibly explain the heightened suspectibility of some patients to drug-induced parkinsonism.
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References
Anders KH, Guerra WF, Tomiyasu U, Verity MA, Vinters HV (1986) The Neuropathology of AIDS: UCLA experience and review. Am J Pathol 124:537–558
Ballard PA, Tetrud JW, Langston JW (1985) Permanent human parkinsonism due to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP): seven cases. Neurology 35:949–956
Davtyan DG, Vinters HV (1987) Wernicke's encephalopathy in AIDS patient treated with zidovudine. Lancet I:919–920
Dreyer EB, Kaiser PK, Offermann JT, Lipton SA (1990) HIV-1 coat protein neurotoxicity prevented by calcium channel antagonists. Science 248:364–367
Edelstein H, Knight RT (1987) Severe Parkinsonism in two AIDS patients taking prochlorperazine. Lancet II:341–342
Fauci AS (1988) The human immunodeficiency virus: infectivity and mechanisms of pathogenesis. Science 239:617–622
Forno LS, Alvord EC (1971) The pathology of parkinsonism. In: McDowell FH, Markham CH (eds) Recent advances in Parkinson's disease. FA Davis, Philadelphia, pp 120–169
Hagler DN, Frame PT (1986) Azidothymidine neurotoxicity. Lancet II:1392–1393
Lee MR, Ho DD, Gurney ME (1987) Functional interaction and partial homology between human immunodeficiency virus and neuroleukin. Science 237:1047–1051
Mann DMA, Yates PO (1974) Lipoprotein pigments: their relationship to ageing in the human nervous system. II. The melanin content of pigmented nerve cells. Brain 97:489–498
Mizusawa H, Hirano A, Llena JF, Shintaku M (1988) Cerebrovascular lesions in acquired immune deficiency syndrome (AIDS). Acta Neuropathol 76:451–457
Nath A, Jankovic J, Pettigrew C (1987) Movement disorders and AIDS. Neurology 37:37–41
Oppenheimer DR (1984) Diseases of the basal ganglia, cerebellum and motor neurons. In: Adams JH, Corsellis JAN, Duchen LW, (eds) Greenfield's neuropathology, 4th edn, John Wiley and Sons, New York, pp 699–747
Petito CK, Cho ES, Lemann W, Navia BA, Price RW (1986) Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review. J Neuropathol Exp Neurol 45:635–646
Reyes MG, Tosch TT, Childrey V, Penaranda C, Noland CK (1983) Reproducibility of stereologic estimates of light microscopic sections. Acta Stereol 2:135–139
Weibel ER (1979) Stereological methods, vol 1. Academic Press, London, pp 26–30
Wiley CA, Schrier RD, Nelson JA, Lampert PW, Oldstone MBA (1986) Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency patients. Proc Natl Acad Sci USA 83:7089–7093
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Supported in part by grants from the National Research Institute of Neurology and Psychology and the Lena Price Memorial Fund. Presented in part at the Annual Meeting of the American Academy of Neurology, Chicago, Ill., April 10, 1989
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Reyes, M.G., Faraldi, F., Senseng, C.S. et al. Nigral degeneration in acquired immune deficiency syndrome (AIDS). Acta Neuropathol 82, 39–44 (1991). https://doi.org/10.1007/BF00310921
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DOI: https://doi.org/10.1007/BF00310921