Pathologic evaluation of the supraoptic and paraventricular nuclei in dementia.

BACKGROUND: The neuropeptide oxytocin, produced in the supraoptic (SON) and paraventricular nuclei (PVN) of the hypothalamus, is now understood to function as a neurotransmitter critical for various aspects of social cognition and pro-social behaviour. While patients with Frontotemporal dementia (FTD) display prominent and progressive deficits in such social behaviours, the integrity of these nuclei in FTD is not known. METHODS: We conducted a quantitative neuropathologic examination of the SON and PVN from patients with FTLD with TDP-43 proteinopathy, Alzheimer's disease, Lewy body disease and controls to determine whether significant pathologic changes or neuronal loss may contribute to the striking behavioural symptoms of FTD. RESULTS: Contrary to predictions, we found both nuclei to be free of significant pathologic change (TDP-43) in FTLD. In contrast, tau related pathology was found in the PVN in Alzheimer's disease, and alpha-synuclein pathology in the SON in patients with Lewy body dementia. CONCLUSIONS: These results indicate that the SON and PVN are resistant to FTLD TDP-43 pathology. They also support prior suggestions that the SON is resistant to Alzheimer's disease (AD) related pathology, and extend this to demonstrate SON susceptibility to alpha-synuclein pathology in patients with Lewy body dementia.

Globular glial tauopathy, a newly recognized white matter tauopathy, with depression/anxiety disorder: report and review of classification.

Several studies have recently described 4-repeat tauopathies that are characterized by the presence of globular glial inclusions. These inclusions are astrocytic or oligodendroglial, show extensive white matter involvement, and have a wide range of neuropathological and clinical presentations. Globular glial tauopathy (GGT) is classified into three subtypes according to clinical manifestations. Type I is characterized by frontotemporal lobar degeneration and represents a group of diseases with diverse clinical and histopathological features. Some of these disorders are associated with abnormal microtubule-associated protein tau gene. Type II presents as motor impairment due to pyramidal involvement, whereas type III is a combination of the features of types I and II. This report describes a rare case of GGT that manifested as depression and anxiety and demonstrates its neuropathological features. We have also compared the features of this case with those of previously reported cases and have revisited the classification.