[COVID-19 and the central and peripheral nervous system]. / COVID-19: Auswirkungen auf das zentrale und periphere Nervensystem.

The health effects of coronavirus disease 2019 (COVID-19) caused by the infection of SARS-CoV­2 (severe acute respiratory syndrome coronavirus 2) are becoming increasingly clear as the pandemic spreads. In addition to the lungs, other organs are also affected, which can significantly influence morbidity and mortality. In particular, neurological symptoms involving the central nervous system can lead to acute or long-term consequences. The mechanisms of this neuropathogenesis of SARS-CoV­2 infection and its relation to acute and chronic neurological symptoms are the subject of current studies investigating a potential direct and indirect viral infection of the nervous system. The following review summarizes the current status of neuropathological manifestations, molecular pathogenesis, possible infection pathways in the nervous system, and systemic effects. In addition, an overview of the Germany-wide CNS-COVID19 registry and collaborations is presented, which should contribute to a better understanding of the neurological symptoms of COVID-19.

An in-depth diagnostic exploration of an inflammation and necrosis syndrome in a population of newborn piglets.

Inflammation and loss of tail integrity can be reasons for serious impairment of animal welfare and one of the major challenges facing modern pig farming. Evidence from practice increasingly suggests that tail lesions might be caused not only by tail biting but also by inflammation and necrosis, which can occur without any action from other pigs. Such changes are not limited to the tail but can also be observed in the ears, heels and soles, claw coronary bands, teats, navel, vulva and face. To describe inflammatory and necrotic manifestations in newborn piglets, all 146 piglets from 11 sows were clinically examined not later than 2 h after birth. In addition, the tail base of 30 randomly selected piglets out of the 146 was histo-pathologically examined as one of the most conspicuously affected body parts. Over 80% of the newborns showed affections in the tail base, claw wall and heels. In 65-87% of the animals, the coronary bands, teats, the face and the ears were affected. None of the 146 piglets was completely free from pathological manifestations. On average, the piglets were affected in six out of nine body parts simultaneously. Histological examinations showed that clear alterations in the skin were already manifested around the time of birth in all examined piglets. Alterations were characterised by the occurrence of numerous lymphocytes and granulocytes throughout the entire subepithelial connective tissue, predominantly in perivascular and perifollicular localisation but also within directly subepithelial glandular ducts and diffusely within the subepithelial connective tissue. In the majority of individuals, the epithelial structure was intact. This concurrence of symptoms in the newborns indicates a primarily endogenous aetiology of an inflammation and necrosis syndrome. Further studies in diverse herd contexts are necessary to establish the conditions for the emergence of such a syndrome and develop welfare indicators.

Neuronal ceroid lipofuscinosis (NCL) is caused by the entire deletion of CLN8 in the Alpenländische Dachsbracke dog.

Neuronal ceroid lipofuscinoses (NCLs) are inherited lysosomal storage diseases that have been described in a variety of dog breeds, where they are caused by different mutations in different genes. However, the causative gene defect in the breed Alpenländische Dachsbracke remained unknown so far. Here we present two confirmed cases of NCL in Alpenländische Dachsbracke dogs from different litters of the same sire with a different dam harboring the same underlying novel mutation in the CLN8 gene. Case 1, a 2-year-old male Alpenländische Dachsbracke was presented with neurological signs including disorientation, character changes including anxiety states and aggressiveness, sudden blindness and reduction of food intake. Magnetic resonance imaging (MRI) scans showed cerebral atrophy with dilation of all cerebral ventricles, thinning of the intermediate mass of the thalamus and widening of the cerebral sulci. Postmortem examination of the central nervous system (CNS) showed neuronal loss in the cerebral cortex, cerebellum and spinal cord with massive intracellular deposits of ceroid pigment. Additional ceroid-lipofuscin deposits were observed in the enteric nervous system and in macrophages within spleen, lymph nodes and lung. Ultrastructural analyses confirmed NCL with the presence of osmiophilic membrane bounded lamellar-like structures. Case 2, a 1,5-year old female Alpenländische Dachsbracke was presented with progressive generalized forebrain disease including mental changes such as fearful reactions to various kinds of external stimuli and disorientation. The dog also displayed seizures, absence of menace reactions and negative cotton-ball test with normal pupillary light reactions. The clinical and post mortem examination yielded similar results in the brain as in Case 1. Whole genome sequencing of Case 1 and PCR results of both cases revealed a homozygous deletion encompassing the entire CLN8 gene as the most likely causative mutation for the NCL form observed in both cases. The deletion follows recessive inheritance since the dam and a healthy male littermate of Case 1 were tested as heterozygous carriers. This is the first detailed description of CLN8 gene associated NCL in Alpenländische Dachsbracke dogs and thus provides a novel canine CLN8 model for this lysosomal storage disease. The presence of ceroid lipofuscin in extracerebral tissues may help to confirm the diagnosis of NCL in vivo, especially in new dog breeds where the underlying mutation is not known.

Metastasizing Esthesioneuroblastoma in a Dog.

A 7-year-old Afghan hound presented with a history of disorientation, loss of vision, and seizures. Magnetic resonance imaging helped identify a mass at the level of the main olfactory bulb that compressed and displaced adjacent tissues in the cribriform plate into the nasal cavity and nasopharynx. Bony structures were osteolytic. After removing almost 80% of the mass, the tumor recurred a few months later. Due to severe respiratory distress and subsequent to an ultrasound diagnosis of a liver tumor, the dog was euthanized. In addition to the nasal mass, a single nodule in the liver and multiple nodules in the lung were present. All masses had similar cell morphology and were diagnosed as metastasizing esthesioneuroblastoma. The neoplastic cells expressed neuron-specific enolase and chromogranin A, and a few cells within the nasal mass were positive for cytokeratin. This is the first description of a canine esthesioneuroblastoma with distant metastases.

Unilateral cerebellar hypoplasia and mesencephalic malformation in a Hanoverian foal.

Neurological cases, especially in foals, are rare in the daily practical work. The most common causes are traumata and infectious diseases of the central nervous system (CNS). This case report provides further insights into the wide spectrum of possible neuropathological lesions by detailing a complex malformation with unilateral neurological signs that occurred later post natum. Thus, clinicians should also be aware of malformations in case of respective neurological patients. A Hanoverian foal was presented with progressive ataxia. General and blood examination revealed no further alterations. By neurologic examination, a unilateral hypermetria was diagnosed and a cysternography of the head was performed. A cerebellar malformation was assumed and the foal was euthanized due to poor prognosis. At necropsy, a unilateral absence of a cerebellar hemisphere and vermis accompanied by contralateral malformation of the mesencephalon was diagnosed. The missing areas of the right cerebellar hemisphere were replaced by a cystic formation. The left part of the mesencephalic lamina quadrigemina was reduced in size and the corpus callosum was hypoplastic. Additional microscopical findings were most obvious near the cyst formation and included angiofibrosis in remaining cerebellar and mesencephalic parenchyma and leptomeninges, heterotopia of cerebellar neurons, sclerosis in cerebellar cortex, focal proliferation of meningeal cells and mild mononuclear perivascular infiltrates. Occassional irregular neuronal arrangement in the mesencephalon was also present. Infectious agents such as Borna disease virus, rabies virus, and equine herpesvirus were not detected. Therefore, the complex malformation in this foal might have been caused by a destructive, possibly ischemic event, or could represent a sequel of a primary retrocerebellar cyst with accompanying compression of adjacent parenchyma.

Aprosencephaly with otocephaly in a lamb (Ovis aries).

Aprosencephaly is a rare condition in veterinary and human medicine characterized by the complete absence of telencephalon and diencephalon. Some cases are accompanied by a facial dysmorphism designated as otocephaly. A stillborn lamb had splanchnocranial anomalies that were classified by computed tomography, magnetic resonance imaging, and pathologic examination as aprosencephaly and otocephaly. The brain included parts of the cerebellum and brainstem but no telencephalon, diencephalon, or mesencephalon. The cerebellum had a structurally normal cortex with expression of neuronal nuclear antigen in the inner and doublecortin in the outer granular cell layers, as well as an irregularly situated nucleus dentatus. Aprosencephaly with otocephaly has been described in mice with heterozygous mutations in the Otx2 gene; however, no causative polymorphisms were detected in the Otx2 gene region of this lamb.

Neurogenesis in a young dog with epileptic seizures.

Epileptic seizures can lead to various reactions in the brain, ranging from neuronal necrosis and glial cell activation to focal structural disorganization. Furthermore, increased hippocampal neurogenesis has been documented in rodent models of acute convulsions. This is a report of hippocampal neurogenesis in a dog with spontaneous epileptic seizures. A 16-week-old epileptic German Shepherd Dog had marked neuronal cell proliferation (up to 5 mitotic figures per high-power field and increased immunohistochemical expression of proliferative cell nuclear antigen) in the dentate gyrus accompanied by microglial and astroglial activation. Some granule cells expressed doublecortin, a marker of immature neurons; mitotically active cells expressed neuronal nuclear antigen. No mitotic figures were found in the brain of age-matched control dogs. Whether increased neurogenesis represents a general reaction pattern of young epileptic dogs should be investigated.

Malignant mesenchymoma in the nasal cavity of a bull.

A 4-year-old bull was presented with facial distortion and abnormal respiratory noise. Endoscopically, a proliferative mass was found obliterating the left nasal cavity and a tumour was suspected. The head was examined after slaughter and there was a well-circumscribed solid structure (15×12×6 cm) extending into the paranasal sinus, the choanal region and the bones of the orbit, with focal penetration of the nasal septum. Microscopically, the mass consisted of well-differentiated trabeculae of woven and lamellar bone, areas of chondromyxomatous, immature and mature cartilaginous tissue, and regions with irregular whorled spindle cells. Tissue differentiation of the mass was variable. Centrally, there was osseous differentiation with an outermost fibromatous area resembling a zone of endochondral ossification. There was suppurative and ulcerative inflammation where the tumour extended through the hard palate and into the pharynx. A nasal malignant mesenchymoma was diagnosed on the basis of these features.

Leukoencephalopathy associated with parvovirus infection in Cretan hound puppies.

Leukoencephalopathies in dogs encompass presumably inherited conditions such as leukodystrophies, hypomyelination or spongiform degeneration, but other causes, such as virus infections and toxic or nutritional factors, might also play a contributory role. In this report, we provide evidence of parvovirus infection and replication in the brains of five 6-week-old Cretan hound puppies suffering from a puppy shaker syndrome and leukoencephalopathy. Although these puppies belonged to two different litters, they were closely related, tracing back two generations to the same sire. Histologically, a mild to moderate lymphohistiocytic meningitis, with focal lymphohistiocytic leukoencephalitis in two animals, and a mild to moderate vacuolation with myelin loss, mainly in the white matter of the cerebellum was detected. Vacuolation was also found in the corpus callosum, fimbria hippocampi, mesencephalon, capsula interna, basal ganglia, and hypothalamus. By immunohistology and in situ hybridization, either parvoviral antigen, DNA, mRNA, or replicative intermediate DNA were detected in the cerebellum, hippocampus, periventricular areas, corpus callosum, cerebral cortex, medulla oblongata, and spinal cord. Parvovirus antigen, DNA, and mRNA were present in cells of the outer granular layer of the cerebellum and in periventricular cells, most likely representing spongioblasts, glial cells, neurons, endothelial cells, occasional macrophages, and ependymal cells. Sequencing revealed canine parvovirus type 2 stretches. Thus, an association of parvovirus infection with the leukoencephalopathy seems likely, possibly facilitated by a genetic predisposition due to the mode of inbreeding in this particular dog breed.

Anencephaly in a german shepherd dog.

Anencephaly results from defects in neural tube closure early in gestation and, to the authors' knowledge, has not been reported in dogs. In this case, the canine fetus was stillborn at the 62nd day of gestation and had a hypoplastic calvarium, with flattened base of the skull and shallow orbits, causing protrusion of the eyes. Macroscopically, the brain was completely missing. Histologically, well-differentiated nerve fibers, fragments of cerebellar folia, and ganglia with large neurons and glial cells were detected in a loose stroma in sections through the cranial bone and adjacent soft tissue in the rudimentary cranial cavity. Immunohistochemically, single cells within the stroma expressed NeuN, consistent with mature neurons, whereas intracranial ganglion cells and nerves had mild expression of doublecortin. The presence of many immature, and only a few mature, neurons in the rudimentary nerve tissue in this case indicates a failure of physiological brain development and differentiation.

Fatal cowpox virus infection in captive banded mongooses (Mungos mungo).

Cowpox virus infections have been described in various domestic and exotic animal species. This report is the first on an outbreak of fatal generalized cowpox virus infection among captive banded mongooses (Mungos mungo, suborder Feliformia). All animals of a colony of 8 mongooses showed a fulminant course of disease. The whole population died (n=7) or was euthanized (n=1) within 11 days. Postmortem examinations were performed on 4 animals. All animals showed extensive necrotizing inflammation of retropharyngeal lymph nodes, typical poxviral skin lesions, and multiple necrotic foci in liver and spleen. Three animals exhibited an ulcerating stomatitis. Pulmonary lesions, a common feature of fatal cowpox virus infections in other feliform species, were not obvious. Histopathologically, characteristic cytoplasmic inclusion bodies were detected in all affected organs but the spleen. Based on transmission electron microscopy and cell culture, Orthopoxvirus was identified as the etiology. The virus was further characterized by polymerase chain reaction and sequence analysis, identifying it as cowpox virus. A survey in the habitat suggests wild brown rats (Rattus norvegicus) as the most likely source of infection.

Proposing the term purkinjeoma: protein gene product 9.5 expression in 2 porcine cardiac rhabdomyomas indicates possible purkinje fiber cell origin.

Rhabdomyomas, defined as rare benign tumors of striated muscle, predominantly occur in the myocardium. In veterinary medicine, cardiac rhabdomyomas have rarely been reported but most frequently in pigs as an incidental finding. In the present case report, multiple circumscribed nodules found in the myocardium of 2 pigs were composed of large, vacuolated, glycogen-loaded cells. They expressed vimentin and desmin, neuron-specific enolase, and atrial natriuretic peptide. In addition, these cells expressed protein gene product 9.5, a marker for neuronal tissue and Purkinje fiber cells, in contrast to adjacent myocytes. The present findings-especially, the protein gene product 9.5 immunoreactivity-provide further evidence for the Purkinje fiber cell origin of the porcine myocardial proliferation. Therefore, the term purkinjeoma or purkinjeomatosis is proposed for cardiac rhabdomyoma in pigs.

Borna disease in an adult alpaca stallion (Lama pacos).

Borna disease (BD) was diagnosed in a 2-year-old male alpaca with a history of chronic suppressed sexual desire and acute stretching convulsions. Microscopical examination of the central nervous system revealed non-purulent meningoencephalitis with mononuclear perivascular cuffing. The diagnosis was confirmed by immunohistochemistry, in-situ hybridization, polymerase chain reaction (PCR) and sequencing of PCR products and alignment with known Borna disease virus sequences. Serological screening of the herd was performed. This is the first detailed report of naturally occurring BD in alpacas.

[Proventricular dilatation disease and Avian Bornavirus as a possible cause]. / Die neuropathische Drüsenmagendilatation der Psittaziden und das aviäre Bornavirus als potenzielle Ursache.

OBJECTIVE: Proventricular Dilatation Disease (PDD) is a very important letal disease in parrots. It affects several psittacine species and is a high risk factor for the health of breeding collections, but is rarely observed in other avian families. To date, the etiology of the disease remained unclear, though a virus infection was always assumed. Recently, a novel virus (Avian Bornavirus [ABV]) was discovered in parrots suffering from PDD so that ABV is now considered as the most likely cause. Despite the fact that clinically healthy birds may be infected with ABV, several studies demonstrate a correlation between ABV-infection and clinically present PDD. Apart from direct virus detection, serological methods allow the demonstration of an infection. CONCLUSIONS: Currently, Avian Bornavirus is the leading candidate as the aetiologic agent of PDD. Breeding collections and birds planned to be introduced into collections should therefore be investigated by molecular biological and serological methods for the presence of an ABV-infection. The diagnostic value of the demonstration of an ABV-infection for the diagnosis of a clinically present PDD has to be investigated further.

Restricted expression of Borna disease virus glycoprotein in brains of experimentally infected Lewis rats.

AIM: Borna disease virus (BDV) induces a persistent infection in the central nervous system (CNS) accompanied by a non-purulent meningoencephalitis. BDV-infection of Lewis rats provides an important model to investigate basic principles of neurotropism, viral persistence and resulting dysfunctions. To date, the in vivo strategies of BDV to persist in the CNS are not fully understood. Viral glycoproteins are main targets of the antiviral defence implicating a controlled expression in case of persistent infections. Therefore, we analysed the expression profiles of the BDV-glycoprotein (BDV-GP) and corresponding BDV-intron II RNA in experimentally infected rat brains, focusing on their spatio-temporal occurrence, regional, cellular and intracellular locations. METHODS: This was carried out by immunohistochemistry and in situ hybridization. The expression pattern of the most abundantly expressed BDV-nucleoprotein (BDV-N) served as a reference. RESULTS: BDV-N mRNA was detected preferentially in the cytoplasm of neurones, whereas BDV-intron II mRNA was found predominantly in the nucleus of brain cells. The genomic RNA was restricted to the nucleus. Expression of BDV-GP was significantly lower than BDV-N expression and mainly limited to cerebral cortex, hippocampus, amygdala and thalamus. BDV-GP was restricted to larger neurones; BDV-N occurred also in astrocytes, oligodendrocytes and ependymal cells. CONCLUSIONS: The expression profiles of BDV-GP, BDV-N and their mRNAs are significantly different, indicating that BDV-GP expression is regulated in vivo. This might be achieved by restricted nuclear export and/or maturation of BDV-intron II mRNA or limited translation as a viral mechanism to escape from the immune response and enable persistence in the CNS.

Expression of activity-dependent neuroprotective protein in the brain of adult rats.

Activity-dependent neuroprotective protein (ADNP) is a VIP-regulated gene, which is essential for brain development. A synthetic peptide (NAP) derived from the ADNP sequence is highly neuroprotective, therefore it has been hypothesised that ADNP has a similar role. ADNP contains classical transcription factor motifs and nuclear localisation domains, but it has also been reported to be secreted and to co-localise with microtubules, indicating that ADNP may have multiple functions. We investigated the pattern of ADNP expression by immunohistology in normal rat brain, in order to generate a framework for future studies examining changes in ADNP expression in response to noxious stimuli or in models of disease. We found widespread ADNP-like immunoreactivity in neurons throughout the rat brain, with the highest expression in the cerebellum, and strong expression in the thalamus, mesencephalon, pons and medulla oblongata. ADNP-like immunoreactivity was mainly observed in the cytoplasm of neurons, and fibre tracts were often strongly positive as well. In addition, positive neuronal nuclei were occasionally observed. ADNP-like immunoreactivity was lost in degenerating "dark" neurons, whereas it appeared to locate to the nucleus in some of the morphologically unaltered adjacent cells. Occasional astrocyte and microglial cells were also positive. We suggest that the widespread expression of ADNP may correlate with the wide-ranging protective effects of NAP, and that the cytoplasmic and axonal localisation of ADNP-like immunoreactivity suggests additional, non-transcriptional functions of ADNP.

Unusual type of reactive astrocytes in the feline central nervous system.

An unusual type of hypertrophic astrocytes termed plump polygonal astrocytes (PPA) has been observed in the feline central nervous system which was characterized in a first preliminary study of 17 cats. These cells presented an oval to polygonal shape, measured about 20 microm in diameter, and displayed short, barely detectable processes. The condensed, hyperchromatic, eccentric nucleus was surrounded by an abundant, homogenous, eosinophilic cytoplasm. These GFAP-and S-100-positive and vimentin-negative cells were predominantly found in brains showing status spongiosus and less frequently in association with inflammation and in brains lacking histological lesions. They were mainly detected in white matter areas of the hindbrain. In addition, these cells were also observed in the dentate hilar region adjacent to degenerated neurons and a small amount of PPA were positive for caspase-3. It remains to be determined if PPA represent a specific type of reactive astrocytes and whether they are characteristic for a specific cause or response in the feline brain.

Non-suppurative meningoencephalitis of unknown origin in cats and dogs: an immunohistochemical study.

Non-suppurative meningoencephalitis of unknown cause is a frequent finding in dogs and cats. Fifty-three dogs and 33 cats with non-suppurative meningoencephalitis of unknown aetiology were examined immunohistochemically for 18 different infectious agents, including viruses, bacteria and prion protein(Sc). In 14 (26%) of the dogs and 13 (39%) of the cats a causative agent was identified in the central nervous system (CNS), two dogs and one cat giving positive results for two infectious agents simultaneously. The study revealed infections with known causative agents (porcine herpes virus 1, feline infectious peritonitis virus, Escherichia coli) and a new disease pattern of parvovirus infection in the CNS of dogs and cats. Infection of the CNS with feline leukaemia virus was found in a cat. Five dogs and four cats gave positive results for West Nile virus (WNV) antigen. In one dog, canine parainfluenza virus antigen was detected in the brain. Four dogs and four cats gave positive results for encephalomyocarditis virus (EMCV). The significance of the detection of WNV and EMCV antigen requires further study. The aetiology remained undetermined in 39 dogs (74%) and 20 cats (61%). Although it is possible that non-infectious causes play a more important role than previously thought, infections with hitherto unrecognized agents cannot be ruled out.