Involvement of the cerebral cortex in progressive supranuclear palsy : immunohistochemistry and electron microscopical examination of the modified Gallyas-Braak method.

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The following results were obtained :1.Gallyas-Braak preparations and immunohistochemistry using anti-tau, anti-ubiquitin, and anti-neurofilaments antibodies demonstrated neurofibrillary tangles (NFTs) and neuropil threads in the cerebral cortex of all 11 brains with progressive supranuclear palsy(PSP). We also found Gallyas-positive and tau-posirive cytoplasmic inclusions in glial cells in the cerebral cortex.2.Conventional electron microscopical examination revealed numerous NFTs composed of twisted tubules (TT) in the cerebral cortex, however, PSP-NFTs of the straight tubular profile were only occasionally found.3.Electron microscopical observation of the plastic-embeddsed Gallyas-sections demonstrated that TT were densely decorated with silver particle. Neither astrocytic glial fibers or myelin sheath showed affinity to silver particle.4.A brain with corticonigral degeneration with neuronal achromasia(CND) was examined for argyrophilic neuronal inclusions (ANIs) ; the immunohistochemical and ultrastructural profile of ANIs in CND were different from those of PSP-NFTs, Alzheimer-NFTs, and Pick bodies.Our conclusions are as follows :1.TT are the major fibrillary component of the Gallyas-positive neuropil threads in the cerebral cortex of PSP.2.Gallyas-and tau-positive glial inclusions, as well as PSP-NFTs indicate that the degenerating process specific to PSP-pathology may involve the cerebral cortex. We consider that those structural alteration in the cerebral cortex may play a certain role in clinical manifestation of dementia in PSP.3.PSP is considered to be a different entity from CND on the basis of the cytopathological alteration.