Nigral burden of alpha-synuclein correlates with striatal dopamine deficit.

Aggregated alpha-synuclein is the hallmark of Parkinson's disease (PD), diffuse Lewy body disease (DLBD), and multiple system atrophy (MSA). Physiologically, alpha-synuclein ensures normal functions of dopamine transporter (DAT) and tyrosine hydoxylase. In alpha-synucleinopathies, it accumulates in neuronal cytoplasm and neurites through several stages. It is unclear whether the accumulation of pathological alpha-synuclein in the substantia nigra in PD correlates with the dopaminergic deficit in the striatal target. We evaluated the impact of the nigral burden of pathological alpha-synuclein immunoreactivity in 27 alpha-synucleinopathy brains by morphometric immunohistochemistry. DAT immunoreactivity in the striatum inversely correlates with the total alpha-synuclein burden in the substantia nigra but not with cytoplasmic inclusion counts only. This result has implications for imaging, clinicopathological correlative studies, and staging of the disease process. (c) 2008 Movement Disorder Society.