Depletion of mesopontine cholinergic and sparing of raphe neurons in multiple system atrophy

The authors immunocytochemically identified mesopontine cholinergic and rostral raphe serotonergic neurons in brains obtained at autopsy from four patients with multiple system atrophy (MSA) and four matched controls. There was a severe depletion of cholinergic neurons in the pedunculopontine (20 ± 2 vs 81 ± 10 cells/section, p< 0.001) and laterodorsal tegmental nucleus (18 ± 3 vs 47 ± 4 cells/section, p < 0.001) in MSA. Whereas there was also depletion of locus ceruleus neurons, there was a striking preservation of rostral raphe neurons in MSA.