Brain gangliosides in the presenile dementia of Pick

Role of gangliosides in brain aging and neurodegeneration

Gangliosides are membrane glycosphingolipids bearing sialic acid residues. Within membranes, gangliosides are specifically enriched in highly organized domains, lipid rafts, and are attributed with diverse functions such as intercellular interactions, cell recognition, neurotransmission, and signal transduction. The highest concentration and variability of ganglioside structures are found in the human brain. Specific temporal and regional distribution of brain gangliosides has been reported; moreover, gangliosides may serve as markers of neurodevelopmental stages, aging and neurodegeneration. Brain ganglioside content and composition as well as ganglioside metabolism are altered in Alzheimer’s disease. It appears that the alterations of ganglioside metabolism leading to changes in membrane physico-chemical properties are not merely a consequence of primary pathology, but may also be involved in the early pathogenesis of Alzheimer’s disease through documented effects on APP proteolytic processing and amyloid aggregation. Investigations of glycolipid metabolic alterations which accompany neurodegenerative disorders provide insight into pathogenetic mechanisms and enable recognition of diagnostic markers as well as molecular structures acting as therapeutic tools interfering with cascade of pathological events.

Pick's disease: a modern approach

Pick's disease is a rare dementing disorder that is sometimes familial. The cardinal features are circumscribed cortical atrophy most often affecting the frontal and temporal poles and argyrophilic, round intraneuronal inclusions (Pick bodies). Clinical manifestations reflect the distribution of cortical degeneration, and personality deterioration and memory deficits are often more severe than visuospatial and apraxic disorders that are common in Alzheimer's disease, but clinical overlap with other non-Alzheimer degenerative disorders is increasingly recognized. Neuronal loss and degeneration are usually maximal in the limbic system, including hippocampus, entorhinal cortex and amygdala. Numerous Pick bodies are often present in the dentate fascia of the hippocampus. Less specific features include leukoencephalopathy and ballooned cortical neurons (Pick cells). Glial reaction is often pronounced in affected cerebral gray and white matter. Tau-immunoreactive glial inclusions are a recently recognized finding in Pick's disease, and neuritic changes have also recently been described. Variable involvement of the deep gray matter and the brainstem is typical, with a predilection for the monoaminergic nuclei and nuclei of the pontine base. Neurochemical studies demonstrate deficits in intrinsic cortical neurotransmitter systems (e.g., somatostatin), but inconsistent loss of transmitters in systems projecting to the cortex (e.g., cholinergic neurons of the basal nucleus). Biochemical and immunocytochemical studies have demonstrated that abnormal tau proteins are the major structural components of Pick bodies. A specific tau protein immunoblotting pattern different from that seen in Alzheimer's disease and certain other disorders has been suggested in some studies. A specific molecular marker and a genetic locus for familial cases are not known.

Cortical distribution of gangliosides in Alzheimer's disease

In Alzheimer's disease, all ganglio-series gangliosides (GM1, GD1a, GD1b and GT1b) were found to be decreased in temporal and frontal cortex, and nucleus basalis of Meynert. In addition, in Alzheimer's disease simple gangliosides (GM2, GM3) were elevated in frontal and parietal cortex, possibly correlating to accelerated lysosomal degradation of gangliosides and/or astrogliosis occurring during neuronal death.

Ganglioside levels in hypoxic brains from neonatal and premature infants

In this study, 13 cases of newborn term-gestational infants and six cases of premature infants who died of hypoxia were selected for the determination of ganglioside levels in several regions of brains obtained at autopsy. Cases were divided into three groups according to the hypoxic interval and gestational age: Group A, six cases of newborn infants. The average time of hypoxia was 6.4 h. Group B, seven cases of newborn infants. The average time of hypoxia was about 71 h. Group C, six cases of premature infants. The average hypoxia time was 34.7 h. Frontal cortex, forebrain, hippocampus, and parahippocampal gyrus and cerebellum of each brain were examined. The method of Ladisch and Gillard (1985) was used to purify and quantify gangliosides. The results showed that total gangliosides decreased significantly in three regions of cerebral hemispheres of group B and in four brain regions of group C, as compared with group A (p less than 0.01). The amount of gangliosides in frontal cortex in group B was lower than in group C (p less than 0.01). The four major gangliosides (GM1, GD1a, GD1b, and GT1b) were all reduced in cerebral hemispheres of group B and C. In hypoxic brains, the percentage of gangliosides also showed some alterations. There was less GD1a in the cerebral hemispheres of group B and the frontal cortex of group C. The amount of GD1b was also less in the frontal cortex and forebrain of group B than in group A or C. The results suggest that severe hypoxia might cause decreases in brain gangliosides that correlate to the severity of brain damage.

Marked loss of cerebral galactolipids in Pick's disease

Studies with two monoclonal antibodies reactive with galactolipids suggest that there is a marked loss of these compounds in the brains of patients with Pick's disease. Quantitative assays, immunocytochemical studies, and thin-layer chromatography confirm that both galactocerebrosides and sulfatides are selectively lost in this condition. This finding appears to be specific for Pick's disease, distinguishing it from Alzheimer's disease and other dementing disorders.