Lewy body disease (LBD) is characterized by the appearance of Lewy neurites and Lewy bodies, which are predominantly composed of α-synuclein. Notably, the cardiac plexus (CP) is one of the main targets of LBD research. Although previous studies have reported obvious differences in the frequency of Lewy body pathology (LBP) in the CP, none of them have confirmed whether LBP preferably appears in any part of the CP. Thus, we aimed to clarify the emergence and/or propagation of LBP in the CP. In this study, 263 consecutive autopsy cases of patients aged ≥50 years were included, with one region per case selected from three myocardial perfusion areas (MPAs) and subjected to proteinase K and then immunohistochemically stained with anti-α-synuclein antibodies to assess LBP. We stained all three MPAs in 17 cases with low-density LBP and observed the actual distribution of LBP. LBP were identified in the CP in 20.2% (53/263) of patients. Moreover, we found that LBP may appear in only one region of MPAs, mainly in the young-old group (35.3% (6/17) of patients). These findings suggest that it is possible to underestimate LBP in the CP, especially in the young-old group, by restricting the search to only one of the three MPAs.

中文翻译：

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心丛中蛋白酶 K 抗性抗 α-突触核蛋白免疫反应性轴突的分布不偏向左心室前壁

路易体病（LBD）的特征是出现路易体和路易体，其主要由α-突触核蛋白组成。值得注意的是，心丛（CP）是LBD研究的主要目标之一。尽管之前的研究报道了 CP 中路易体病理 (LBP) 频率的明显差异，但没有一项研究证实 LBP 是否优选出现在 CP 的任何部位。因此，我们的目的是阐明 LBP 在 CP 中的出现和/或传播。本研究纳入263例年龄≥50岁患者的连续尸检病例，每例从3个心肌灌注区（MPA）中选择一个区域，进行蛋白酶K，然后用抗α-突触核蛋白抗体进行免疫组化染色，以评估LBP 。我们对 17 例低密度 LBP 的所有三个 MPA 进行了染色，并观察了 LBP 的实际分布。20.2% (53/263) 的患者在 CP 中发现 LBP。此外，我们发现LBP可能仅出现在MPA的一个区域，主要出现在年轻老年组（35.3%（6/17）的患者）。这些发现表明，通过将搜索仅限于三个 MPA 之一，可能会低估 CP 中的 LBP，尤其是年轻老年群体中的 LBP。