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Size-dependent myelinated fiber loss in the corticospinal tract in Shy-Drager syndrome and amyotrophic lateral sclerosis

Division of Neurology, Fourth Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, and the Departments of Pathology and Neurology, Nagoya University School of Medicine, Tsurumai, Nagoya, Japan.

Morphometric evaluation was performed on myelinated fibers of the corticospinal tract at the seventh thoracic spinal cord segment from three patients with Shy-Drager syndrome (SDS), six patients with amyotrophic lateral sclerosis (ALS), and five patients with nonneurologic symptoms. In SDS, small-sized myelinated fibers were nearly completely depleted, while large-sized myelinated fibers were considerably well preserved. In ALS, on the contrary, large myelinated fibers were predominantly decreased. These results suggested that selective vulnerability of axonal loss depends on fiber size and should be considered in interpretation of pathology of corticospinal tracts.

Address correspondence and reprint requests to Dr. Sobue, Division of Neurology, Fourth Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi 480-11, Japan.

Received April 25, 1986. Accepted for publication in final form June 18, 1986.

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