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Acta Neuropathol (2000) 100 : 50–62 © Springer-Verlag 2000

R E G U L A R PA P E R

Ori Brenner · Joseph J. Wakshlag ·


Brian A. Summers · Alexander de Lahunta

Alaskan Husky encephalopathy –


a canine neurodegenerative disorder resembling subacute
necrotizing encephalomyelopathy (Leigh syndrome)

Received: 6 August 1999 / Revised, accepted: 18 October 1999

Abstract The gross and histopathological findings in the sible pathogenetic role of astrocytes in the evolution of
brain and spinal cord of five Alaskan Husky dogs with a these lesions. An inherited metabolic derangement of un-
novel incapacitating and ultimately fatal familial and pre- known nature is postulated as the cause of this breed-spe-
sumed hereditary neurodegenerative disorder are de- cific disorder.
scribed. Four dogs presented with neurological deficits
before the age of 1 year (7–11 months) and one animal at Key words Dog · Alaskan Husky · Metabolic
2.5 years old. Clinical signs in all dogs were of acute on- encephalopathy · Leigh’s disease · Subacute necrotizing
set and included ataxia, seizures, behavioral abnormali- encephalomyelopathy
ties, blindness, facial hypalgesia and difficulties in pre-
hension of food. In animals allowed to survive, the dis-
ease was static but with frequent recurrences. Pathological Introduction
findings were limited to the central nervous system.
Grossly visible bilateral and symmetrical cavitated foci Since its initial description in 1951 [25], the term Leigh’s
were consistently present in the thalamus with variable disease (LD) or, more appropriately, Leigh syndrome (LS)
extension into the caudal brain stem. Microscopic lesions [12, 50] has been used in human neurology and neu-
were more widespread and included foci of bilateral and ropathology to designate patients with characteristic bilat-
symmetrical degeneration in the basal nuclei, midbrain, eral and symmetrical brain stem lesions that feature tissue
pons and medulla, as well as multifocal lesions at the base destruction, capillary proliferation, and neuronal sparing.
of sulci in the cerebral cortex and in the gray matter of The precise distribution of lesions within the brain stem
cerebellar folia in the ventral vermis. Neuronal loss with and involvement of other parts of the central nervous sys-
concomitant neuronal sparing, spongiosis, vascular hyper- tem (CNS) vary [9, 16, 27]. Until the 1980s, variability in
trophy and hyperplasia, gliosis, cavitation and transient the clinical presentation of LS allowed confident diagno-
mixed inflammatory infiltration were the main histo- sis to be established only by postmortem examination [46,
pathological findings. In addition, a population of reactive 50]. In the last few years, clinical and neuroradiological
gemistocytic astrocytes with prominent cytoplasmic vac- findings have been defined and permit antemortem pre-
uolation was noted in the thalamus. Lesions of this nature sumptive diagnosis [12, 21, 43, 45, 49]. Investigations of
in this distribution within the neuroaxis have not been re- LS have revealed an array of biochemical and genetic ab-
ported in dogs. The neuropathological findings resemble normalities, clearly demonstrating that the characteristic
Leigh’s disease/subacute necrotizing encephalomyelo- complex of neuropathological features traditionally re-
pathy of man. Neuronal sparing in conjunction with ap- quired to make this diagnosis does not correlate to a single
parently transient astrocytic vacuolation point to the pos- and discrete disease entity. Rather, it has been proposed
that LS may be viewed as a paradigm in that it represents
the response of the developing CNS to energy deprivation
O. Brenner · J. J. Wakshlag · B. A. Summers · A. de Lahunta (!) [12]. Currently, some 75% of the cases in which the typi-
Department of Biomedical Sciences, cal phenotype of LS is found are known to be caused by
College of Veterinary Medicine, Cornell University, diverse defects of the mitochondrial respiratory chain.
Ithaca, NY 14853-6401, USA
Fax: +1-607-253-3541
The cause of the remaining cases is unknown [12].
In 1992, one of us (A.D.) recognized a novel degener-
Present address: ative disease affecting the CNS of juvenile Alaskan
O. Brenner
Experimental Animal Center, Husky dogs. Between 1992 and 1998 neurological and
The Weizmann Institute of Science, Rehovot 76100, Israel neuropathological studies were carried out at our institu-
51

Table 1 Signalment and clini-


cal signs of five Alaskan Dog Gender No. Age at Age at Clinical signs
Husky dogs with Alaskan affected/ onset death
Husky encephalopathy litter size (months) (months)a
1 F 2/4 7 10 Ataxia, visual deficits, propulsive behavior
abnormal prehension
a All dogs were euthanized 2 M 1/5 9 14 Ataxia, visual deficits, propulsive behavior
b Littermates abnormal prehension
c Anaffected female littermate 3 F 2/4b 8 10 Ataxia
was diagnosed by computed 4 F 2/4b 11 18 Seizures, episodic ataxia, visual deficits
tomography at the age of 2.5 5 F 2/6c 30 32 Episodic seizures, semicoma, ataxia,
years and died naturally at 4 propulsive behavior
years old

tion on five Alaskan Husky dogs (four females and one


male, from four litters) with this condition (Table 1).
Pathological findings of the first cases (dogs 1 and 2 of
this report) have been briefly reported [42]. Here we pre-
sent the first comprehensive neuropathological descrip-
tion of this disorder based on necropsy studies of the five
affected animals. We have designated this disease
Alaskan Husky encephalopathy.

Materials and methods


Clinical evaluation and necropsy of five dogs (dogs 1–5) were per-
formed at the College of Veterinary Medicine at Cornell Univer-
sity. Specimens of brain, spinal cord, peripheral nerves and vis-
ceral organs were fixed in 10% neutral buffered formalin, pro-
cessed routinely in an automatic tissue processor, embedded in
paraffin, sectioned at 5 µm, and stained with hematoxylin and
eosin (H&E). Selected CNS sections were stained with Luxol-fast
blue-cresyl Echt violet and Bielschowsky’s silver stain.
Immunohistochemical examination was performed on deparaf-
finized sections processed by streptavidin-biotin-peroxidase com-
plex procedure with diaminobenzidine as the chromogen. The pri-
mary antibodies against glial fibrillary acidic protein (GFAP;
Dako, polyclonal, 1 : 300) and vimentin (Dako, monoclonal, 1 : 40)
were used. Before staining for vimentin, slides were microwave
treated.

Results

Clinical findings
A detailed description of the neurological findings is re-
ported separately [48]. In brief, the onset of clinical signs Fig. 1 A Bilateral and symmetrical oblique cavitation of the thal-
was before 1 year of age (7–11 months) in four of the five amus. B In some dogs, the thalamic lesion extends caudally to the
cases and at 2.5 years of age in other dog. The onset was reticular formation in the medulla oblongata, where it retains its
usually sudden with either ataxia (n =3) or seizures (n = oblique orientation (arrows). Note bilateral and symmetrical de-
generation in the white matter of the reticulospinal and rubrospinal
2). In two dogs, both seizures and ataxia developed during tracts (asterisks). Both lesions are seen at this magnification as re-
the course of the disease. The ataxia included varying de- duced myelin staining (LFB Luxol-fast blue). A, B Dog 1. LFB
grees of cerebellar and vestibular signs with hypermetria staining; A × 3, B × 4.6
and balance loss. Gait abnormalities also included hyper-
tonicity of all four limbs and proprioceptive deficits. Most
dogs had a disturbance of their behavior varying from ob- longer periods, the signs either remained static or improved,
tundation to propulsive pacing and apparent visual deficits. but recurrences were common and included both gait ab-
Prehension of food was often abnormal. Decreased noci- normalities and seizures. One female dog (not included in
ception, especially facial hypalgesia, was noted in some this report) died naturally at 4 years of age following a
animals. In most dogs the neuroanatomic diagnosis was disease course lasting over 1 year. All other animals were
diffuse involvement of the brain including cerebrum, euthanized between 2 and 7 months following onset of
brain stem and cerebellum. In dogs that were observed for clinical signs.
52

Pathology

Gross examination

The outer surface of the brain and spinal cord was normal.
Transverse sections of the brain revealed bilateral and
symmetrical soft gray cavities in the thalamus, which ex-
tended to the medulla in severely affected dogs (Fig. 1). In
less profoundly affected dogs, the bilateral and symmetri-
cal cavities were segmental rather than contiguous
throughout the brain stem. The thalamus was invariably
the most extensively affected region. Thalamic cavitary
changes were oriented along an oblique dorsolateral to
ventromedial axis, resulting in a V-shaped appearance,
and involved approximately a third of the parenchyma,
measuring on average 1.5 × 0.5 cm. More caudally, the
malacic foci were markedly smaller but tended to retain
an oblique orientation. In the cerebrum, the cortical rib-
bon at the base of numerous sulci was attenuated and
slightly brown tinged. Such cerebral foci were randomly
distributed, although concentrated in the parietal and tem-
poral lobes. No gross abnormalities were detected in the
spinal cord or outside the CNS.

Light microscopy

Distribution and classification of the lesions. All five


dogs had histopathological CNS lesions of similar nature
and distribution but of variable severity. Brain lesions
were found in the cerebrum, brain stem and cerebellum,
and occurred in two distribution patterns: (1) bilateral and
symmetrical degeneration within the basal nuclei, thala-
mus, midbrain, pons and medulla oblongata and (2) mul-
tifocally at the base of sulci in the cerebral cortex and in
the cortex of the ventral vermis of the cerebellum. In re-
gions where gray and white matter are separated, neuro-
parenchymal changes primarily affected the gray matter.
In the brain stem, this predilection was less discernable.
Lesions in the spinal cord were mild, inconsistent and
limited to the white matter. All brain lesions exhibited
neuronal depletion with variable neuronal sparing, vascu-
lar prominence, spongiosis and gliosis. Distinction between
active degeneration and quiescent lesions was made. The
following were considered indicative of ongoing degener-
ation: marked vascular prominence, the presence of intact
and ischemic neurons, glial necrosis, mild to moderate
gliosis and an occasional mixed infiltrate of inflammatory
cells, thought to be secondary to tissue necrosis. Quies-
cent foci were characterized by less prominent vascula-
ture with more advanced gliosis and neuronal loss in the Fig. 2 A–C An inactive lesion with well-demarcated boundaries
absence of ischemic neurons. Spongiosis and cavitary (arrows) visible at this magnification because of associated myelin
changes were observed in both types of lesions. In active loss. The affected area is profoundly gliotic and the center has un-
dergone cavitation. B Neuronal survival in a gliotic region. Two
degeneration, such cavities occurred in a mildly to moder- reactive gemistocytic astrocytes are indicated by arrows. C Sur-
ately gliotic neuropil and contained gitter cells with occa- vival of neurons with normal morphology (arrows) in a cavitated
sional lymphocytes. In quiescent ‘burnt out’ lesions, cav- area. A, B Dog 2, C dog 1. A LFB, × 15; B H&E, × 152; C H&E,
ities were surrounded by a sclerotic neuropil and gitter × 142
cells were absent. Both active and inactive lesions coex-
isted in the same animals, and were sometimes juxtaposed
53

Fig. 3 A–D Thalamus. A A discrete focus with both active and in the surrounding white matter (Fig. 2). In the center of
quiescent phases of degeneration. In this GFAP preparation, ex- the lesion, the neuroparenchyma had undergone almost
tensive astrogliosis is seen as punctate dark structures scattered
throughout much of the lesion. Two cavitated areas are present. complete dissolution leaving an empty space traversed by
Peripheral to the gliotic region are segments undergoing active de- infrequent blood vessels, astrocytic processes and low
generation (solid arrow and open arrow), one of which (open ar- numbers of axons. At the margins of the cavities, the neu-
row) is identified at this magnification by its lack of GFAP stain- ropil was replaced by an admixture of reactive gemisto-
ing. B Higher magnification of a region undergoing active degen-
eration (indicated by an open arrow in A). The neuropil is edema- cytic astrocytes, gitter cells, proliferated capillaries and
tous, partly dissolved and contains an admixture of proliferated surviving axons, some with focal swellings (spheroids). In
glial and mononuclear cells. There is conspicuous neuronal and this region, and less commonly in the more frankly cavi-
axonal preservation. C Focus of active degeneration (indicated by tated center, there were variable numbers of surviving
a solid arrow in A) with vascular hypertrophy and hyperplasia,
mixed mononuclear and granulocytic infiltration, gliosis and rare-
neurons, either isolated or in small groups within irregular
faction. D Higher magnification from the central inactive compo- islands of neuropil. Most surviving neurons appeared nor-
nent of the lesion in A showing surviving neurons within a gliotic mal but occasional swollen and chromatolytic forms were
neuropil (GFAP glial fibrillary acidic protein). A–D Dog 4. also encountered. Despite a normal appearance in H&E-
A GFAP, × 175; B Bielschowsky, × 175; C H&E, × 175; D GFAP stained sections, the perikaryon of some neurons in af-
× 350
fected foci stained black with a silver stain. Typically, this
was observed in areas with features of long-standing de-
and many foci displayed features intermediate between generation containing low numbers of surviving neurons.
these two extremes. In contrast, neurons in areas of active degeneration were
not argyrophilic.
Thalamus. In all animals, the most extensive gross lesion Microgliosis and astrogliosis of variable intensity were
was a bilateral and symmetrical obliquely oriented cavita- observed in non-cavitated lesions. A GFAP preparation
tion situated approximately in the mid thalamus. Histo- emphasized the focal nature of the gliosis and the sharp
logically, this corresponded to a well-demarcated focus of delineation between affected and unaffected parenchyma,
severe gray matter liquefaction with lesser degeneration in which only scattered Wallerian degeneration was seen.
54

trophy and hyperplasia of endothelial cells and other


cellular elements within vascular walls as well as due to
liquefaction of the neuropil with exposure of the vascula-
ture.
A striking component of the thalamic lesion was the
occurrence of numerous vacuolated gemistocytic astro-
cytes interspersed among conventional reactive astrocytes
(Fig. 4). Vacuolated gemistocytic astrocytes contained sin-
gle to numerous (average 5–6/cell but at times >20) ap-
parently empty cytoplasmic vacuoles varying in size from
<1–8 µm with an average of 4 µm The astrocytic cyto-
plasmic vacuolation was evident in H&E-stained slides
but was seen to advantage in GFAP preparations. Vi-
mentin stained small numbers of these cells. Although
gemistocytic astrocytes were a common element of le-
sions at other sites, cytoplasmic vacuoles were not de-
tected in astrocytes outside of the thalamus.

Non-thalamic bilateral and symmetrical lesions. Destruc-


tive bilateral and symmetrical lesions of variable severity
but less extensive in comparison to the thalamus, were
present in the dorsolateral caudate nucleus, dorsal puta-
men, dorsal claustrum, caudal colliculi, midbrain tegmen-
tum and the reticular formation in the medulla oblongata.
All the lesions were morphologically similar to the thala-
mic degeneration, except that vacuolated astrocytes were
not detected. Silver stains showed remarkable axonal
preservation within most affected regions. Mild bilateral
and symmetrical as well as randomly scattered Wallerian
degeneration in the reticular formation, tegmentum and
the reticulo-rubrospinal upper motor neuron (UMN) tracts
was observed.

Cerebrum (Fig. 5). Within the cerebral cortex there were


multiple, apparently random foci of minimal to profound
cortical attenuation associated with laminar necrosis, neu-
ronal depletion, neuropil loss, gliosis, spongiosis and
sometimes cavitation. As these neocortical lesions oc-
curred most commonly at the base of sulci, they assumed
an arcuate form with the most severely affected portion at
the base of the sulcus and variable extension into the ad-
jacent gray matter of the cortex.
Although degenerative changes occurred in a laminar
fashion, the neuronal layers affected were inconsistent. In
Fig. 4 A, B Thalamus. A GFAP stain of a gliotic focus demon- some foci, the superficial and middle cerebral laminae
strates many reactive astrocytes with cytoplasmic vacuolation. A were involved with relative sparing of deeper laminae,
few are indicated by arrows. B Cytoplasmic vacuoles within reac- while in others the converse was observed.
tive astrocytes have sharp margins and are variably sized /thick ar- Neuronal depletion varied from mild to profound. In
rows). Some vacuoles are minute, as may be barely seen in the cy-
toplasm of the astrocyte at the bottom right corner (thin arrow). A
general, neuronal loss was seen as zones of gliotic neu-
Dog 1, B dog 3. A GFAP, × 186, B GFAP, × 350 ropil containing a diminished complement of neurons and
such changes were a regular finding in all animals. In ac-
tive lesions, the surrounding neuropil was sometimes only
In some animals, older sclerotic lesions coexisted with re- minimally gliotic, imparting the impression of neuronal
gions of active degeneration (Fig. 3). In these cases, a cav- ‘drop out’. In more advanced lesions the neuropil was col-
itated core with a gliotic rim containing surviving neurons lapsed, the gliosis more extensive and the neuronal loss
was in turn surrounded by zones of active degeneration. more dramatic. Surviving neurons, both large and small
Vessels in areas undergoing active degeneration were and mostly morphologically normal, were often malori-
more conspicuous than those in adjacent sclerotic and qui- ented and haphazardly scattered within the attenuated
escent sites. This vascular prominence was due to hyper- neuropil, presumably due to parenchymal collapse.
55

Fig. 5 A–F Cerebrum. A An active lesion at the base of a sulcus. are decreased. A thick arrow indicates mild gliosis of the glia limi-
The lesion has an arcuate outline, identified at this magnification by tans at the base of the sulcus. Relatively normal gray matter is on the
vascular prominence in the affected segment. The vascular promi- far right. D An early, active lesion with a row of necrotic ‘ischemic’
nence is due to hypertrophy and hyperplasia of vascular cells as well neurons (arrows). A few adjacent neurons are morphologically nor-
as mixed perivascular inflammatory infiltration. A more extensive mal (asterisks). E An inactive lesion at the base of a sulcus (thick ar-
infiltrate of similar composition is present in the overlying row points to vessels within the overlying meninges). The neuropil is
meninges. B Higher magnification of an area included in A. The shrunken with pronounced gliosis and neuronal loss. Note surviving
meningeal (arrow) and perivascular infiltrate is composed of neurons (some marked with thin arrows), unobtrusive vessels and
mononuclear cells and granulocytes, barely discernable at this mag- spongiosis in a vaguely laminar pattern. F An inactive lesion with
nification by their irregular nuclear contours. There is spongiosis of cavitation of the superficial gray matter extending to the overlying
the neuropil with mild to moderate gliosis. C An active lesion with meninges. The cavitated area is traversed by gliovascular trabeculae.
prominent vascular hyperplasia and hypertrophy in the superficial An asterisk indicates the base of the sulcus. A–D Dog 4, E dog 3,
gray matter. There is mild spongiosis, gliosis and neuronal numbers F dog 1. A–F H&E; A, F × 35; B × 175; C, E × 87.5; D × 350
56

Fig. 6 A–D Cerebellum. A Well-demarcated segmental atrophy af- ter. C A quiescent lesion with profound atrophy of all cortical layers.
fecting contiguous folia in the vermis (asterisks). The cortex in the Advanced fibrillary gliosis affects the molecular layer (M) and the
most dorsal folium (top) is normal. Note also relative sparing of depleted and attenuated granular layer (G) which are separated by a
more lateral gray matter (arrows). B Higher magnification of an area band of Bergmann’s gliosis (B). Thick arrows indicate the gray and
in the most ventral folium in A demonstrating sparing of Purkinje white matter junction. D A focus of subacute degeneration with nu-
neurons (arrows with p) within a moderately gliotic neuropil. There merous necrotic granule cell neurons seen as dark dots scattered
is subtotal atrophy of the granular cell layer with residual granule throughout a gliotic and edematous granular layer. There is loss of
cells visible as dark dots. Thick arrows indicate the gray and white all Purkinje neurons and Bergmann’s gliosis (B). Note a surviving
matter junction. A few hypertrophied astrocytes (arrows with a) are Golgi neuron (arrow with g) (M molecular layer). A, B Dog 2; C,
present in the atrophic gray matter and in the underlying white mat- D dog 4. A, B LFB; C, D H&E; A × 87.5, B–D × 175
57

Spongiosis accompanied the changes described above gliosis of the molecular layer. Of note was the presence of
and similarly followed a laminar pattern. It was composed surviving Golgi neurons of normal morphology in the gli-
of innumerable, mostly small vacuoles of indeterminate otic granule cell layer and less commonly of a few Purk-
location within the neuropil as well as of enlarged empty inje neurons. In some of the animals, cerebellar cortical
spaces surrounding ischemic neurons, presumably repre- degeneration was associated with mild to moderate gliosis
senting swollen astrocytic foot processes. At some sites, of the fastigial and interposital cerebellar nuclei.
spongiosis progressed to cavitation leaving optically Cerebellar white matter changes resembled white mat-
empty spaces traversed by gliovascular trabeculae, at ter changes elsewhere in the neuroaxis.
times surrounded by histiocytes, gitter cells, lymphocytes
and eosinophils. Microgliosis and astrogliosis of variable Spinal cord. Two dogs had spinal cord lesions of signifi-
intensity were observed in affected neocortex. A striking cant severity. In these animals, there was a discrete bilat-
and selective decrease in GFAP-positive astrocytes within eral and symmetrical C-shaped band of ongoing Wallerian
the affected laminae of active lesions resulted in a laminar degeneration and moderate astrogliosis situated in the
pattern of immunoreactivity with increased numbers of dorsal half of the lateral funiculus. This well-demarcated,
GFAP-positive reactive astrocytes above and below but approximately 1-mm-wide band situated deep in the dor-
not within degenerate laminae. In contrast, quiescent le- solateral funiculus was evident throughout the entire
sions contained GFAP-positive astrocytes throughout the length of the spinal cord, but was most severe in the cer-
entire width of the gray matter as well as in the underly- vical portion. Anatomically, this distribution corresponds
ing white matter. Similar observations were made in to descending UMN axons running within the reticulo-
GFAP preparations of brain stem lesions. rubrospinal tract. A second bilateral and symmetrical fo-
There was moderate gliosis in the white matter subja- cus of moderate Wallerian degeneration accompanied by
cent to affected gray matter, particularly at sites where the mild gliosis was present in the ventral funiculus flanking
cortical lesion was severe. In the white matter further the ventral sulcus. Also here, the cervical spinal cord
from such sites, there was often an impression of a more showed the greatest degree of involvement. In other dogs,
widespread, milder gliotic process. Astrocytes were reac- spinal cord lesions were inconspicuous and consisted of
tive with slightly enlarged nuclei and minimal expanded minimal to mild active Wallerian degeneration, most often
cytoplasm. They stained positively with GFAP and vi- involving the lateral funiculus in the cervical spinal cord.
mentin, the presence of the latter intermediate filament None of the dogs had lesions in the gray matter of the
confirming their altered, reactive state [37]. Sporadic spinal cord.
spheroids and modest Wallerian degeneration, most no-
table in the white matter close to affected gray matter,
were also seen. Discussion

Cerebellum (Fig. 6). The cerebellar cortical lesion princi- We describe a novel incapacitating and ultimately fatal fa-
pally involved the ventral portion of the vermis. As in the milial neurodegenerative disorder affecting Alaskan
neocortex and brain stem, active and quiescent phases of husky dogs. Onset of neurological deficits was acute and
the lesion were identifiable, often juxtaposed and clearly occurred in most cases (four of the five animals) before 1
demarcated from unaffected tissue. In active lesions, there year of age. Neurological signs included ataxia, seizures,
was partial depletion of granular neurons, the granule cell behavioral abnormalities, apparent blindness, facial hy-
layer was spongiotic, expanded by edema and contained palgesia, loss of conscious proprioception, and difficulties
large amounts of pyknotic and karyorrhectic nuclear de- in the prehension of food. The neurological disorder was
bris. These changes were accompanied by loss of Purkinje episodic. In dogs allowed to survive, gradual improve-
neurons, astrocytic (Bergmann’s) gliosis, mild to moderate ment after the acute deterioration of neurological function
granular layer gliosis and mild hypertrophy of capillary was observed. However, recurrences were common and
endothelial cells. Active lesions progressed through inter- led to euthanasia in most cases.
mediate stages characterized generally by an increasing In addition to the five Alaskan Husky dogs included in
degree of neuronal depletion and gliosis with decreasing this study, one of us (A.D.) received in consultation
amount of nuclear debris, edema and spongiosis. Segmen- histopathological slides of autopsy material from six other
tally in affected areas, Purkinje neurons of normal mor- Alaskan Husky dogs with similar lesions. To date, we
phology were seen immediately adjacent to numerous py- have examined autopsy material from a total of 11 spon-
knotic granular neurons, possibly implying that in some taneous cases (5 males and 6 females) of this disorder in
locations, loss of granular neurons preceded depletion of seven litters of Alaskan Husky dogs from five kennels in
Purkinje neurons. the USA. The incidence of the disease is probably higher,
In the fully developed ‘end stage’ lesion, which pre- as on several occasions littermates of affected dogs were
dominated, cerebellar folia were markedly attenuated with euthanized following the onset of characteristic neurolog-
all cortical layers atrophic and collapsed. There was wide- ical deficits but pathological studies were not pursued.
spread loss of Purkinje neurons, advanced Bergmann’s
gliosis, complete depletion of the granule cell layer, se-
vere gliosis of the depleted granule cell layer and milder
58

Neuroanatomical correlation ria. Similar neuropathological findings are described in


several spontaneous (see below) and experimental [36]
Some of the clinical signs in these dogs can be correlated disorders of animals. In dogs, thiamine deficiency causes
with the location of structural lesions observed on gross well-demarcated bilateral and symmetrical spongy change
and microscopic examination of the CNS. Neurological and necrosis of many brain stem nuclei. The caudal col-
signs may also reflect a functional disturbance of neuronal liculus is the most severely affected structure and thala-
populations not revealed by light microscopy. This is mic cavitation is lacking. Microscopically, lesions exhibit
common in metabolic disorders. The neocortical or thala- hypertrophy and hyperplasia of endothelial and adventi-
mic lesion could be the site of seizure initiation. Damage tial cells, gliosis, frequent hemorrhages and variable neu-
to thalamic relay nuclei may account for nasal hypalgesia ronal preservation [34]. The encephalopathy induced by
and loss of conscious proprioception. Lesions in the retic- thiamine deficiency shares many similarities with the
ular formation could explain some of the other neurologi- Alaskan Husky encephalopathy but differs in several as-
cal deficits. Dysfunction of the pontine and medullary pects. In Alaskan Husky encephalopathy, involvement of
component of the reticular formation may be responsible the caudal colliculus is infrequent and mild, cerebral and
for the UMN deficits in the gait. Involvement of the as- cerebellar cortical lesions are characteristic and hemor-
cending component, specifically the ascending reticular rhage is not a feature. Canine disorders of unknown etiol-
activating system, could contribute to the suppressed sen- ogy but possibly inherited, which are characterized by
sorium. Thalamic and reticular formation lesions may symmetrical gray matter rarefaction with neuronal pre-
have led to the frequently observed difficulties in prehen- servation, include a neurodegenerative condition in Aus-
sion of food. The propulsive tendencies are difficult to lo- tralian Cattle Dogs [6] and familial cerebellar ataxia with
calize but often involve the motor basal nuclei, some of hydrocephalus in Bull Mastiffs [8]. The polioencephalo-
which are affected in dogs with this encephalopathy (cau- myelopathy of the Australian Cattle Dog differs from the
date nucleus, putamen and claustrum). The structural ba- Alaskan Husky encephalopathy in its extensive spinal
sis for the visual deficits is unknown. The clinical signs cord lesions, more discrete targeting of gray matter nuclei
support a central visual problem, but the cerebral lesion is in the brain stem and more remarkable neuronal preserva-
unlikely to be related to these deficits, as it is segmental tion. The lesions in the Bull Mastiffs are spongiotic rather
and more prevalent in the parietal and temporal lobes than frankly cavitary, their distribution is different and
rather than the occipital lobe. No consistent lesions were they are accompanied by hydrocephalus. Lesions with
present in the retina, optic nerve, optic chiasm, optic tract similar histopathological findings are also recognized in
or lateral geniculate nucleus in the thalamus. The cerebel- farm animals. In pigs, focal symmetrical poliomalacia due
lar vestibular component of the gait disorder implies the to selenium poisoning [41] or of unknown cause [52] is
presence of further neuronal dysfunction than is evident in well documented. Identical lesions can be produced in
the limited cortical degeneration of the ventral vermis. pigs by the experimental administration of 6-aminonico-
tinamide (6-AN) [30, 53], an antimetabolite of niacin with
a selective gliotoxic effect [26]. Several outbreaks of a
Neuropathology neurological disorder of unknown etiology with lesions of
similar morphology in the spinal cord, brain stem and
Thalamus and other bilateral and symmetrical lesions cerebellum are documented in sheep in Africa [2] and in
cattle (multifocal subacute necrotizing encephalomyelo-
In general, bilateral and symmetrical CNS lesions are pathy in Simmental calves [40] and focal symmetrical po-
thought to be due to either metabolic aberrations (neu- liomalacia of the spinal cord in Ayrshire calves [31]).
rodegenerative disorders and toxicoses) or are determined A striking element of the thalamic lesion in Alaskan
by vascular anatomy, regardless of whether they involve Husky encephalopathy is the presence of vacuolated reac-
the white matter, gray matter or both. Consistent neuronal tive gemistocytic astrocytes. Astrocytes with cytoplasmic
and axonal survival, a prominent feature of this canine en- vacuolation are an unusual finding both in veterinary and
cephalopathy, renders ischemia unlikely. Ischemia is ex- human neuropathology. In the polioencephalomyelopathy
pected to cause non-selective destruction, or if less severe, of the Australian Cattle Dogs, vacuolated gemistocytic as-
to primarily involve neurons [24]. Intoxication by an ex- trocytes were observed [6]. More recently, vacuolated as-
ogenous agent is unlikely, given the widely scattered ori- trocytes and perineuronal satellite cells in ganglia were ob-
gin of the animals. We propose a metabolic derangement, served in dogs following prolonged, low-level experimen-
presumably hereditary in this breed, as the cause of this tal administration of 6-AN [22]. Rarely, vacuolated astro-
neurodegeneration. Initial pedigree studies and test mat- cytes may be seen admixed among conventional reactive
ing suggest an inherited basis with an autosomal recessive astrocytes in areas of advanced gliosis in the dog (O.B.
mode of inheritance (J.J.W., unpublished). personal observation).
In man, bilateral and symmetrical brain stem lesions Ultrastructural studies are required to identify the mor-
with tissue destruction, vascular proliferation and variable phological basis of the astrocytic cytoplasmic vacuolation
neuronal survival may be seen either in LS or Wernicke’s in Alaskan Husky encephalopathy. In MELAS (mitochon-
encephalopathy. These conditions can be differentiated drial encephalopathy, lactic acidosis and stroke-like epi-
according to neuropathological [27] and clinical [35] crite- sodes), smooth muscle cells and to a lesser degree endo-
59

thelial cells of blood vessels in the brain contain small does not occur. Quiescent ‘burnt out’ lesions involving all
vacuoles which have been shown by ultrastructural exam- cortical layers are the most frequent finding and resemble
ination to correspond to proliferated and swollen mito- long-standing lesions of cerebellar cortical abiotrophy, as
chondria [10, 39]. Why vacuolated reactive astrocytes are seen in dogs, However, survival of isolated Golgi neurons
observed only in the thalamus and not in other bilateral and rarely Purkinje neurons would be unusual in a cere-
and symmetrical lesions in Alaskan Husky encephalopa- bellar abiotrophy or a hypoxic lesion, to which Purkinje
thy is unknown. It may relate to the fact that degenerative neurons are particularly susceptible [16]. Gliosis of the
changes are most severe at this location. fastigial and interposital cerebellar nuclei is probably a re-
flection of trans-synaptic degeneration following loss of
Purkinje neurons in the vermis. In animals, selective in-
Cerebrum volvement of the ventral vermis was reported in five of
six dogs with thiamine deficiency [34] and in three of five
Cerebrocortical lesions in this encephalopathy bear some animals with cardiac arrest [32].
resemblance to cerebrocortical necrosis (CCN)/polioen-
cephalomalacia as encountered in the dog, but differ in
their distribution within the cortical mantle. CCN in dogs White matter
is seen sporadically, either alone or in conjunction with le-
sions elsewhere in the brain. In some cases, the underly- Degenerative changes in this encephalopathy preferen-
ing cause is known, e.g., intraoperative cardiac arrest tially affect the gray matter but the white matter is not en-
[32], cyanide poisoning [18], thiamine deficiency [34], tirely spared. In brain stem lesions for example, the de-
lead poisoning [54] or hypoglycemia [23]. Sometimes structive process frequently involves surrounding white
the cause is undetermined [3, 18]. In other cases, CCN oc- matter. In the cerebrum, cerebellum and spinal cord, white
curs with coexistent conditions such as meningitis, throm- matter lesions are either necrotizing, undergoing Wal-
boembolic disease, atherosclerosis [3], canine distemper lerian degeneration, pure gliosis, or a mixture. While de-
encephalitis, infectious canine hepatitis [18], or gastroen- generative white matter changes are clearly accentuated in
teritis [13], but the relationship between the two is un- the vicinity of gray matter lesions, they are not limited
clear. Whereas cerebrocortical lesions in Alaskan Husky to these regions. Some of the Wallerian degeneration in
encephalopathy occur exclusively at the base of sulci, a the midbrain, medulla and spinal cord is bilateral and
similar predilection has not been noted in canine CCN. In symmetrical and anatomically consistent with UMN de-
man, the tendency of a circulatory disturbance to involve generation of the reticulo- and rubrospinal tracts, possibly
gray matter at the base of sulci rather than at their crest is reflecting the bilateral and symmetrical lesion in the retic-
well recognized [7, 19]. In contrast, this predilection has ular formation. Widespread gliosis may reflect cerebral
not been well documented in veterinary neuropathology. edema which is prone to occur in white matter. Such pure
Occasionally in the Alaskan Husky encephalopathy, an gliosis, perhaps the most pervasive white matter lesion in
inflammatory infiltrate comprising histiocytes as well as this condition, is widespread and often mild and thus dif-
neutrophils and eosinophils is observed in acutely com- ficult to delineate.
promised regions and is interpreted as secondary to tissue
necrosis. The occasional eosinophilic component is un-
usual but is well documented in cerebrocortical necrosis Nature and distribution of the lesions
(‘salt poisoning’) and in focal symmetrical poliomyelo-
malacia [52] in pigs. It could be suggested that the corti- Irrespective of site in the neuroaxis, affected regions share
cal lesion is secondary to seizure activity. Although several histopathological similarities. They primarily in-
seizures are common in Alaskan Husky encephalopathy, volve the gray matter, tissue destruction and neuronal loss
they were not present in three of the five dogs in this re- is seen concomitant with variable neuronal sparing, there
port. Further, the association between seizure disorders is striking hypertrophy and hyperplasia of capillaries,
and brain injury in domestic animals is much less clearly spongiosis and gliosis are prominent, and active and inac-
established than in human subjects. In dogs with idio- tive phases of the degenerative process are discernable.
pathic epilepsy, ischemic neuronal change rarely occurs White matter changes seem to be largely reactive. The
[42]. Cortical necrosis, interpreted as seizure induced, is classification of lesions into active, quiescent and inter-
seen in some cases of canine distemper encephalitis. The mediate stages based on morphological features, is based
pyriform lobe and the hippocampus are selectively af- on the definitions of Cavanagh and Harding [9] who
fected [3]. analysed a series of cases with LS. It seems possible that
areas of tissue destruction with partial neuronal sparing,
as seen in this canine encephalopathy, could be the result
Cerebellum of a primary gliopathic process with neuronal loss a sec-
ondary event. Studies with glial toxins such as 6-AN,
The cerebellar cortical lesion, which mainly involves the which produce lesions of similar morphology, are sup-
ventral vermis, shares many similarities with degenerative portive of this contention. It remains to be determined
changes seen in other areas, but progression to cavitation whether the transient vacuolation of astrocytes in Alaskan
60

Table 2 Suspecteda spontaneous mitochondrial diseases in domestic animals (EM electron microscopy)
Species No. Organ affected and main Features suggesting mitochondrial involvement Reference
cases clinical signs
Irish Terrier 1 Skeletal muscle; stiff gait, Degenerative myopathic changes by histology, [51]
difficulty in swallowing, abnormal enzyme distribution by histochemistry,
muscle atrophy with high tone metabolic defect in isolated mitochondria
Sussex Spaniela 1 Skeletal muscle; exercise Lactic acidosis, pyruvate dehydrogenase deficiency [20]
intolerance
Simmental and > 30 CNS; pelvic limb ataxia, Bilateral and symmetrical malacic lesions in brain [14, 17, 40]
Simmental cross caudal paresis, sudden death stem (olivary nucleus most consistent) and in some
calves cases spinal cord with hypertrophied capillaries and
frequent neuronal preservation
Old English 2 Skeletal muscle; episodic Exertional lactic acidosis; EM: excessive numbers [4]
Sheepdogs weakness of mitochondria and glycogen accumulation in
skeletal myofibers. One dog had scattered ragged
red fibers
Arabian 1 Skeletal muscle; profound Lactic acidosis, a few ragged red fibers; EM: [44]
horsea exercise intolerance aggregates of large mitochondria with bizarre
cristae, deficiency of Complex I respiratory chain
enzyme documented
Jack Russell 1 Skeletal muscle; progressive Lactic acidosis, ragged red fibers; EM: large [29]
Terrier exercise intolerance subsarcolemmal accumulations of normal
mitochondria
Swaledale Not CNS Increased CSF lactate, bilateral and symmetrical [28]
lambs given brain stem lesions with neuronal sparing
periaqueductal gray matter, olives and thalamus
Australian 3 CNS; seizures with progression Bilateral and symmetrical cavitating lesions in the [6]
Cattle dogs to spastic tetraparesis brain stem and spinal cord with neuronal sparing;
EM: increased numbers of morphologically normal
mitochondria in astrocytes
English 1 CNS; ataxia, mild behavioral Marked atrophy of optic nerves and tract, bilateral [5]
Springer abnormalities and symmetrical spongiosis in the brain stem; EM:
Spaniel mitochondria with abnormal morphology in neurons
Dogs 25 Skeletal muscle; myalgia, Resting lactic acidosis, abnormal accumulation of [38]
weakness, muscle atrophy lipid primarily in type 1 fibers
a Enzyme deficiency demonstrated

Husky encephalopathy is a reflection of a gliocentric de- brain stem and lateral walls of the third ventricle, primar-
generative process or a nonspecific event. The topography ily in its caudal part. Brain lesions are usually bilateral
of Alaskan Husky encephalopathy lesions in the neu- and symmetrical and show a tendency to be non-contigu-
roaxis is unexplained, as is often the case with neurode- ous. They do not respect gray and white matter bound-
generative diseases of animals and man. There is some aries, especially in the brain stem [27]. Characteristic fea-
overlap in the distribution of extracortical lesions between tures of acute lesions are loosening and spongiosis of the
Alaskan Husky encephalopathy and canine CCN due to neuropil followed by necrosis. There is capillary prolifer-
various causes [3]. As some cases of canine CCN are ation, macrophage infiltration, gliosis and occasional
caused by energy deprivation (thiamine deficiency, perivascular cuffs. An important feature is the relative
cyanide poisoning), an overlap is not surprising. preservation of neurons. Findings may vary in different
regions of the same case; while some areas are ‘end stage’
lesions, others show florid changes [16]. The destructive
Comparison of Alaskan Husky encephalopathy and LD process is episodic and total tissue damage is cumulative
[9]. In human autopsy material, lesions with quiescent
Since its initial description in 1951 [25], LS/LD subacute features predominate [9]. Astrocytic vacuolation is not de-
necrotizing encephalomyelopathy has been recognized in scribed in LS.
man as a neuropathological syndrome [9, 27, 45, 46, 50]. The lesions of LS bear a considerable resemblance in
In the last decade, numerous investigations have shed their distribution and quality to Alaskan Husky en-
light on the clinical recognition [21, 49], neuroimaging cephalopathy. There are differences in the topography of
findings [43], enzymatic deficiencies, genetic mutations lesions between the canine and human disorders. In LS,
and inheritance patterns [1, 12, 15, 45] of this heteroge- the most frequent involved regions are the midbrain
neous disorder. The pathological diagnosis of LS rests tegmentum and substantia nigra [9, 27], the pontine
upon the demonstration of characteristic lesions in the tegmentum [27] and the medullary tegmentum [9, 27]. In-
61

volvement of the neuroaxis outside the brain stem (e.g., Acknowledgements This study was supported by the Zipporah S.
basal nuclei, corona radiata, optic nerves, cerebellum, Fleisher Fund for Canine Neurologic Research. The authors thank
Dr. Roger P. Pitts of Duluth, Minnesota for initiating this study,
spinal cord) is variable. In Alaskan Husky encephalopathy, Dr. Susan Morgello of the Division of Neuropathology, Depart-
the thalamus is the most severely affected region but is in- ment of Pathology, The Mount Sinai Medical Center for her infor-
volved only in half [27] or less [9] of LS cases. Involve- mative discussions of comparative neuropathology, Dr. Victor L.
ment of cerebral gray matter is a consistent feature of F. Friedrich of the Brookdale Center for Molecular and Develop-
mental Biology, The Mount Sinai Medical Center, New York, NY
Alaskan Husky encephalopathy. Although recognized in for his assistance with ultrastructural studies and Dr. T. Robinson
LD [47], it is very uncommon and seen in only 10% [27] who wrote the first detailed description of this condition in his fi-
or less [9] of cases. A more detailed comparison of the nal year at the College of Veterinary Medicine, Cornell University.
distribution of lesions in LS and Alaskan Husky en- The expert technical support of Ms. Joy Cramer, Ms. Tina Smith
cephalopathy is unwarranted at this stage, in part because and Ms. Alexis Wenski-Roberts is greatly appreciated.
the distribution of LS is very variable [27, 33, 46]. Pre-
liminary electron microscopic examination of brain tissue
and conventional light microscopic examination of skele- References
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1205

Note added in proof Through the curtesy of Dr. T. van Winkle,


University of Pennsylvania, we have examined the brain sections
of an 8-month-old Yorkshire Terrier with identical lesions to the
Alaskan Husky encephalopathy. Bilateral thalamic cavitation was
evident on MRI examination of this Yorkshire Terrier.

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