The major goals of Core C are to support the research activities of this PPG by obtaining, characterizing, and distributing postmortem brain tissues from patients with MSA. The Core will provide detailed neuropathological data from these cases to Core and Project investigators, as well as provide advice and technical support to investigators in this PPG. These goals will be accomplished by the following specific aims: 1. To perform brain autopsies on PPG participants with clinical features of MSA in a timely fashion and according to standard protocol. 2. To provide detailed neuropathologic evaluation to establish a definitive diagnosis and to document the presence or absence of other central (CNS) and peripheral (PNS) nervous system pathologies. Neuropathologic data for all brains will be collected using standardized methods for gross dissection and neurohistology. These approaches include hematoxylin and eosin (H&E), myelin and silver stains, and The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and Braak scoring, in all cases. Additionally we will immunostain tissues with antibodies to a-synuclein. In cases with Lewy bodies (LB), LBs will be counted in cortical regions to assign a diagnostic category according to the Consortium for Dementia with Lewy Bodies criteria. We will assess the distribution and abundance of GCIs and related LB-like neuronal inclusions, dystrophic synuclein neurites, and other synuclein pathologies in the CNS and PNS of patients with MSA, compared to controls without MSA or any other neurological disease. 3. Collect cerebral spinal fluid (CSF), blood (huffy coat), and blood-spot samples on all cases. CSF and huffy coat samples will be frozen and banked for future research studies. 4. Store brain tissue and CSF, blood (buffy coat), and blood spot samples and provide pathologically well-characterized tissue samples for on-going research (Projects 2, 3, and Core D). 5. Monitor the acquisition and distribution of these tissue samples using a computerized database and maintain a computerized archive of histopathologic findings for research use by investigators in this PPG. 6. Provide advice and technical support to facilitate studies by PPG investigators on synucleinopathies and synucleinopathy models, especially Projects 2 and 3. 6. Prepare and store DNA from MSA patients.
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