Fig. 1.

Neuropathology of MSA and cell-to-cell propagation of α-syn. It is believed that in MSA oligodendrocytes accumulate α-syn after a process of propagation from neurons or other oligodendroglial cells. Increased expression and/or reduced α-syn clearance in neurons may stimulate the accumulation of misfolded forms of the protein as NCIs, and their release and propagation to oligodendrocytes via exocytosis or within extracellular vesicles (EVs). Reduced α-syn clearance in oligodendrocytes may also enhance its accumulation in the form of GCIs, and induce its release to the extracellular environment. It is also possible that enhanced expression of the α-syn gene is present in oligodendrocytes. These neuropathological events represent potential targets for therapeutic intervention in MSA.