Supplementary Table 1

Case / Age at death
(yr) / Diagnosis / Disease duration
(yr) / Cause(s) of death / Post-mortem interval (hr)
MS1# / 42, F / MS (SP) / 12 / sepsis, bronchopneumonia / 24
MS2* / 44, F / MS (SP) / 10 / sepsis, bronchopneumonia / 9
MS3* / 55, F / MS (SP) / 32 / NA / 17
MS4* / 58, F / MS (SP) / 27 / sepsis, bronchopneumonia / 26
MS5* / 59, F / MS (SP) / 18 / NA / 20
MS6* / 59, M / MS (SP) / 23 / carcinomatosis (lung) / 15
MS7* / 62, M / MS (SP) / 24 / respiratory failure / 12
MS8* / 63, M / MS (SP) / 40 / sepsis, bronchopneumonia / 15
MS9* / 80, F / MS (SP) / 36 / bowel obstruction / 13
MS10* / 80, M / MS (SP) / 40 / carcinomatosis (lung) / 31
PD1# / 76, F / PD / 7 / sepsis, bronchopneumonia / 12
PD2# / 79, M / PD / 12 / sepsis, bronchopneumonia / 15
PD3# / 82, M / PD / NA / NA / 24
PD4# / 85, F / PD / 12 / respiratory failure / 17
PD5# / 87, M / PD / 19 / sepsis, infected sacral pressure sore / 15
AD1‡ / 72, M / AD / NA / cardiorespiratory failure / 12-24
AD2‡ / 73, F / AD / NA / sepsis, bronchopneumonia / 12-24
AD3‡ / 77, F / AD / NA / sepsis and urinary tract infection / 12-24
AD4‡ / 80, F / AD / NA / cardiac arrest / 12-24
AD5‡ / 86, M / AD / NA / cardiorespiratory failure / 12-24
CON1* / 39, F / - / - / sepsis, peritonitis / 9
CON2‡ / 40, M / - / - / ischaemic heart disease / 28
CON3* / 43, M / - / - / sepsis, urinary tract infection / 15
CON4* / 49, M / - / - / myocardial infarction / 11
CON5* / 60, M / - / - / cardiac arrest / 19
CON6* / 67, M / - / - / ischaemic heart disease / 18
CON7# / 68, M / - / - / carcinomatosis (colon) / 24
CON8* / 75, F / - / - / cardiac arrest / 7
CON9† / 96, F / - / - / sepsis, bronchopneumonia / 9

Supplementary Table 1. Clinical details of cases

The mean age of MS cases was 60.2  12.6, controls 59.7  18.9, PD 81.8  4.4 and AD 77.6  5.7. Kruskal-Wallis test showed a significant difference between groups (p=0.009). The age of MS and control cases were not significantly different, although PD and AD cases were significantly older than MS and controls (Mann Whitney U-test, p=0.027 and p=0.025). The difference in post-mortem intervals between MS, PD and controls was not statistically significant (Kruskal-Wallis test p=0.826). Furthermore, the percentage of respiratory enzyme deficient choroid plexus epithelial cells was not significantly different in cases where sepsis was a cause of death compared with cases without, when all cases with a neurological disease were pooled (sepsis versus non-sepsis: 2.83 ± 0.57 versus 2.96 ± 0.67, p=0.84) and controls (sepsis versus non-sepsis: 0.92 ± 0.23 versus 0.81 ± 0.19, p=0.81) were analysed separately).

*from NeuroResource (UK).#from UK Multiple Sclerosis and Parkinson’s Disease Tissue Bank.‡from Newcastle Brain Tissue Resource.†from Cleveland Clinic.AD; Alzheimer’s disease. CON; controls. MS; multiple sclerosis.PD; Parkinson’s disease.SP; secondary progressive.NA; not available.
Supplementary Table 2

Primary antibody / Produced in (Type) / Target / Concentration / Manufacturer
AIF / rabbit polyclonal / apoptosis inducing factor / 1:100 / Cell Signalling Technologies
CD3 / mouse IgG1 / T lymphocytes / 1:400 / Dako
CD68 / mouse IgG1 / macrophages/
microglia / 1:400 / Dako
CD163 / mouse IgG1 / perivascular macrophages/
microglia / 1:300 / Novocastra
complex II-70kDa / mouse IgG1 / complex II subunit (nuclear DNA encoded) / 1:200 / Mitosciences
complex IV subunit-I / mouse IgG2a / complex IV subunit (mtDNA encoded) / 1:100 / Mitosciences
HLA-DR, DP, DQ / mouse IgG1 / MHC class II / 1:800 / Dako
iNOS / rabbit polyclonal / inducible nitric oxide synthase / 1:2500 / Millipore
MPO / rabbit polyclonal / myeloperoxidase / 1:4000 / Dako
NOX-1 / rabbit polyclonal / NADPH-oxidase subunit / 1:1000 / Sigma-Aldrich
p22phox / rabbit polyclonal / NADPH-oxidase subunit / 1:2000 / Santa Cruz Biotechnology
porin / mouse IgG2b / voltage gated anion channel / 1:400 / Mitosciences

Supplementary Table 2. Details of antibodies

MHC; major histocompatibility complex. NADPH; nicotinamide adenine dinucleotide phosphate
Supplementary Table 3

MS / PD / AD / CON
Complex IV deficient* / 173.4  75.9
(96) / 246.4  78.5
(91) / 229.4  84.9
(124) / 209.6  75.4
(162)
Complex IV intact / 117.5  28.1
(81) / 122.1  34.4
(52) / 105.8  23.6
(47) / 113.1  22.1
(71)

Supplementary Table 3. Area of choroid plexus epithelial cells in multiple sclerosis (MS), Parkinson’s disease (PD), Alzheimer’s disease (AD) and controls (CON)

Area of choroid plexus epithelial cells in m2. Parentheses indicate number of cells analyzed. Means  standard deviation are shown. *The area of complex IV deficient cells in MS, PD, AD and controls were significantly greater than cells with intact complex IV activity (p<0.001).