title: Olfactory pathogenesis of idiopathic Parkinson disease revisited.
abstract: Idiopathic Parkinson disease (PD) is traditionally considered a movement disorder with hallmark lesions located in the substantia nigra pars compacta (SNpc). However, recent histopathological studies of some PD cases suggest the possibility of a multisystem disorder which progresses in a predictable sequence as described in Braak's staging criteria. The disease process starts in the dorsal motor nucleus of the vagus (dmX) and anterior olfactory nucleus and bulb, and from there, spreads through the brainstem nuclei to ultimately reach the SNpc, which then presents as symptomatic PD. In this article, we would like to revisit the olfactory pathogenesis of PD based on Braak's staging system and review anatomical pathways supporting such a possibility. We also suggest some biomarkers for early stages of PD. Additionally, we present and discuss the possibility that a prion-like process underlies the neurodegenerative changes in PD.
authors.affiliation: Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA. lernera@mail.nih.gov
authors.forename: Alicja
authors.initials: A
authors.lastname: Lerner
authors.forename: Anto
authors.initials: A
authors.lastname: Bagic
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis / Q000473:pathology; D016229:Amyloid beta-Peptides / Q000378:metabolism; D001933:Brain Stem / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology; D008032:Limbic System / Q000473:pathology; D009410:Nerve Degeneration / Q000175:diagnosis / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology; D009474:Neurons / Q000473:pathology; D009830:Olfactory Bulb / Q000473:pathology*; D009832:Olfactory Nerve / Q000473:pathology*; D010300:Parkinson Disease / Q000175:diagnosis / Q000473:pathology*; D017096:Prion Diseases / Q000175:diagnosis / Q000473:pathology*; D013378:Substantia Nigra / Q000473:pathology*; D014630:Vagus Nerve / Q000473:pathology; D020421:Vagus Nerve Diseases / Q000175:diagnosis / Q000473:pathology*; D051844:alpha-Synuclein / Q000378:metabolism
chemical_list: D016229:Amyloid beta-Peptides; D051844:alpha-Synuclein