title: Neuropathology of non-motor features of Parkinson disease.
abstract: Non-motor manifestations of Parkinson disease (PD) are common and some may actually antedate motor dysfunction. Extrapyramidal signs in PD are tightly linked to striatonigral dopaminergic denervation associated with neuronal loss and Lewy bodies in the residual neurons of the substantia nigra. Lewy bodies composed of abnormal alpha-synuclein are the histologic hallmark of PD, and their presence beyond midbrain dopaminergic neurons is considered to be the pathologic substrate of many, if not all, of the non-motor manifestations of PD. We review the pathologic correlates of autonomic dysfunction (cardiac and gastrointestinal), hyposmia, depression, rapid eye movement behavior disorder and dementia in PD For each non-motor clinical feature there is strong evidence to suggest a role for alpha-synuclein pathology, lending further support for the notion that PD is a multisystem alpha-synucleinopathy.
authors.affiliation: Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA. dickson.dennis@mayo.edu
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Dickson
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Fujishiro
authors.forename: Carolyn
authors.initials: C
authors.lastname: Orr
authors.forename: Anthony
authors.initials: A
authors.lastname: DelleDonne
authors.forename: Keith A
authors.initials: KA
authors.lastname: Josephs
authors.forename: Roberta
authors.initials: R
authors.lastname: Frigerio
authors.forename: Melinda
authors.initials: M
authors.lastname: Burnett
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Parisi
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Klos
authors.forename: J Eric
authors.initials: JE
authors.lastname: Ahlskog
mesh_terms: D000818:Animals; D001007:Anxiety / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D003704:Dementia / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D003863:Depression / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D016631:Lewy Bodies / Q000473:pathology*; D010300:Parkinson Disease / Q000150:complications* / Q000473:pathology*; D020187:REM Sleep Behavior Disorder / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D051844:alpha-Synuclein / Q000378:metabolism*
chemical_list: D051844:alpha-Synuclein