Neuropathology of non-motor features of Parkinson disease.
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.
Dickson
Dennis W
DW
Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA. dickson.dennis@mayo.edu
Fujishiro
Hiroshige
H
Orr
Carolyn
C
DelleDonne
Anthony
A
Josephs
Keith A
KA
Frigerio
Roberta
R
Burnett
Melinda
M
Parisi
Joseph E
JE
Klos
Kevin J
KJ
Ahlskog
J Eric
JE
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*
D051844:alpha-Synuclein