The progression of pathology in Parkinson's disease
The progression of pathology in Parkinson's disease
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DOI：
10.1111/j.1749-6632.2009.05118.x
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发表时间：
2010-01-01
期刊：
影响因子：
--
通讯作者：
McCann, Heather
中科院分区：
文献类型：
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作者：
Halliday, Glenda Margaret;McCann, Heather
为了确定帕金森病整个病程中的病理进展，我们纵向跟踪临床队列尸检，并确定了三种以不同速度进展的临床病理表型。典型的帕金森病具有中脑多巴胺神经元的初始快速损失，伴随路易体浸润到大脑中的缓慢进展（数十年）。当路易体侵入新皮层时，痴呆症就会介入。年龄较大的患者（> 70岁）发病较早，病程较短。奇怪的是，他们在整个大脑中有更多的含有α-突触核蛋白的路易体，许多人还患有与年龄相关的斑块病理学。相比之下，路易体痴呆症的病程最短，大量路易体和阿尔茨海默型病变浸润大脑。这些数据表明，两个年龄相关的因素影响帕金森病的病理进展-症状发作的年龄和与年龄相关的阿尔茨海默型病理的程度和类型。
To identify the progression of pathology over the entire course of Parkinson's disease, we longitudinally followed a clinical cohort to autopsy and identified three clinicopathological phenotypes that progress at different rates. Typical Parkinson's disease has an initial rapid loss of midbrain dopamine neurons with a slow progression of Lewy body infiltration into the brain (over decades). Dementia intervenes late when Lewy bodies invade the neocortex. Older onset patients (> 70 years old) dement earlier and have much shorter disease durations. Paradoxically, they have far more alpha-synuclein-containing Lewy bodies throughout the brain, and many also have additional age-related plaque pathology. In contrast, dementia with Lewy bodies has the shortest disease course, with substantive amounts of Lewy bodies and Alzheimer-type pathologies infiltrating the brain. These data suggest that two age-related factors influence pathological progression in Parkinson's disease-the age at symptom onset and the degree and type of age-related Alzheimer-type pathology.