New findings on the neuropathology of multiple system atrophy
New findings on the neuropathology of multiple system atrophy
复制标题
DOI：
10.1016/s1566-0702(01)00374-5
复制
发表时间：
2002-02-28
影响因子：
2.7
通讯作者：
Benarroch, EE
中科院分区：
文献类型：
--
作者：
Benarroch, EE
多系统萎缩(MSA)是一个典型的例子，说明中枢自主神经网络在控制心血管、呼吸、膀胱和胃肠功能方面的整合作用。越来越多的证据表明，神经化学定义的脑干神经元组在MSA中受到选择性影响的程度比帕金森病要严重得多。它们包括延髓头端腹外侧区投射到中间外侧细胞柱的儿茶酚胺能神经元(C1组)和尾侧延髓腹外侧区去甲肾上腺素能神经元(A1组)，前者投射到下丘脑的大细胞核，调节血管加压素(AVP)的释放。这些神经元的缺失可能至少部分解释了直立性低血压、压力感受性反射功能障碍的发生，以及对低血压的反应导致反射性AVP释放受损。有初步证据表明，疑核腹外侧部的心脏迷走神经元与致密区的分支运动神经元不同，也可能在MSA中受到影响。延髓弓状核中胆碱能神经元的丢失可能导致MSA患者自动换气功能障碍，特别是在睡眠中。(C)2002 Elsevier Science B.V.保留所有权利。
Multiple system atrophy (MSA) provides a typical example of the integrative role of the central autonomic network in controlling cardiovascular, respiratory, bladder and gastrointestinal functions. There is increasing evidence that neurochemically defined neuronal groups of the brainstem are selectively affected in MSA to a much greater degree than in Parkinson's disease. These include the catecholaminergic neurons of the rostral ventrolateral medulla (C1 group) which project to the intermediolateral cell column and are involved in modulation of sympathetic vasomotor outflow, and noradrenergic neurons of the caudal ventrolateral medulla (A1 group) projecting to the magnocellular nuclei of the hypothalamus and regulating vasopressin (AVP) release. Loss of these groups of neurons may, at least in part, explain the development of orthostatic hypotension, baroreflex dysfunction, and impaired reflex AVP release in response to hypotension. There is preliminary evidence that cardiovagal neurons of the ventrolateral portion of the nucleus ambiguus, distinct from the branchimotor neurons of the compact region, may also be affected in MSA. Loss of cholinergic neurons in the medullary arcuate nucleus, considered by some to be the homologous to the central chemosensitive region of the ventral medullary surface, may contribute to disturbances in automatic ventilation, particularly during sleep, in patients with MSA. (C) 2002 Elsevier Science B.V. All rights reserved.