The dorsal motor nucleus of the vagus is not an obligatory trigger site of Parkinson's disease:: a critical analysis of α-synuclein staging
The dorsal motor nucleus of the vagus is not an obligatory trigger site of Parkinson's disease:: a critical analysis of α-synuclein staging
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DOI：
10.1111/j.1365-2990.2007.00923.x
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发表时间：
2008-06-01
影响因子：
5
通讯作者：
Pearce, R. K. B.
中科院分区：
文献类型：
--
作者：
Kalaitzakis, M. E.;Graeber, M. B.;Pearce, R. K. B.
目的：已经提出帕金森病（PD）的α -突触核蛋白（α Syn）病理以可预测的尾-吻侧方式传播，最早的变化见于迷走神经（DMV）的背侧运动核。然而，这种典型的α - Syn病理传播的可靠性一直受到质疑。此外，α - Syn病理在脊髓和大脑中的比较发生还没有深入研究。方法：为了解决这些问题，我们从伦敦帝国学院的英国帕金森病协会组织库检查了71例PD。评估了α - Syn病理在几个脑区和脊髓的发生率和地理分布。结果：以黑质（SN, 100%）为主，其次为迈纳特基底核（NBM, 98.5%）。53%的病例显示α - Syn的分布模式与α - Syn在PD大脑的尾-吻侧扩散相一致。然而，47%的病例不符合预测的α Syn病理扩散，7%的DMV未受影响，即使在SN和皮质区域发现α Syn包涵体。我们还观察到，在DMV的影响下，脊髓中α Syn的发生率很高，在少数情况下，DMV不受影响。结论：我们的研究结果表明SN和NBM主要参与PD，但不支持在所有PD脑中存在α Syn病理的髓质诱导位点。
Aims: It has been proposed that alpha-synuclein (alpha Syn) pathology in Parkinson's disease (PD) spreads in a predictable caudo-rostral way with the earliest changes seen in the dorsal motor nucleus of the vagus nerve (DMV). However, the reliability of this stereotypical spread of alpha Syn pathology has been questioned. In addition, the comparative occurrence of alpha Syn pathology in the spinal cord and brain has not been closely studied. Methods: In order to address these issues, we have examined 71 cases of PD from the UK Parkinson's Disease Society Tissue Bank at Imperial College, London. The incidence and topographic distribution of alpha Syn pathology in several brain regions and the spinal cord were assessed. Results: The most affected regions were the substantia nigra (SN; in 100% of cases) followed by the Nucleus Basalis of Meynert (NBM) in 98.5%. Fifty-three per cent of cases showed a distribution pattern of alpha Syn compatible with a caudo-rostral spread of alpha Syn through the PD brain. However, 47% of the cases did not fit the predicted spread of alpha Syn pathology and in 7% the DMV was not affected even though alpha Syn inclusions were found in SN and cortical regions. We also observed a high incidence of alpha Syn in the spinal cord with concomitant affection of the DMV and in a few cases in the absence of DMV involvement. Conclusions: Our results demonstrate a predominant involvement of the SN and NBM in PD but do not support the existence of a medullary induction site of alpha Syn pathology in all PD brains.