Thalamic changes in Parkinson's disease
Thalamic changes in Parkinson's disease
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DOI：
10.1016/s1353-8020(09)70804-1
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发表时间：
2009-12-01
影响因子：
4.1
通讯作者：
Halliday, Glenda M.
中科院分区：
文献类型：
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作者：
Halliday, Glenda M.
帕金森病最显著的区别之一是运动回路中丘脑神经元活动的变化。由于多巴胺替代疗法在很大程度上缓解了这些运动回路异常，因此已经假设基底神经节中的病理完全负责异常的丘脑活动，然后渗透到运动回路。然而，有相当多的证据表明，丘脑本身的病理有助于帕金森病的异常神经活动特征。在一系列检查丘脑变性程度的研究中，我们观察到左旋多巴反应性帕金森病患者的丘脑板内核选择性变性。涉及的核团包括尾侧板内核（中央-正中/束旁复合体）、带旁核、兜状核和中央外侧核。中央-正中/旁束复合体提供了从丘脑到壳核的重要的多巴胺能反馈，并且是灵长类动物中大大扩大的通路。在特发性帕金森病中，丘脑的这个区域有30-40%的损失，其中不含小清蛋白的神经元退化最多（平均损失70%）。我们最近的工作表明，这一途径的保存可能有助于帕金森氏病的肌张力障碍。中央外侧核和丘状核退化30- 50%，而副丘脑核维持55%的神经元损失，与显著的α-突触核蛋白沉积相关，这与疾病持续时间相关。对这些区域的损伤似乎会影响认知、意识和知觉。这些研究表明，直接丘脑病理有助于帕金森病的症状。(C)2009爱思唯尔有限公司保留所有权利。
One of the most marked differences to be identified in Parkinson's disease is the change in activity of thalamic neurons in the motor circuits. Because dopamine replacement therapies largely alleviate these motor circuit abnormalities, it has been assumed that pathology in the basal ganglia is entirely responsible for the aberrant thalamic activity which then permeates the motor circuits. However, there is considerable evidence that pathology in the thalamus itself contributes to the abnormal neural activity characteristic of Parkinson's disease. In a series of studies examining the degree of degeneration in the thalamus, we have observed selective degeneration in the intralaminar thalamic nuclei in patients with levodopa-responsive Parkinson's disease. The nuclei involved are the caudal intralaminar nuclei (the centre-median/parafascicular complex), the parataenial, cucullar and central lateral nuclei. The centre-median/parafascicular complex provides important glutaminergic feedback from the thalamus to the putamen and is a pathway that is greatly enlarged in primates. There is 30-40% loss in this region of the thalamus in idiopathic Parkinson's disease, with non-parvalbumin-containing neurons degenerating the most (70% average loss). Our recent work suggests that the preservation of this pathway may contribute to dystonia in Parkinson's disease. The central lateral and cucullar thalamic nuclei degenerate 30-50%, while the parataenial nucleus sustains a 55% loss of neurons in association with significant alpha-synuclein deposition which correlates with disease duration. Damage to these regions appears to impact on cognition, awareness and perception. These studies suggest that direct thalamic pathology contributes to the symptoms of Parkinson's disease. (C) 2009 Elsevier Ltd. All rights reserved.