Zusammenfassung
Der idiopathische Morbus Parkinson ist eine stetig voranschreitende degenerative Erkrankung der zentralen, peripheren und enterischen Nervensysteme des Menschen. Neben der Substantia nigra erleiden eine Reihe weiterer Komponenten des motorischen Systems sowie zahlreiche Zentren des limbischen Systems und der autonomen Regulation schwere Zerstörungen. Nur wenige der zahlreichen Arten von Nervenzellen, die das menschliche Zentralnervensystem aufbauen, entwickeln die für den Morbus Parkinson charakteristischen und vornehmlich aus aggregiertem α-Synuklein bestehenden Lewy-Körper und Lewy-Neuriten, die zum vorzeitigen Absterben der betroffenen Neurone führen. Aufgrund der selektiven neuronalen Vulnerabilität ergibt sich eine charakteristische Verteilung der Veränderungen innerhalb des zentralen Nervensystems mit entsprechenden Einbußen der Funktionsfähigkeit zahlreicher Systeme. Die Veränderungen entstehen in zeitlich geordneter Reihenfolge. Der aszendierende pathologische Prozess ergreift innerhalb des Gehirns zunächst das dorsale Glossopharyngeus- und Vagusareal, zerstört nachfolgend weitgehend die Substantia nigra, erreicht dann den Mesokortex der Hirnrinde und dehnt sich von hier ausgehend in der Endphase der Erkrankung über weite Bereiche des Neokortex aus.
Abstract
Parkinson’s disease is a continuously progressive degenerative disorder of the central, peripheral and enteric human nervous systems. Not only the substantia nigra, but also a number of other components of the motor and limbic systems, as well as the autonomic regulation, suffer heavy damages. Only a few of the many types of nerve cells in the human central nervous system develop the characteristic Lewy bodies and Lewy neurites. They are composed primarily of aggregated α-synuclein and lead to the premature destruction of the affected neurons. Due to the selective neuronal vulnerability, a distinctive distribution of changes occurs within the central nervous system, leading to a corresponding loss of functionality in many systems. The changes occur in an ordered timely fashion. The ascending pathological process begins within the brain at the glossopharyngeal and vagal areas, nearly destroys the substantia nigra, and reaches the mesocortex of the gray matter. From here it expands to further areas of the neocortex, thereby marking the end phase of the disease.
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Danksagung
Diese Arbeit entstand mit dankenswerter Unterstützung durch die Deutsche Forschungsgemeinschaft und des Bundesministeriums für Forschung, Bildung und Technologie. Der besondere Dank der Autoren gebührt Frau I. Szasz für die Anfertigung der Graphiken.
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Sandmann-Keil, D., Braak, H. Zur postmortalen Diagnose des idiopathischen Morbus Parkinson. Pathologe 26, 214–220 (2005). https://doi.org/10.1007/s00292-004-0722-5
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DOI: https://doi.org/10.1007/s00292-004-0722-5