Critical appraisal of brain pathology staging related to presymptomatic and symptomatic cases of sporadic Parkinson’s disease

  • G. M. Halliday
  • K. Del Tredici
  • H. Braak
Part of the Journal of Neural Transmission. Supplementa book series (NEURALTRANS, volume 70)

Summary

Clinical Parkinson’s disease (PD) is a well-characterised syndrome that benefits significantly from dopamine replacement therapies. A staging procedure for sporadic PD pathology was developed by Braak et al. assuming that the abnormal deposition of α-synuclein indicates the intracellular process responsible for clinical PD. This paradigm has merit in corralling patients with similar cellular mechanisms together and determining the potential sequence of events that may herald the clinical syndrome. Progressive pathological stages were identified — 1) preclinical (stages 1–2), 2) early (stages 3–4, 35% with clinical PD) and 3) late (stages 5–6, 86% with clinical PD). However, preclinical versus early versus late-stage cases should on average be progressively older at the time of sampling, a feature not observed in the cohort analysed. In this cohort preclinical cases would have developed extremely late-onset PD compared with the other types of cases analysed. While the staging scheme is a valuable concept, further development is required.

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References

  1. Benarroch EE, Schmeichel AM, Low PA, Boeve BF, Sandroni P, Parisi JE (2005) Involvement of medullary regions controlling sympathetic output in Lewy body disease. Brain 128: 338–344PubMedCrossRefGoogle Scholar
  2. Braak H, Del Tredici K, Rüb U, de Vos RAI, Jansen Steur ENH, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24: 197–211PubMedCrossRefGoogle Scholar
  3. Braak H, Rüb U, Steur ENH, Del Tredici K, de Vos RAI (2005) Cognitive status correlates with neuropathologic stage in Parkinson disease. Neurology 64: 1404–1410PubMedGoogle Scholar
  4. Harding AJ, Stimson E, Henderson JM, Halliday GM (2002) Clinical correlates of selective pathology in the amygdala of patients with Parkinson’s disease. Brain 125: 2431–2445PubMedCrossRefGoogle Scholar
  5. Jankovic J (2005) Progression of Parkinson’s disease. Are we making progress in charting the course? Arch Neurol 62: 351–352PubMedCrossRefGoogle Scholar
  6. Jankovic J, Rajput AH, McDermott MP, Perl DP (2000) The evolution of diagnosis in early Parkinson disease. Parkinson Study Group. Arch Neurol 57: 369–372PubMedCrossRefGoogle Scholar
  7. Jellinger KA (2004) Lewy body-related α-synucleinopathy in the aged human brain. J Neural Transm 111: 1219–1235PubMedCrossRefGoogle Scholar
  8. Mikolaenko I, Pletnikova O, Kawas CH, O.Brien R, Resnick SM, Crain B, Troncoso JC (2005) α-Synuclein lesions in normal aging, Parkinson disease, and Alzheimer disease: evidence from the Baltimore Longitudinal Stduy of Aging (BLSA). J Neuropathol Exp Neurol 64: 156–162PubMedGoogle Scholar
  9. Parkkinen L, Kauppinen T, Pirttila T, Autere JM, Alafuzoff I (2005) α-Synuclein pathology does not predict extrapyramidal symptoms or dementia. Ann Neurol 57: 82–91PubMedCrossRefGoogle Scholar
  10. Parkkinen L, Soininen H, Alafuzoff I (2003) Regional distribution of α-synuclein pathology in unimpaired aging and Alzheimer disease. J Neuropathol Exp Neurol 62: 363–367PubMedGoogle Scholar
  11. Saito Y, Ruberu NN, Sawabe M, Arai T, Kazama H, Hosoi T, Yamanouchi H, Murayama S (2004) Lewy body-related α-synucleinopathy in aging. J Neuropathol Exp Neurol 63: 742–749PubMedGoogle Scholar
  12. Wakisaka Y, Furuta A, Tanizaki Y, Kiyohara Y, Iida M, Iwaki T (2003) Age-associated prevalence and risk factors of Lewy body pathology in a general population: the Hisayama study. Acta Neuropathol 106: 374–382PubMedCrossRefGoogle Scholar
  13. Wirdefeldt K, Gatz M, Pawitan Y, Pedersen NL (2005) Risk and protective factors for Parkinson’s disease: a study of Swedish twins. Ann Neurol 57:27–33PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • G. M. Halliday
    • 1
  • K. Del Tredici
    • 2
  • H. Braak
    • 2
  1. 1.Prince of Wales Medical Research InstituteUniversity of New South WalesRandwick, SydneyAustralia
  2. 2.Institute for Clinical NeuroanatomyJW Goethe University ClinicFrankfurt am MainGermany

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