Parkinson’s disease: premotor clinico-pathological correlations

  • E. Ch. Wolters
  • H. Braak
Part of the Journal of Neural Transmission. Supplementa book series (NEURALTRANS, volume 70)

Summary

Parkinsonism is a clinical syndrome characterized by bradykinesia, hypo-/akinesia, muscular rigidity, and resting tremor, mainly caused by Parkinson’s disease (PD). Progressive loss of nigral neurons with Lewy bodies is considered an essential neuropathological feature. Recent studies, however, indicate that nigral degeneration is only a part of this synucleinopathy, and clinical symptoms go far beyond motor parkinsonism. Olfactory disturbances, autonomic dysfunction, pain, sleep fragmentation, depression, and dementia with or without psychosis are frequently seen. The variability in the expression of these signs and symptoms suggests multiple causes and/or pathogeneses within the present diagnostic disease entity. In this article, a recently proposed staging of PD-related brain pathology will be correlated with the various clinical expressions. It will be argued that the specific topographical sequence of the pathology, depending on the extent and progression of the degenerative process at defined sites, may explain the individually variable expression of this disease.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • E. Ch. Wolters
    • 1
  • H. Braak
    • 2
  1. 1.Department of NeurologyVU University Medical CenterAmsterdamThe Netherlands
  2. 2.Institute for Clinical NeuroanatomyJ.W. Goethe UniversityFrankfurt/MainGermany

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