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Fortschr Neurol Psychiatr. 2010 Mar;78 Suppl 1:S2-4. doi: 10.1055/s-0029-1245179. Epub 2010 Mar 1.

[Pathophysiology of sporadic Parkinson's disease].

[Article in German]

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Klinische Neuroanatomie, Zentrum f├╝r Klinische Forschung, Neurologische Universit├Ątsklinik Ulm.


Sporadic Parkinson's disease is a multisystem disorder that involves predisposed nerve cell types in circumscribed regions of the entire human nervous system (peripheral, enteric, and central nervous systems). A recent staging procedure for the pathological process proposes that, in the brain, the formation of intraneuronal Lewy bodies and Lewy neurites begins at two sites and continues in a topographically predictable sequence in 6 stages, during which components of the olfactory, autonomic, limbic, and somatomotor systems become progressively involved. In stages 1 - 2, the Lewy body pathology is confined to the medulla oblongata/pontine tegmentum and anterior olfactory structures. In stages 3 - 4, the substantia nigra, other nuclei of the basal mid- and forebrain, and the mesocortex become the focus of initially subtle and, then, severe changes. During this phase, the illness probably becomes clinically manifest. In the final stages 5 - 6, the lesions appear in the neocortex.

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