Stanley Fahn Lecture 2005: the staging procedure for the inclusion body pathology associated with sporadic Parkinson’s disease reconsidered
Abstract
The synucleinopathy known as sporadic Parkinson's disease (PD) is a multisystem disorder that severely damages predisposed nerve cell types in circumscribed regions of the human nervous system. A recent staging procedure for the inclusion body pathology associated with PD proposes that, in the brain, the pathological process (formation of proteinaceous intraneuronal Lewy bodies and Lewy neurites) begins at two sites and continues in a topographically predictable sequence in six stages, during which components of the olfactory, autonomic, limbic, and somatomotor systems become progressively involved. In stages 1 to 2, the Lewy body pathology is confined to the medulla oblongata/pontine tegmentum and anterior olfactory structures. In stages 3 to 4, the substantia nigra and other nuclei of the basal mid- and forebrain become the focus of initially subtle and, then, severe changes. During this phase, the illness probably becomes clinically manifest. In the final stages 5 to 6, the lesions appear in the neocortex. This cross-sectional study originally was performed on 168 autopsy cases using material from 69 incidental cases and 41 clinically diagnosed PD patients as well as 58 age- and gender-matched controls. Here, the staging hypothesis is critically reconsidered and discussed.
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DA neurons have physiological characteristics that make them particularly vulnerable, such as long axons, poorly or completely unmyelinated, that provide massive projections in the target areas.
“DA neurons have physiological characteristics that make them particularly vulnerable (Chan et al., 2010), such as long axons, poorly or completely unmyelinated, that provide massive projections in the target areas (Braak et al., 2006).”
From Nilotinib restores memory function by preventing dopaminergic neuron degeneration in a mouse model of Alzheimer’s Disease (2021) · cites this paper as Braak et al., 2006
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- Authors
- Braak, H., Bohl, J. R., Müller, C. M., Rüb, U., de Vos, R. A. I., & Del Tredici, K.
- Affiliations
- Goethe University Frankfurt (DE)
- Corresponding author
- Braak, Heiko
- ORCID
- Braak, Heiko
- Venue
- Movement Disorders
- Publisher
- Wiley
- Published
- 2006-10-31
- Volume
- 21
- Issue
- 12
- Pages
- 2042-2051
- ISSN
- 0885-3185 (ISSN-L)
- 1531-8257
- OpenAlex
- W2106935339
- Cited by
- 630
- References
- 114
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 17 · 2023: 24 · 2022: 32 · 2021: 35 · 2020: 35 · 2019: 34 · 2018: 31 · 2017: 30 · 2016: 28 · 2015: 32 · 2014: 30 · 2013: 35 · 2012: 43
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Movement Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Nuclear Receptors and Signaling
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, Lewy bodies, Lewy neurites, synucleinopathies, disease staging, substantia nigra, medulla oblongata, olfactory bulb, neocortex, autopsy findings, neuropathology
- MeSH terms
- Animals, Inclusion Bodies, Humans, Parkinson Disease, Disease Progression
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