Stages in the development of Parkinson’s disease-related pathology
Abstract
The synucleinopathy, idiopathic Parkinson's disease, is a multisystem disorder that involves only a few predisposed nerve cell types in specific regions of the human nervous system. The intracerebral formation of abnormal proteinaceous Lewy bodies and Lewy neurites begins at defined induction sites and advances in a topographically predictable sequence. As the disease progresses, components of the autonomic, limbic, and somatomotor systems become particularly badly damaged. During presymptomatic stages 1-2, inclusion body pathology is confined to the medulla oblongata/pontine tegmentum and olfactory bulb/anterior olfactory nucleus. In stages 3-4, the substantia nigra and other nuclear grays of the midbrain and forebrain become the focus of initially slight and, then, severe pathological changes. At this point, most individuals probably cross the threshold to the symptomatic phase of the illness. In the end-stages 5-6, the process enters the mature neocortex, and the disease manifests itself in all of its clinical dimensions.
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Parkinson's disease has distinctive neuropathological brain changes including formation of Lewy bodies and Lewy neurites.
“The disease has distinctive neuropathological brain changes.There is formation of abnormal proteinaceous spherical bodies called Lewy bodies (Fig. 1), and a spindleor thread-like and, in part, branching Lewy neurites in the somata of the involved nerve cells, beginning at defined induction sites and advancing in a topographically predictable sequence within the nervous system (Braak et al. 2004).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Braak et al. 2004
Lewy bodies and Lewy neurites begin at defined induction sites and advance in a topographically predictable sequence within the nervous system in Parkinson's disease.
“There is formation of abnormal proteinaceous spherical bodies called Lewy bodies (Fig. 1), and a spindleor thread-like and, in part, branching Lewy neurites in the somata of the involved nerve cells, beginning at defined induction sites and advancing in a topographically predictable sequence within the nervous system (Braak et al. 2004).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Braak et al. 2004
In the end stage (stages 5-6) of Parkinson's disease, the process enters the neocortex with a wide variety of clinical manifestations.
“In the end stage (stage 5-6), the process enters the neocortex with a wide variety of clinical manifestations (Braak et al. 2004).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Braak et al. 2004
In the pre-symptomatic stages (1-2) of Parkinson's disease, inclusion bodies are confined to the medulla oblongata/pontine tegmentum and olfactory bulb/anterior olfactory nucleus.
“In the pre-symptomatic stages of the disease (stages 1-2), the inclusion bodies are confined to the medulla oblongata/pontine tegmentum and olfactory bulb/anterior olfactory nucleus.”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Braak et al. 2004
With progression of Parkinson's disease, the substantia nigra and other nuclei of the midbrain and forebrain become affected (stages 3-4).
“With progression of the disease, substantia nigra and other nuclei of the midbrain and forebrain become affected (stages 3-4).”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Braak et al. 2004
Evidence for Braak's theory is supported by both preclinical and clinical evidence demonstrating the presence of α-synuclein deposits in enteric neurons of the gut before the detection of misfolded α-synuclein in the CNS.
“Evidence for this theory is supported by both preclinical and clinical evidence demonstrating the presence of α-synuclein deposits in enteric neurons of the gut before the detection of misfolded α-synuclein in the CNS (Braak et al., 2004; Bencsik et al., 2014).”
From Microbiome–microglia connections via the gut–brain axis (2019) · cites this paper as Braak et al., 2004
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Archer, T., Kostrzewa, R. M., Beninger, R. J., & Palomo, T. (2011) · Neurotoxicity Research · doi:10.1007/s12640-010-9190-2 · Cited by 34 · see citing works
Chan, D. G., Ventura, K., Villeneuve, A., Du Bois, P., & Holahan, M. R. (2022) · Journal of Parkinson's Disease · doi:10.3233/jpd-223461 · Cited by 24 · see citing works
Placidi, F., Izzi, F., Romigi, A., Stanzione, P., Marciani, M. G., Brusa, L., Sperli, F., Galati, S., Pasqualetti, P., & Pierantozzi, M. (2008) · Journal of Neurology · doi:10.1007/s00415-008-0836-4 · Cited by 21 · see citing works
Tau pathology and neurodegeneration: An obvious but misunderstood link
Delacourte, A. (2008) · Journal of Alzheimer s Disease · doi:10.3233/jad-2008-14412 · Cited by 18 · see citing works
Lesion of the Cerebellar Noradrenergic Innervation Enhances the Harmaline-Induced Tremor in Rats
Kolasiewicz, W., Kuter, K., Nowak, P., Pastuszka, A., & Ossowska, K. (2011) · The Cerebellum · doi:10.1007/s12311-011-0250-9 · Cited by 14 · see citing works
Kim, E.-J., Vatsavayai, S., & Seeley, W. W. (2016) · The Behavioral Neurology of Dementia · doi:10.1017/9781139924771.008 · Cited by 7 · see citing works
- Authors
- Braak, H., Ghebremedhin, E., Rüb, U., Bratzke, H., & Del Tredici, K.
- Affiliations
- Goethe University Frankfurt (DE)
- Corresponding author
- Braak, Heiko
- ORCID
- Braak, Heiko
- Venue
- Cell and Tissue Research
- Published
- 2004-08-24
- Volume
- 318
- Issue
- 1
- Pages
- 121-134
- ISSN
- 0302-766X (ISSN-L)
- 1432-0878
- OpenAlex
- W1999385317
- Cited by
- 2,689
- References
- 5
- Citations by year
- 2026: 52 · 2025: 113 · 2024: 130 · 2023: 131 · 2022: 173 · 2021: 162 · 2020: 170 · 2019: 149 · 2018: 139 · 2017: 185 · 2016: 134 · 2015: 144 · 2014: 148 · 2013: 131 · 2012: 140
- FWCI
- 8.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Cell and Tissue Research (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
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- Parkinson's disease, synucleinopathies, Lewy bodies, Lewy neurites, disease progression, pathological stage, substantia nigra, medulla oblongata, olfactory bulb, autonomic dysfunction, limbic system, presymptomatic stage, neocortex
- MeSH terms
- Brain, Humans, Parkinson Disease
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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