Where Does Parkinson Disease Pathology Begin in the Brain?
Abstract
The substantia nigra is not the induction site in the brain of the neurodegenerative process underlying Parkinson disease (PD). Instead, the results of this semi-quantitative study of 30 autopsy cases with incidental Lewy body pathology indicate that PD in the brain commences with the formation of the very first immunoreactive Lewy neurites and Lewy bodies in non-catecholaminergic neurons of the dorsal glossopharyngeus-vagus complex, in projection neurons of the intermediate reticular zone, and in specific nerve cell types of the gain setting system (coeruleus-subcoeruleus complex, caudal raphe nuclei, gigantocellular reticular nucleus), olfactory bulb, olfactory tract, and/or anterior olfactory nucleus in the absence of nigral involvement. The topographical parcellation of the nuclear grays described here is based upon known architectonic analyses of the human brainstem and takes into consideration the pigmentation properties of a few highly susceptible nerve cell types involved in PD. In this sample and in all 58 age- and gender-matched controls, Lewy bodies and Lewy neurites do not occur in any of the known prosencephalic predilection sites (i.e. hippocampal formation, temporal mesocortex, proneocortical cingulate areas, amygdala, basal nucleus of Meynert, interstitial nucleus of the diagonal band of Broca, hypothalamic tuberomamillary nucleus).
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
LBD occurs frequently in the olfactory bulb in older adults.
“Although not part of this classification scheme, it is important to realize that LBD also occurs frequently in the olfactory bulb in older adults and should be sampled when possible [20].”
From National Institute on Aging–Alzheimer’s Association guidelines for the neuropathologic assessment of Alzheimer’s disease: a practical approach (2012) · cites this paper as [20]
Cites
Neuropathological stageing of Alzheimer-related changes.
Braak, H., & Braak, E. (1991) · Acta Neuropathologica · doi:10.1007/bf00308809 · Cited by 16,123 · see citing works
Self-citationThe relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease.
Gibb, W. R., & Lees, A. J. (1988) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.51.6.745 · Cited by 3,481 · see citing works
Diagnostic Criteria for Parkinson Disease
Gelb, D. J., Oliver, E., & Gilman, S. (1999) · Archives of Neurology · doi:10.1001/archneur.56.1.33 · Cited by 2,822 · see citing works
Hughes, A. J., Ben-Shlomo, Y., Daniel, S. E., & Lees, A. J. (1992) · Neurology · doi:10.1212/wnl.42.6.1142 · Cited by 1,313 · see citing works
Chapter 1 The emotional motor system
Holstege, G., Bandler, R., & Saper, C. B. (1996) · Progress in Brain Research · doi:10.1016/s0079-6123(08)61855-5 · Cited by 379 · see citing works
Chapter 33 The greater limbic system, the emotional motor system and the brain
Nieuwenhuys, R. (1996) · Progress in brain research · doi:10.1016/s0079-6123(08)61887-7 · Cited by 134 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Staging of brain pathology related to sporadic Parkinson’s disease
Braak, H., Tredici, K. D., Rüb, U., de Vos, R. A. I., Jansen Steur, E. N. H., & Braak, E. (2003) · Neurobiology of Aging · doi:10.1016/s0197-4580(02)00065-9 · Cited by 10,777 · see citing works
Self-citationHyman, B. T., Phelps, C. H., Beach, T. G., Bigio, E. H., Cairns, N. J., Carrillo, M. C., Dickson, D. W., Duyckaerts, C., Frosch, M. P., Masliah, E., et al. (2012) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2011.10.007 · Cited by 3,092 · see citing works
Montine, T. J., Phelps, C. H., Beach, T. G., Bigio, E. H., Cairns, N. J., Dickson, D. W., Duyckaerts, C., Frosch, M. P., Masliah, E., Mirra, S. S., et al. (2012) · Acta Neuropathologica · doi:10.1007/s00401-011-0910-3 · Cited by 2,992 · see citing works
“Although not part of this classification scheme, it is important to realize that LBD also occurs frequently in the olfactory bulb in older adults and should be sampled when possible [20].”
The spectrum of disease in chronic traumatic encephalopathy
McKee, A. C., Stein, T. D., Nowinski, C. J., Stern, R. A., Daneshvar, D. H., Alvarez, V. E., Lee, H.-S., Hall, G., Wojtowicz, S. M., Baugh, C. M., et al. (2013) · Brain · doi:10.1093/brain/aws307 · Cited by 2,098 · see citing works
Braak, H., R�b, U., Gai, W. P., & Del Tredici, K. (2003) · Journal of Neural Transmission · doi:10.1007/s00702-002-0808-2 · Cited by 1,683 · see citing works
Self-citationBraak, H., de Vos, R. A. I., Bohl, J., & Del Tredici, K. (2006) · Neuroscience Letters · doi:10.1016/j.neulet.2005.11.012 · Cited by 1,354 · see citing works
Self-citationParkinson's disease: a dual‐hit hypothesis
Hawkes, C. H., Del Tredici, K., & Braak, H. (2007) · Neuropathology and Applied Neurobiology · doi:10.1111/j.1365-2990.2007.00874.x · Cited by 1,021 · see citing works
Self-citationNeuropathological assessment of Parkinson’s disease: refining the diagnostic criteria
Dickson, D. W., Braak, H., Duda, J. E., Duyckaerts, C., Gasser, T., Halliday, G. M., Hardy, J., Leverenz, J. B., Del Tredici, K., Wszolek, Z. K., et al. (2009) · The Lancet Neurology · doi:10.1016/s1474-4422(09)70238-8 · Cited by 972 · see citing works
Self-citationParkinson's Disease and Parkinsonism: Neuropathology
Dickson, D. W. (2012) · Cold Spring Harbor Perspectives in Medicine · doi:10.1101/cshperspect.a009258 · Cited by 847 · see citing works
The pathological process underlying Alzheimer’s disease in individuals under thirty
Braak, H., & Del Tredici, K. (2011) · Acta Neuropathologica · doi:10.1007/s00401-010-0789-4 · Cited by 812 · see citing works
Self-citationSpreading of pathology in neurodegenerative diseases: a focus on human studies
Brettschneider, J., Tredici, K. D., Lee, V. M.-Y., & Trojanowski, J. Q. (2015) · Nature Reviews Neuroscience · doi:10.1038/nrn3887 · Cited by 790 · see citing works
Self-citationBraak, H., Bohl, J. R., Müller, C. M., Rüb, U., de Vos, R. A. I., & Del Tredici, K. (2006) · Movement Disorders · doi:10.1002/mds.21065 · Cited by 630 · see citing works
Self-citationThe bowel and beyond: The enteric nervous system in neurological disorders
Rao, M., & Gershon, M. D. (2016) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2016.107 · Cited by 629 · see citing works
Neuropathology of Parkinson disease
Dickson, D. W. (2018) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2017.07.033 · Cited by 623 · see citing works
Brain-Gut-Microbiota Axis in Parkinson’s Disease
Mulak, A. (2015) · World Journal of Gastroenterology · doi:10.3748/wjg.v21.i37.10609 · Cited by 583 · see citing works
Exploring Braak’s hypothesis of Parkinson’s disease
Rietdijk, C. D., Perez-Pardo, P., Garssen, J., van Wezel, R. J. A., & Kraneveld, A. D. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00037 · Cited by 395 · see citing works
Evidence that incidental Lewy body disease is pre-symptomatic Parkinson’s disease
Dickson, D. W., Fujishiro, H., DelleDonne, A., Menke, J., Ahmed, Z., Klos, K. J., Josephs, K. A., Frigerio, R., Burnett, M., Parisi, J. E., et al. (2008) · Acta Neuropathologica · doi:10.1007/s00401-008-0345-7 · Cited by 364 · see citing works
Uemura, N., Yagi, H., Uemura, M. T., Hatanaka, Y., Yamakado, H., & Takahashi, R. (2018) · Molecular Neurodegeneration · doi:10.1186/s13024-018-0257-5 · Cited by 328 · see citing works
Parkinson's Disease: The Dual Hit Theory Revisited
Hawkes, C. H., Del Tredici, K., & Braak, H. (2009) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2009.04365.x · Cited by 303 · see citing works
Self-citationGastrointestinal dysfunction in Parkinson's disease
Pfeiffer, R. F. (2011) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2010.08.003 · Cited by 298 · see citing works
Salvatore, C., Cerasa, A., Castiglioni, I., Gallivanone, F., Augimeri, A., Lopez, M., Arabia, G., Morelli, M., Gilardi, M. C., & Quattrone, A. (2014) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2013.11.016 · Cited by 299 · see citing works
Pellegrini, C., Antonioli, L., Colucci, R., Blandizzi, C., & Fornai, M. (2018) · Acta Neuropathologica · doi:10.1007/s00401-018-1856-5 · Cited by 270 · see citing works
The olfactory bulb as the entry site for prion-like propagation in neurodegenerative diseases
Rey, N. L., Wesson, D. W., & Brundin, P. (2018) · Neurobiology of Disease · doi:10.1016/j.nbd.2016.12.013 · Cited by 257 · see citing works
Uchihara, T., & Giasson, B. I. (2016) · Acta Neuropathologica · doi:10.1007/s00401-015-1485-1 · Cited by 249 · see citing works
α-Synuclein in gut endocrine cells and its implications for Parkinson’s disease
Chandra, R., Hiniker, A., Kuo, Y.-M., Nussbaum, R. L., & Liddle, R. A. (2017) · JCI Insight · doi:10.1172/jci.insight.92295 · Cited by 236 · see citing works
Cheng, J., Liao, Y., Dong, Y., Hu, H., Yang, N., Kong, X., Li, S., Li, X., Guo, J., Qin, L., et al. (2020) · Autophagy · doi:10.1080/15548627.2020.1719723 · Cited by 233 · see citing works
Gastrointestinal dysfunction in Parkinson's Disease
Jost, W. H. (2010) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2009.08.020 · Cited by 222 · see citing works
Lewy Body Pathology in Normal Elderly Subjects
Markesbery, W. R., Jicha, G. A., Liu, H., & Schmitt, F. A. (2009) · Journal of Neuropathology & Experimental Neurology · doi:10.1097/nen.0b013e3181ac10a7 · Cited by 210 · see citing works
Microbiota-gut-brain signalling in Parkinson's disease: Implications for non-motor symptoms
Felice, V. D., Quigley, E. M., Sullivan, A. M., O'Keeffe, G. W., & O'Mahony, S. M. (2016) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2016.03.012 · Cited by 205 · see citing works
Altered Proteins in the Aging Brain
Elobeid, A., Libard, S., Leino, M., Popova, S. N., & Alafuzoff, I. (2016) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nlw002 · Cited by 202 · see citing works
Anxiety in Parkinson’s disease: A critical review of experimental and clinical studies
Prediger, R. D. S., Matheus, F. C., Schwarzbold, M. L., Lima, M. M. S., & Vital, M. A. B. F. (2012) · Neuropharmacology · doi:10.1016/j.neuropharm.2011.08.039 · Cited by 190 · see citing works
Neuronal vulnerability, pathogenesis, and Parkinson's disease
Sulzer, D., & Surmeier, D. J. (2013) · Movement Disorders · doi:10.1002/mds.25187 · Cited by 184 · see citing works
Gastroparesis and Parkinson’s disease: a systematic review
Heetun, Z. S., & Quigley, E. M. M. (2012) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2011.12.004 · Cited by 182 · see citing works
Dopamine: A Modulator of Circadian Rhythms in the Central Nervous System
Korshunov, K. S., Blakemore, L. J., & Trombley, P. Q. (2017) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2017.00091 · Cited by 173 · see citing works
Intercellular Spread of Protein Aggregates in Neurodegenerative Disease
Davis, A. A., Leyns, C. E. G., & Holtzman, D. M. (2018) · Annual Review of Cell and Developmental Biology · doi:10.1146/annurev-cellbio-100617-062636 · Cited by 131 · see citing works
Calderón-Garcidueñas, L., González-Maciel, A., Reynoso-Robles, R., Kulesza, R. J., Mukherjee, P. S., Torres-Jardón, R., Rönkkö, T., & Doty, R. L. (2018) · Environmental Research · doi:10.1016/j.envres.2018.06.027 · Cited by 110 · see citing works
Calcium, Bioenergetics, and Parkinson’s Disease
Zampese, E., & Surmeier, D. J. (2020) · Cells · doi:10.3390/cells9092045 · Cited by 79 · see citing works
The pathology roadmap in Parkinson disease
Surmeier, D. J., & Sulzer, D. (2013) · Prion · doi:10.4161/pri.23582 · Cited by 74 · see citing works
Chronic Traumatic Encephalopathy Within an Amyotrophic Lateral Sclerosis Brain Bank Cohort
Walt, G. S., Burris, H. M., Brady, C. B., Spencer, K. R., Alvarez, V. E., Huber, B. R., Guilderson, L., Abdul Rauf, N., Collins, D., Singh, T., et al. (2018) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nly092 · Cited by 45 · see citing works
Zhong, G., Naismith, S. L., Rogers, N. L., & Lewis, S. J. G. (2011) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2011.04.020 · Cited by 39 · see citing works
Staging Neurodegenerative Disorders: Structural, Regional, Biomarker, and Functional Progressions
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
- Authors
- Del Tredici, K., Rüb, U., de Vos, R. A. I., Bohl, J. R. E., & Braak, H.
- Affiliations
- Goethe University Frankfurt (DE)
- ORCID
- Braak, Heiko
- Venue
- Journal of Neuropathology & Experimental Neurology
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-05
- Volume
- 61
- Issue
- 5
- Pages
- 413-426
- ISSN
- 0022-3069 (ISSN-L)
- 1554-6578
- OpenAlex
- W1237068170
- Cited by
- 773
- References
- 6
- Citations by year
- 2026: 15 · 2025: 23 · 2024: 30 · 2023: 28 · 2022: 45 · 2021: 26 · 2020: 37 · 2019: 52 · 2018: 27 · 2017: 44 · 2016: 27 · 2015: 40 · 2014: 19 · 2013: 31 · 2012: 34
- FWCI
- 15.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Neuropathology & Experimental Neurology (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, substantia nigra, gigantocellular reticular nucleus, olfactory bulb, olfactory tract, anterior olfactory nucleus, brainstem
- MeSH terms
- Aged, Aged, 80 and over, Female, Glossopharyngeal Nerve, Humans, Locus Coeruleus, Male, Nerve Tissue Proteins, Olfactory Bulb, Olfactory Pathways, Parkinson Disease, Raphe Nuclei, Reticular Formation, Substantia Nigra, Vagus Nerve, Lewy Bodies, Synucleins
About these checks
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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review