Cited by 191Parkinson's Disease Mechanisms and TreatmentsNeurological disorders and treatmentsNuclear Receptors and Signaling

Many faces of Parkinson's disease: non-motor symptoms of Parkinson's disease

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Lee, Hye Mi, Koh, Seong-Beom·2015·Journal of Movement Disorders

Abstract

The micro-architecture of the substantia nigra was studied in control cases of varying age and patients with parkinsonism. A single 7μ section stained with haematoxylin and eosin was examined at a specific level within the caudal nigra using strict criteria. The pars compacta was divided into a ventral and a dorsaltier, and each tier was further subdivided into 3 regions. In 36 control cases there was a linear fallout of pigmented neurons with advancing age in the pars compacta of the caudal substantia nigra at a rate of 4.7% per decade. Regionally, the lateral ventral tier was relatively spared (2.1% loss per decade) compared with the medial ventral tier (5.4%) and the dorsal tier (6.9%). In 20 Parkinson's disease (PD) cases of varying disease duration there was an exponential loss of pigmented neurons with a 45% loss in the first decade. Regionally, the pattern was opposite to ageing. Loss was greatest in the lateral ventral tier (average loss 91%) followed by the medial ventral tier (71%) and the dorsal tier (56%). The presymptomatic phase of PD from the onset of neuronal loss was estimated to be about 5 yrs. This phase is represented by incidental Lewy body cases: individuals who die without clinical signs of PD or dementia, but who are found to have Lewy bodies at post-mortem. In 7 cases cell loss was confined to the lateral ventral tier (average loss 52%) congruent with the lateral ventral selectivity of symptomatic PD. It was calculated that at the onset of symptoms there was a 68% cell loss in the lateral ventral tier and a 48% loss in the caudal nigra as a whole. The regional selectivity of PD is relatively specific. In 15 cases of striatonigral degeneration the distribution of cell loss was similar, but the loss in the dorsal tier was greater than PD by 21%. In 14 cases of Steele-Richardson- Olszewski syndrome (SRO) there was no predilection for the lateral ventral tier, but a tendency to involve the medial nigra and spare the lateral. These findings suggest that agerelated of pigmented nigral cells is not an important factor in the pathogenesis of PD.

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  • Levodopa therapy has several side effects, does not prevent dopaminergic neuron degeneration, and has no effects on non-motor symptoms.

    “This therapy has several side effects (Schrag and Quinn, 2000), it does not prevent dopaminergic neuron degeneration, and has no effects on non-motor symptoms (Lee and Koh, 2015).”
  • Prolonged use of levodopa induces severe side effects such as dyskinesia and motor fluctuation, and as the disease progresses patients might eventually develop levodopa-resistance.

    “The prolonged use of levodopa induces severe side effects such as dyskinesia and motor fluctuation (Schrag and Quinn, 2000) and as the disease progresses patients might eventually develop levodopa-resistance (Lebouvier et al., 2010;Lee and Koh, 2015).”
  • Many non-motor symptoms in Parkinson's disease are unresponsive to dopaminergic treatments.

    “Many of the non-motor symptoms are unresponsive to dopaminergic treatments (Lee and Koh, 2015;Schrag and Quinn, 2000).”

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Authors
Lee, H. M., & Koh, S.-B.
Affiliations
Korea University (KR)
Corresponding author
Koh, Seong-Beom
Venue
Journal of Movement Disorders
Published
2015-05-31
Volume
8
Issue
2
Pages
92-97
ISSN
  • 2005-940X (ISSN-L)
  • 2093-4939
OpenAlex
W582237744
Cited by
191
References
55
Citations by year
2026: 22 · 2025: 26 · 2024: 23 · 2023: 19 · 2022: 14 · 2021: 21 · 2020: 16 · 2019: 17 · 2018: 7 · 2017: 11 · 2016: 11 · 2015: 4
FWCI
1.45
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of Movement Disorders (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Neurology › Neurological disorders and treatments
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Nuclear Receptors and Signaling
Keywords
Parkinson's disease, substantia nigra, regional selectivity, Lewy bodies, presymptomatic phase, striatonigral degeneration, progressive supranuclear palsy, aging, non-motor symptoms, neurodegeneration

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