The pathology roadmap in Parkinson disease
Open accessAbstract
An under-appreciated clue about pathogenesis in Parkinson disease (PD) is the distribution of pathology in the early and middle stages of the disease. This pathological 'roadmap' shows that in addition to dopaminergic neurons in the substantia nigra pars compacta (SNc), a significant number of other central and peripheral neuronal populations exhibit Lewy pathology, phenotypic dysregulation or frank degeneration in PD patients. This spatially distributed, at-risk population of neurons shares a number of features, including autonomously generated activity, broad action potentials, low intrinsic calcium buffering capacity and long, poorly myelinated, highly branched axons. Many, and perhaps all, of these traits add to the metabolic burden in these neurons, suggesting that mitochondrial deficits could drive pathogenesis in PD-in agreement with a large segment of the literature. What is less clear is how this neuronal phenotype might shape the susceptibility to proteostatic dysfunction or to the spread of α-synuclein fibrils deposited in the extracellular space. The review explores the literature on these issues and their translational implications.
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Parkinson's disease is proposed to start with CNS inflammation low in the brainstem, as in the Braak hypothesis, or with excitotoxic events anywhere, producing microglial •NO and O2•− and causing α-synuclein aggregates and Lewy bodies.
“Summarizing, the proposal is that Parkinson’s disease starts with CNS inflammation low in the brainstem, as in the Braak hypothesis (246), or with excitotoxic events anywhere, producing microglial •NO and O2•− and causing α-synuclein aggregates and Lewy bodies.”
From Chemiexcitation: Mammalian Photochemistry in the Dark<sup>†</sup> (2023) · cites this paper as [246]
The Introduction (page unavailable) describes early Parkinson’s pathology in the brainstem and says Braak and collaborators suggest that neurons in the dorsal motor nucleus of the vagus are first to degenerate. That supports the citation’s brainstem-starting comparison, but the paper does not describe CNS inflammation as the initiating event. The citation is attached to the Braak comparison, not the sentence’s later proposed microglial mechanism. (LLM, conf=0.85)
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Interactions of iron, dopamine and neuromelanin pathways in brain aging and Parkinson's disease
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Chemiexcitation: Mammalian Photochemistry in the Dark<sup>†</sup>
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- Authors
- Surmeier, D. J., & Sulzer, D.
- Affiliations
- Northwestern University (US)
- Columbia University (US)
- Corresponding author
- Surmeier, D. James
- Venue
- Prion
- Publisher
- Informa UK Limited
- Published
- 2013-01
- Volume
- 7
- Issue
- 1
- Pages
- 85-91
- ISSN
- 1933-6896 (ISSN-L)
- 1933-690X
- PMC
- PMC3609055
- OpenAlex
- W1981573235
- Cited by
- 74
- References
- 118
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 2 · 2020: 6 · 2019: 11 · 2018: 3 · 2017: 7 · 2016: 4 · 2015: 7 · 2014: 8 · 2013: 5
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Prion (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Neurological Disorders and Stroke (P50-NS38370, P50NS038370, P50NS047085)
- 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 body pathology, Lewy bodies, Lewy neurites, dopaminergic neurons, substantia nigra pars compacta, neuronal vulnerability, mitochondrial dysfunction, calcium buffering, axon morphology, pathogenesis, neurodegeneration
- MeSH terms
- Animals, Brain, Calcium, Humans, Mitochondria, Neurons, Parkinson Disease, Substantia Nigra, Oxidative Stress, alpha-Synuclein
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.
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