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The Parkinson's-Reversing Breakthrough
Hydrocephalus
Note: It has recently become popular to classify some neurodegenerative diseases based on the protein abnormality (molecular pathology) that is believed to be central to the pathogenesis. This interpretation is often supported by genetic analysis of familial cases. Although this type of classification may help to organize discussion of the comparative pathology and biochemistry between conditions, it may be an oversimplification, which will require revision in the future. For instance, it is increasingly recognized that many of the "tauopathies" often have some accumulation of a-synuclein and vice versa.
Note: It has recently become popular to classify some neurodegenerative diseases based on the protein abnormality (molecular pathology) that is believed to be central to the pathogenesis. This interpretation is often supported by genetic analysis of familial cases. Although this type of classification may help to organize discussion of the comparative pathology and biochemistry between conditions, it may be an oversimplification, which will require revision in the future. For instance, it is increasingly recognized that many of the "tauopathies" often have some accumulation of a-synuclein and vice versa.
to produce symptoms and, at autopsy, most cases show more than 80% reduction (15). Significant neuronal loss also occurs in the locus ceruleus, dorsal motor nucleus of the vagus, raphe nuclei, and nucleus basalis. LBs may be found in all of these locations as well as numerous other subcortical structures. Neurodegeneration is accompanied by reactive changes including astrogliosis and microglial cell activation. In pigmented nuclei, neuromelanin is released from dying neurons and may lie free within the neuropil or be taken up by macrophages.
In 1912, Frederich H. Lewy first described intraneuronal inclusions in the substantia innominata and dorsal motor nucleus of the vagus, in patients with paralysis agitans (16). Seven years later, Tretiakoff recognized similar inclusions in the substantia nigra and called them corps de Lewy (17). Since then, LBs have been considered the pathological hallmark of idiopathic PD and most
Table 2
Comparative Neuropathology of Major Causes of Parkinsonism
Table 2
Comparative Neuropathology of Major Causes of Parkinsonism
|
Disease |
Most Diagnostic Pathology |
Other Characteristic Pathology |
|
idiopathic Parkinson's |
• subcortical LBs0 |
• cortical LBs0 |
|
disease |
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