Moore Robert Y
Departments of Neurology and Neuroscience, University of Pittsburgh, 3471 Fifth Avenue, Suite 811, Pittsburgh, PA 15213, USA.
Parkinsonism Relat Disord. 2003 Aug;9 Suppl 2:S65-71. doi: 10.1016/s1353-8020(03)00063-4.
Understanding of the pathophysiology of Parkinson disease (PD) has advanced rapidly over the last two decades through basic and clinical studies using modern neuroanatomical, clinical assessment, neuropathological and functional brain imaging methods. Two interacting processes determine the development of functional impairment, neuronal degeneration with selective denervation of specific regions and compensatory responses, which oppose the effects of denervation. The clinical manifestations of PD, at least in early stages, reflect selective degeneration of dopamine neurons in the substantia nigra projecting through the nigrostriatal pathway to the caudal putamen with compensatory changes in this and related systems. Positron emission tomography with specific ligands for the dopamine system is a powerful tool for analysis of both degenerative and compensatory processes in the pathophysiology of Parkinson disease in vivo and can be used to confirm the diagnosis of dopamine deficient Parkinson disease.
在过去二十年中，通过运用现代神经解剖学、临床评估、神经病理学和功能性脑成像方法进行的基础和临床研究，对帕金森病（PD）病理生理学的理解取得了迅速进展。两个相互作用的过程决定了功能障碍的发展，即神经元变性伴特定区域的选择性去神经支配以及代偿反应，后者对抗去神经支配的影响。PD的临床表现，至少在早期阶段，反映了黑质中多巴胺能神经元通过黑质纹状体通路投射至尾状壳核的选择性变性，以及该系统和相关系统的代偿性变化。使用针对多巴胺系统的特异性配体进行正电子发射断层扫描，是在体内分析帕金森病病理生理学中变性和代偿过程的有力工具，可用于确诊多巴胺缺乏型帕金森病。
