Poewe Werner
Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.
Mov Disord. 2007 Sep;22 Suppl 17:S374-8. doi: 10.1002/mds.21681.
Nonmotor symptoms have recently become a focus of renewed clinical interest and research in Parkinson's disease (PD). Autonomic and cognitive dysfunction are among the most prevalent of these nonmotor aspects of the disease. Although exact clinico-pathological correlations have not been established, alpha-synuclein pathology with Lewy body formation in the central and peripheral autonomic nervous system as well as in neocortical areas are generally believed to be driving factors for autonomic failure and cognitive decline in PD. Recent pathological and clinical studies have suggested greater prevalence of clinical dysautonomia and cardiac sympathetic denervation in PD dementia and dementia with Lewy bodies as compared with PD without dementia. This raises the possibility that spread of synuclein pathology to involve neocortical areas producing cognitive decline could be somehow linked to involvement of the autonomic nervous system in PD.
非运动症状最近重新成为帕金森病（PD）临床关注和研究的焦点。自主神经功能障碍和认知功能障碍是该疾病这些非运动方面中最常见的症状。尽管尚未建立确切的临床病理相关性，但一般认为，α-突触核蛋白病理改变以及在中枢和外周自主神经系统以及新皮质区域形成路易小体是导致PD患者自主神经功能衰竭和认知功能下降的驱动因素。最近的病理和临床研究表明，与非痴呆型PD相比，PD痴呆和路易体痴呆患者临床自主神经功能障碍和心脏交感神经去神经支配的发生率更高。这增加了一种可能性，即突触核蛋白病理改变扩散至新皮质区域导致认知功能下降可能在某种程度上与PD患者自主神经系统受累有关。
