Jellinger K A
L. Boltzmann Institute of Clinical Neurobiology, Lainz-Hospital, Vienna, Austria.
Mol Chem Neuropathol. 1991 Jun;14(3):153-97. doi: 10.1007/BF03159935.
In Parkinson's disease (PD), in addition to degeneration of the nigrostriatal dopaminergic pathway, a variety of neuronal systems are involved, causing multiple neuromediator dysfunctions that account for the complex patterns of functional deficits. Degeneration affects the dopaminergic mesocorticolimbic system, the noradrenergic locus ceruleus (oral parts) and motor vagal nucleus, the serotonergic raphe nuclei, the cholinergic nucleus basalis of Meynert, pedunculopontine nucleus pars compacta, Westphal-Edinger nucleus, and many peptidergic brainstem nuclei. Cell losses in subcortical projection nuclei range from 30 to 90% of controls; they are more severe in depressed and demented PD patients. Most of the lesions are region-specific, affecting not all neurons containing a specific transmitter or harboring Lewy bodies. In contrast to Alzheimer's disease (AD), subcortical system lesions in Parkinson's disease appear not to be related to cortical pathology, suggesting independent or concomitant degeneration. The pathogenesis of multiple-system changes contributing to chemical pathology and clinical course of Parkinson's disease are unknown.
在帕金森病（PD）中，除黑质纹状体多巴胺能通路变性外，多种神经元系统也受累，导致多种神经介质功能障碍，这解释了功能缺陷的复杂模式。变性影响多巴胺能中脑皮质边缘系统、去甲肾上腺素能蓝斑（嘴侧部分）和迷走神经运动核、5-羟色胺能中缝核、胆碱能梅纳特基底核、脚桥被盖核致密部、韦斯特法尔-埃丁格核以及许多肽能脑干核。皮质下投射核中的细胞损失占对照的30%至90%；在抑郁和痴呆的PD患者中更为严重。大多数病变具有区域特异性，并非影响所有含有特定递质或有路易小体的神经元。与阿尔茨海默病（AD）不同，帕金森病中的皮质下系统病变似乎与皮质病理无关，提示存在独立或伴随的变性。导致帕金森病化学病理和临床病程的多系统变化的发病机制尚不清楚。
