Parkinson's Disease Research, Education and Clinical Center/MS #127, Philadelphia VA Medical Center, Philadelphia, PA 19104, USA.
J Neurol Sci. 2010 Feb 15;289(1-2):49-54. doi: 10.1016/j.jns.2009.08.042. Epub 2009 Sep 23.
Olfactory dysfunction has gained recognition as an early and nearly universal feature of Lewy body Parkinson's disease (PD). Recently, research efforts have focused on the use of early non-motor symptoms of PD as early biomarkers and have suggested that investigating neurodegeneration in the aspects of the nervous system subserving these symptoms may offer important insights into the pathophysiology of Lewy body PD. Therefore, there has been interest in characterizing the pathology observed in the olfactory bulb and system of patients with PD, dementia with Lewy bodies and perhaps more importantly, in subjects with incidental Lewy pathology, defined as people with Lewy pathology without evidence of Parkinsonism or dementia during life. The olfactory bulb may be ideally suited to investigations into the pathophysiology of the Lewy body disorders as it is one of the few areas of the brain wherein the entirety of neurons susceptible to Lewy neurodegeneration, including the dendritic arborization, cell soma, axon and synaptic terminals, can be examined in the same preparation. Interestingly, there is a lack of Lewy neurodegeneration in the dopaminergic neurons of the olfactory bulb and paradoxically, an apparent increase in dopaminergic neurons in some PD patients compared to controls. In this report, the known neuropathology of the olfactory system in PD will be reviewed and the advantages of investigating degeneration of the olfactory bulb as a model of Lewy neurodegeneration will be discussed.
嗅觉功能障碍已被认为是路易体帕金森病（PD）的早期且几乎普遍存在的特征。最近，研究工作集中在使用 PD 的早期非运动症状作为早期生物标志物上，并表明研究这些症状所涉及的神经系统方面的神经退行性变可能为路易体 PD 的病理生理学提供重要的见解。因此，人们对描述 PD、路易体痴呆以及可能更重要的是，在具有意外路易体病理的患者（即一生中没有帕金森病或痴呆证据但存在路易体病理的人）的嗅球和系统中观察到的病理学特征产生了兴趣。嗅球可能非常适合研究路易体疾病的病理生理学，因为它是大脑中少数几个可以在同一准备中检查易受路易体神经退行性变影响的神经元的全部（包括树突分支、细胞体、轴突和突触末端）的区域之一。有趣的是，嗅球中的多巴胺能神经元中没有路易体神经退行性变，而且与对照组相比，一些 PD 患者的多巴胺能神经元似乎明显增加，这有点矛盾。在本报告中，将回顾 PD 中嗅觉系统的已知神经病理学，并讨论将嗅球退化作为路易体神经退行性变模型进行研究的优势。
