Rinne J O, Rummukainen J, Paljärvi L, Rinne U K
Department of Neurology, University of Turku, Finland.
Ann Neurol. 1989 Jul;26(1):47-50. doi: 10.1002/ana.410260107.
Regional neuronal loss in the substantia nigra was studied in relation to extrapyramidal symptoms and dementia in 12 patients with idiopathic Parkinson's disease (PD) and in 18 control subjects. Four areas of the right substantia nigra were investigated at the level of the superior colliculus and caudal red nucleus. In Parkinson's disease, the percentages of neurons, from the medial to the lateral part of the substantia nigra, were reduced to 49%, 31%, 41%, and 25% of the control values. The number of neurons in the lateral part showed a negative correlation with the severity of rigidity and hypokinesia, whereas tremor was less noticeable in patients with few neurons. The degree of dementia of the patients had a significant correlation only with neuronal loss in the medial part of the substantia nigra, suggesting, in view of the topographical organization of the neurons in the substantia nigra, that intact projections to the caudate nucleus and limbic and cortical areas are a prerequisite for normal cognitive functioning and that their dysfunction leads to clinical dementia.
研究了12例特发性帕金森病（PD）患者和18例对照者黑质区域神经元丢失与锥体外系症状及痴呆的关系。在中脑上丘和尾侧红核水平对右侧黑质的四个区域进行了研究。在帕金森病患者中，从黑质内侧到外侧部分，神经元百分比分别降至对照值的49%、31%、41%和25%。外侧部分的神经元数量与强直和运动迟缓的严重程度呈负相关，而神经元数量少的患者震颤不太明显。患者的痴呆程度仅与黑质内侧部分的神经元丢失有显著相关性，鉴于黑质神经元的拓扑组织，这表明向尾状核、边缘系统和皮质区域的完整投射是正常认知功能的先决条件，其功能障碍会导致临床痴呆。
