Department of Biochemistry, Rappaport Faculty of Medicine and Research Institute, Technion-Israel Institute of Technology, Haifa 31096, Israel.
Neuroregeneration Research Institute, McLean Hospital, Belmont, MA 02478, USA; Harvard Medical School, Boston, MA 02115, USA.
Trends Neurosci. 2017 Jan;40(1):4-14. doi: 10.1016/j.tins.2016.10.008. Epub 2016 Nov 25.
Parkinson's disease (PD) is recognized by the accumulation of α-synuclein within neurons. In contrast to the current ascending theory where α-synuclein would propagate from neuron to neuron, we now propose the threshold theory for PD based on evidence of parallel degeneration of both central nervous system (CNS) and peripheral nervous system (PNS) in PD. The functional threshold is lower for the emergence of early symptoms before the classical motor symptoms of PD. This is due to the larger functional reserve of the midbrain dopamine and integrated basal ganglia motor systems to control movement. This threshold theory better accounts for the current neurobiology of PD symptom progression compared to the hypothesis that the disease ascends from the PNS to the CNS as proposed by Braak's hypothesis.
帕金森病(PD)是由神经元内α-突触核蛋白的积累引起的。与目前的上升理论相反,该理论认为α-突触核蛋白会从神经元传播到神经元,我们现在根据 PD 中中枢神经系统(CNS)和周围神经系统(PNS)的平行退化的证据,提出 PD 的阈值理论。在出现 PD 的经典运动症状之前,早期症状出现的功能阈值较低。这是由于中脑多巴胺和整合基底神经节运动系统的更大功能储备来控制运动。与 Braak 假说提出的疾病从 PNS 上升到 CNS 的假说相比,该阈值理论更好地解释了 PD 症状进展的当前神经生物学。