Jellinger Kurt A
Institute of Clinical Neurobiology, Vienna, Austria.
Int Rev Neurobiol. 2017;133:13-62. doi: 10.1016/bs.irn.2017.05.005. Epub 2017 Jun 27.
Parkinson's disease (PD), a multiorgan neurodegenerative disorder associated with α-synuclein deposits throughout the nervous system and many organs, is clinically characterized by motor and nonmotor features, many of the latter antedating motor dysfunctions by 20 or more years. The causes of the nonmotor manifestations such as olfactory, autonomic, sensory, neuropsychiatric, visuospatial, sleep, and other disorders are unlikely to be related to single lesions. They are mediated by the involvement of both dopaminergic and nondopaminergic systems, and diverse structures outside the nigrostriatal system that is mainly responsible for the motor features of PD. The nonmotor alterations appear in early/prodromal stages of the disease and its further progression, suggesting a topographical and chronological spread of the lesions. This lends further support for the notion that PD is a multiorgan proteinopathy, although the exact relationship between presymptomatic and later developing nonmotor features of PD and neuropathology awaits further elucidation.
帕金森病（PD）是一种多器官神经退行性疾病，与α-突触核蛋白在整个神经系统和许多器官中的沉积有关，其临床特征包括运动和非运动症状，其中许多非运动症状比运动功能障碍早出现20年或更长时间。嗅觉、自主神经、感觉、神经精神、视觉空间、睡眠及其他障碍等非运动症状的病因不太可能与单一病变有关。它们是由多巴胺能和非多巴胺能系统以及黑质纹状体系统之外的多种结构参与介导的，而黑质纹状体系统主要负责帕金森病的运动特征。非运动改变出现在疾病的早期/前驱期及其进一步发展过程中，提示病变存在拓扑学和时间上的扩散。这进一步支持了帕金森病是一种多器官蛋白病的观点，尽管帕金森病症状前和后期出现的非运动特征与神经病理学的确切关系还有待进一步阐明。
