Malatt Camille, Tagliati Michele
Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Curr Opin Neurol. 2022 Apr 1;35(2):220-229. doi: 10.1097/WCO.0000000000001042.
The aim of this review was to provide an update on current and emerging knowledge of the neuropathological processes affecting the locus coeruleus/norepinephrine (LC/NE) system, their effect on Alzheimer's disease and Parkinson's disease symptomatology, including efforts to translate these notions into therapeutic actions targeting the noradrenergic system.
Over the past 2 years, work from multiple groups has contributed to support an early role of locus coeruleus degeneration and/or hyperactivation in the neurodegenerative process, including a trigger of neuroinflammation. Imaging advances are allowing the quantification of locus coeruleus structural features in vivo, which is critical in the early stages of disease. Nonmotor and noncognitive symptoms, often secondary to the involvement of the LC/NE system, are becoming more important in the definition of these diseases and their treatment.
The diverse symptomatology of Parkinson's disease and Alzheimer's disease, which is not limited to cardinal motor and cognitive abnormalities, strongly suggests a multisystem neurodegenerative process. In this context, it is increasingly clear how the LC/NE system plays a key role in the initiation and maintenance of the neurodegenerative process.
本综述旨在更新有关影响蓝斑/去甲肾上腺素（LC/NE）系统的神经病理过程的现有及新出现的知识，及其对阿尔茨海默病和帕金森病症状学的影响，包括将这些概念转化为针对去甲肾上腺素能系统的治疗行动的努力。
在过去两年中，多个研究小组的工作支持了蓝斑变性和/或过度激活在神经退行性过程中的早期作用，包括引发神经炎症。影像学进展使得能够在体内量化蓝斑的结构特征，这在疾病早期至关重要。通常继发于LC/NE系统受累的非运动和非认知症状，在这些疾病的定义及其治疗中变得越来越重要。
帕金森病和阿尔茨海默病的多样症状学，不限于主要的运动和认知异常，强烈提示存在多系统神经退行性过程。在这种背景下，LC/NE系统如何在神经退行性过程的启动和维持中发挥关键作用日益清晰。
