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The underlying mechanism of prodromal PD: insights from the parasympathetic nervous system and the olfactory system Liu, Shu-Ying; Chan, Piu; Stoessl, A. J

Abstract

Neurodegeneration of Parkinson’s disease (PD) starts in an insidious manner, 30–50% of dopaminergic neurons have been lost in the substantia nigra before clinical diagnosis. Prodromal stage of the disease, during which the disease pathology has started but is insufficient to result in clinical manifestations, offers a valuable window for disease-modifying therapies. The most focused underlying mechanisms linking the pathological pattern and clinical characteristics of prodromal PD are the prion hypothesis of alpha-synuclein and the selective vulnerability of neurons. In this review, we consider the two potential portals, the vagus nerve and the olfactory bulb, through which abnormal alpha-synuclein can access the brain. We review the clinical, pathological and neuroimaging evidence of the parasympathetic nervous system and the olfactory system in the neurodegenerative process and using the two systems as models to discuss the internal homogeneity and heterogeneity of the prodromal stage of PD, including both the clustering and subtyping of symptoms and signs. Finally, we offer some suggestions on future directions for imaging studies in prodromal Parkinson’s disease.

Item Metadata

Title
The underlying mechanism of prodromal PD: insights from the parasympathetic nervous system and the olfactory system
Creator
Liu, Shu-Ying; Chan, Piu; Stoessl, A. J
Contributor
Djavad Mowafaghian Centre for Brain Health. Pacific Parkinson’s Research Centre
Publisher
BioMed Central
Date Issued
2017-02-20
Description
Neurodegeneration of Parkinson’s disease (PD) starts in an insidious manner, 30–50% of dopaminergic neurons have been lost in the substantia nigra before clinical diagnosis. Prodromal stage of the disease, during which the disease pathology has started but is insufficient to result in clinical manifestations, offers a valuable window for disease-modifying therapies. The most focused underlying mechanisms linking the pathological pattern and clinical characteristics of prodromal PD are the prion hypothesis of alpha-synuclein and the selective vulnerability of neurons. In this review, we consider the two potential portals, the vagus nerve and the olfactory bulb, through which abnormal alpha-synuclein can access the brain. We review the clinical, pathological and neuroimaging evidence of the parasympathetic nervous system and the olfactory system in the neurodegenerative process and using the two systems as models to discuss the internal homogeneity and heterogeneity of the prodromal stage of PD, including both the clustering and subtyping of symptoms and signs. Finally, we offer some suggestions on future directions for imaging studies in prodromal Parkinson’s disease.
Subject
Parkinson's disease; Prodromal; Alpha-synuclein; Parasympathetic nervous system; Olfactory system; Subtype
Genre
Article
Type
Text
Language
eng
Date Available
2017-12-14
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0362031
URI
http://hdl.handle.net/2429/64013
Affiliation
Other UBC; Non UBC
Citation
Translational Neurodegeneration. 2017 Feb 20;6(1):4
Publisher DOI
10.1186/s40035-017-0074-8
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s).
Rights URI
http://creativecommons.org/licenses/by/4.0/
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DSpace

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Attribution 4.0 International (CC BY 4.0)