Prof. Amos D. Korczyn discusses "Is there a need to refine Parkinson’s Disease?"
MDPD 2010 - Barcelona
The Sieratzki Chair of Neurology, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv 69978, Israel
Parkinson's disease (PD) has initially been described as a clinical syndrome, although the exact definition has changed over the past centuries. The inclusion of the pathological changes added another level of complexity, with Lewy bodies, synuclein deposits and neuronal loss in the substantia nigra being used alternatively. A third level of complexity was added with the recognition of genetic mutations resulting in parkinsonism, sometimes with and sometimes without Lewy body deposition, and the identification of frequent additional important pre-motor manifestations.
These different points of view on the definition of PD have important implications on the study of the etiology and even the therapy of PD.
Prof. Heinz Reichmann shares his: "View point: Etiology in Parkinson's disease. Dual hit or spreading intoxication"
MDPD 2010 - Barcelona
Professor and Chair Dept. Neurology, Dean of Medical Faculty, University of Dresden
Parkinson's disease is not only a movement disorder: non-motor symptoms such as loss of smell, constipation, depression, cognitive impairment, sleep problems and disturbances of the autonomic nervous system also feature. The etiology is still unknown, although an increasing number of gene-related Parkinsonian syndromes have been identified. It is intriguing to speculate that PD starts by the intake of a toxin, bacteria or virus. This idea stems from the fact that pathological abnormalities such as Lewy neuritis, Lewy bodies and alpha-synuclein accumulation are first found in the enteric nervous system of the gut and in the olfactory bulb. There is increasing evidence that the disease may spread out from the enteric nervous system of the gut via the vagal nerve up to the brain. Here we present data from animal work which supports this assumption.