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Neuroanatomy and Pathology of Sporadic Parkinson's Disease

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Neuroanatomy and Pathology of Sporadic Parkinson's Disease Reviews and critical articles covering the entire field of normal anatomy (cytology, histology, cyto- and histochemistry, electron microscopy, macroscopy, experimental morphology and embryology and comparative anatomy) are published in Advances in Anatomy, Embryology and Cell Biology. Papers dealing with anthropology and clinical morphology that aim to encourage cooperation between anatomy and related disciplines will also be accepted. Papers are normally commissioned. Original papers and communications may be submitted and will be considered for publication provided they meet the requirements of a review article and thus fit into the scope of “Advances”. English language is preferred. It is a fundamental condition that submitted manuscripts have not been and will not simultaneously be submitted or published elsewhere. With the acceptance of a manuscript for publication, the publisher acquires full and exclusive copyright for all languages and countries. Twenty-five copies of each paper are supplied free of charge. Manuscripts should be addressed to P r o f . D r . F. BECK, Howard Florey Institute, University of Melbourne, Parkville, 3000 Melbourne, Victoria, Australia e-mail: [email protected] P r o f . D r . F . CLASCÁ, Department of Anatomy, Histology and Neurobiology, Universidad Autónoma de Madrid, Ave. Arzobispo Morcillo s/n, 28029 Madrid, Spain e-mail: [email protected] P r o f . D r . M . FROTSCHER, Institut für Anatomie und Zellbiologie, Abteilung für Neuroanatomie, Albert-Ludwigs-Universität Freiburg, Albertstr. 17, 79001 Freiburg, Germany e-mail: [email protected] P r o f . D r . D . E . H A I N E S , Ph.D., Department of Anatomy, The University of Mississippi Med. Ctr., 2500 North State Street, Jackson, MS 39216–4505, USA e-mail: [email protected] Prof. Dr. N. HIROKAWA, Department of Cell Biology and Anatomy, University of Tokyo, Hongo 7–3–1, 113-0033 Tokyo, Japan e-mail: [email protected] Dr. Z. KMIEC, Department of Histology and Immunology, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland e-mail: [email protected] P r o f . D r . H . - W. KORF, Zentrum der Morphologie, Universität Frankfurt, Theodor-Stern Kai 7, 60595 Frankfurt/Main, Germany e-mail: [email protected] P r o f . D r . E . MARANI, Department Biomedical Signal and Systems, University Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands e-mail: [email protected] P r o f . D r . R . PUTZ, Anatomische Anstalt der Universität München, Lehrstuhl Anatomie I, Pettenkoferstr. 11, 80336 München, Germany e-mail: [email protected] Prof. Dr. Dr. h.c. Y. SANO, Department of Anatomy, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, 602 Kyoto, Japan Prof. Dr. Dr. h.c. T.H. SCHIEBLER, Anatomisches Institut der Universität, KoellikerstraBe 6, 97070 Würzburg, Germany P r o f . D r . J . - P. TIMMERMANS, Department of Veterinary Sciences, University of Antwerpen, Groenenborgerlaan 171, 2020 Antwerpen, Belgium e-mail: [email protected] 201 Advances in Anatomy, Embryology and Cell Biology Editors F. Beck, Melbourne . F. Clascá, Madrid M. Frotscher, Freiburg . D.E. Haines, Jackson N. Hirokawa, Tokyo . Z. Kmiec, Gdansk H.-W. Korf, Frankfurt . E. Marani, Enschede R. Putz, München . Y. Sano, Kyoto T.H. Schiebler, Würzburg J.-P. Timmermans, Antwerpen Heiko Braak and Kelly Del Tredici N e u r o a n a t o m y and Pathology of Sporadic Parkinson’s Disease With 29 Figures Heiko Braak Kelly Del Tredici Institute for Clinical Neuroanatomy Institute for Clinical Neuroanatomy Goethe University Frankfurt Goethe University Frankfurt Theodor Stern Kai 7 Theodor Stern Kai 7 60590 Frankfurt am Main 60590 Frankfurt am Main Germany Germany e-mail: [email protected] e-mail: [email protected] ISSN 0301-5556 ISBN 978-3-540-79849-1 e-ISBN 978-3-540-79850-7 Library of Congress Control Number: 2008932111 © 2009 Springer-Verlag Berlin Heidelberg This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting reproduction on microfilm or in any other way, and storage in data banks. Duplication of this p u b l i c a t i o n o r parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable to prosecution under the German Copyright Law. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Printed on acid-free paper 9 8 7 6 5 4 3 2 1 springer.com List of Contents 1 Prologue . 1 1.1 sPD and Parkinsonism . 2 1.2 sPD Is a Proteinopathy Linked to the Development of Abnormal Intraneuronal Inclusions (Lewy Pathology: Lewy Neurites, Lewy bodies, Lewy plaques) . 3 2 Morphology of Lewy Pathology . 8 2.1 The Protein α-Synuclein . 8 2.2 Protein Misfolding and Abnormal Aggregation of α-Synuclein . 9 2.3 Light Microscopic Visualization of Lewy Pathology . 10 2.3.1 Lewy Neurites . 12 2.3.2 Granular Aggregations . 13 2.3.3 Pale Bodies and Lewy Bodies . 13 2.3.4 Lewy Plaques . 14 2.4 Degradation of Lewy Pathology . 14 2.5 Lewy Pathology Can Co-occur with Pathology Related to Other Disorders . 15 3 The Evolving Distribution Pattern of Lewy Pathology Associated with sPD Renders Neuropathological Staging Possible . 15 3.1 Incidental Lewy Pathology. 15 3.2 Presymptomatic and Symptomatic Phases . 15 3.3 Vulnerable Regions are Interconnected Anatomically . 18 4 Stage 1 . 20 4.1 Pathology in Olfactory Structures . 20 4.2 Basic Organization of the Medullary Autonomic Region . 21 4.3 Involvement of Preganglionic Parasympathetic Projection Neurons . 21 4.4 Pathology in the Enteric Nervous System . 23 4.5 Is sPD Inducible by a Neurotropic Pathogen Akin to a Slow Virus? . 23 4.6 Involvement of Preganglionic and Postganglionic Sympathetic Projection Neurons . 29 4.7 Pathology in Lamina I of the Spinal Cord . 29 5 Stage 2 . 32 5.1 Involvement of the Medulla Oblongata and Pontine Tegmentum . 32 5.2 Basic Organization of the Gain Setting System . 35 5.2.1 Lower Raphe Nuclei . 35 5.2.2 Magnocellular Reticular Nuclei . 35 5.2.3 Coeruleus–Subcoeruleus Complex . 36 5.3 Potential Functional Consequences of the Lesions . 37 vi List of Contents 6 Stage 3 . 38 6.1 Involvement of the Mesencephalic Tegmentum and Basal Forebrain . 38 6.1.1 Central Subnucleus of the Amygdala . 38 6.1.2 Substantia Nigra and Adjoining Nuclei . 40 6.2 Basic Organization of Nonthalamic Nuclei with Diffuse Projections . 43 6.2.1 Magnocellular Nuclei of the Basal Forebrain . 44 6.2.2 Pedunculopontine Tegmental Nucleus . 44 6.2.3 Tuberomamillary Nucleus . 45 6.2.4 Upper Raphe Nuclei . 45 6.3 Potential Functional Consequences of the Lesions . 46 7 Stage 4 . 48 7.1 Involvement of the Amygdala and Thalamus . 49 7.1.1 Amygdala . 49 7.1.2 Thalamus . 50 7.2 Basic Organization of the Cerebral Cortex and Limbic Circuit . 52 7.2.1 Allocortex and Neocortex . 52 7.2.2 Mesocortex. 57 7.2.3 Limbic Circuit . 58 7.3 Involvement of the Temporal Mesocortex and Hippocampal Formation . 59 7.3.1 Temporal Mesocortex . 59 7.3.2 Hippocampal Formation . 60 7.4 Involvement of Insular, Subgenual, and Anterior Cingulate Areas . 60 7.5 Potential Functional Consequences of the Lesions . 61 8 Stages 5 and 6 . 64 8.1 Involvement of Neocortex and Basal Ganglia . 65 8.1.1 Neocortex . 65 8.1.2 Basal Ganglia . 67 8.2 Basic Organization of the Basal Ganglia and Striatal Circuit . 69 8.2.1 Striatum . 69 8.2.2 Pallidum . 71 8.2.3 Subthalamic Nucleus . 72 8.2.4 Claustrum . 73 8.3 Dot-Like Inclusions and Abnormally Altered Astrocytes in the Forebrain . 73 8.4 Disruption of the Striatal Circuit . ..
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