臨床神経学

<シンポジウム33―1>パーキンソン病の病態から臨床update

病態

長谷川 隆文

東北大学大学院医学系研究科神経・感覚器病態学講座神経内科学分野〔〒980―8574 宮城県仙台市青葉区星陵町1―1〕

The tetrad of Parkinson's disease (PD) including tremor, rigidity, akinesia and postural instability are attributed to the loss of dopaminergic neurons in the substantia nigra. Both environmental factors and genetic predisposition are supposed to be implicated in the initiation and progression of the disease. Particularly, much attention has been focused on α-synuclein (αSYN) since αSYN is not only found in Lewy bodies characteristic of PD, but also mutations in the gene for αSYN can cause inherited forms of PD. Recent studies have shown that αSYN can be secreted into the extracellular milieu, thereby propagate Lewy pathology to neighboring cells in a prion-like manner. This concept sounds attractive as an acceptable explanation for the stereotypic distribution of Lewy pathology in PD. In addition to the classic motor symptoms, a variety of non-motor manifestations may affect on the patient's quality of life. Of all, hyposmia is prevalent in PD and may precede the onset of motor symptoms. We found that odor identification test scores correlated positively with the impairment of short-term memory and visuospatial functions. Furthermore, our data from fear-conditioning experiment indicated that the key player in the processing of emotional memories appears to be the amygdala, which has tight connections to primary olfactory areas.
Full Text of this Article in Japanese PDF (487K)

(臨床神経, 51:1165−1167, 2011)
key words:パーキンソン病,αシヌクレイン,運動症状,非運動症状,プリオン仮説

(受付日:2011年5月20日)