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Lesions outside the CNS in Parkinson's disease

Authors

  • Ruth Djaldetti MD,

    Corresponding author
    1. Department of Neurology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel
    2. The Norma and Alan Aufzien Chair for Research of Parkinson's Disease, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    • Department of Neurology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel
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  • Nirit Lev MD,

    1. The Norma and Alan Aufzien Chair for Research of Parkinson's Disease, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Felsenstein Research Center, Beilinson Campus, Petah Tiqva, Israel
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  • Eldad Melamed MD

    1. Department of Neurology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel
    2. The Norma and Alan Aufzien Chair for Research of Parkinson's Disease, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract

Parkinson's disease (PD) is not a simple movement disorder induced just by loss of dopaminergic neurons in the substantia nigra pars compacta. Apparently, the substantia nigra is not the only or the first brain region damaged in PD. Moreover, older and recent studies have shown that the degenerative process in PD is much more extensive and affects not only the central nervous system (CNS) but also the peripheral autonomic nervous system and the organs outside the brain that the latter innervates. These include mainly the gastrointestinal tract, the heart, kidneys, urogenital system, and skin. Additional extra-CNS organs that are involved in PD include the eye and the adrenal gland. This article reviews the anatomical, physiological, and clinical features of extracerebral manifestations of PD, and describes their relevance to the etiology and pathogenesis of the disease. It establishes this illness as a systemic CNS and peripheral disorder that warrants new hypotheses regarding its causation and progression. © 2009 Movement Disorder Society

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