The second brain and Parkinson’s disease

Authors

  • Thibaud Lebouvier,

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
    4. CHU Nantes, Department of Neurology, Nantes, France
    5. Inserm, CIC-04, Nantes, France
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  • Tanguy Chaumette,

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
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  • Sébastien Paillusson,

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
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  • Charles Duyckaerts,

    1. Laboratoire de Neuropathologie R. Escourolle, Hôpital de la Salpêtrière, Paris, France
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  • Stanislas Bruley des Varannes,

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
    4. Inserm, CIC-04, Nantes, France
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  • Michel Neunlist,

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
    4. CHU Nantes, Department of Neurology, Nantes, France
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  • Pascal Derkinderen

    1. Inserm, U913, CHU Nantes, 44093 Nantes, France
    2. University of Nantes, Nantes, France
    3. CHU Nantes, Institut des Maladies de l’Appareil Digestif, Nantes, France
    4. CHU Nantes, Department of Neurology, Nantes, France
    5. Inserm, CIC-04, Nantes, France
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Dr P. Derkinderen, 1Inserm, U913, as above.
E-mail: derkinderenp@yahoo.fr

Abstract

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s disease. It has been classically considered that the pathological hallmarks of Parkinson’s disease, namely Lewy bodies and Lewy neurites, affect primarily the substantia nigra. Nevertheless, it has become increasingly evident in recent years that Parkinson’s disease is a multicentric neurodegenerative process that affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Remarkably, recent reports have shown that the lesions in the enteric nervous system occurred at a very early stage of the disease, even before the involvement of the central nervous system. This led to the postulate that the enteric nervous system could be critical in the pathophysiology of Parkinson’s disease, as it could represent a route of entry for a putative environmental factor to initiate the pathological process (Braak’s hypothesis). Besides their putative role in the spreading of the pathological process, it has also been suggested that the pathological alterations within the enteric nervous system could be involved in the gastrointestinal dysfunction frequently encountered by parkinsonian patients. The scope of the present article is to review the available studies on the enteric nervous system in Parkinson’s disease patients and in animal models of the disease. We further discuss the strategies that will help in our understanding of the roles of the enteric nervous system, both in the pathophysiology of the disease and in the pathophysiology of the gastrointestinal symptoms.

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