Neuroanatomy of Parkinson's disease.: Changes in the neuronal cytoskeleton in only few of the susceptible cell types leads to progressive destruction of affected regions of the limbic and motor systems

Morbus Parkinson is a progressive degenerative disease of the human centra I, peripheral, and enteric nervous systems. In the course of the disease, not only the substantia nigra, but also extranigral components of the motor system, as well as numerous limbic system and autonomic centers undergo serious damage. Accordingly, Parkinson's disease is a multisystem disorder. Only specific types of projection neurons fall victim to it. The first manifestation of the pathological process which causes the disease are abnormalities of the neuronal cytoskeleton. Intracytoplasmic inclusions evolving in the form of Lewy bodies in perikarya and Lewy neurites in the neuronal processes result in premature cell death of the affected neurons. On the basis of this selective neuronal vulnerability, a categorization emerges of the pathological changes within the nervous system and corresponding functional impairments.