Neuropathology of non-motor features of Parkinson disease

Dennis W. Dickson, Hiroshige Fujishiro, Carolyn Orr, Anthony DelleDonne, Keith A. Josephs, Roberta Frigerio, Melinda Burnett, Joseph E. Parisi, Kevin J. Klos, J. Eric Ahlskog

Research output: Contribution to journalArticlepeer-review

192 Scopus citations


Non-motor manifestations of Parkinson disease (PD) are common and some may actually antedate motor dysfunction. Extrapyramidal signs in PD are tightly linked to striatonigral dopaminergic denervation associated with neuronal loss and Lewy bodies in the residual neurons of the substantia nigra. Lewy bodies composed of abnormal α-synuclein are the histologic hallmark of PD, and their presence beyond midbrain dopaminergic neurons is considered to be the pathologic substrate of many, if not all, of the non-motor manifestations of PD. We review the pathologic correlates of autonomic dysfunction (cardiac and gastrointestinal), hyposmia, depression, rapid eye movement behavior disorder and dementia in PD For each non-motor clinical feature there is strong evidence to suggest a role for α-synuclein pathology, lending further support for the notion that PD is a multisystem α-synucleinopathy.

Original languageEnglish (US)
Pages (from-to)S1-S5
JournalParkinsonism and Related Disorders
Issue numberSUPPL. 3
StatePublished - Dec 2009


  • Autonomic
  • Dementia
  • Hyposmia
  • Rapid eye movement sleep behavior disorder
  • Synucleinopathy

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology


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