Although essays in ScienceOfParkinsons.com are informative, they
merit scrutiny. Yes, atypicalities of alpha-synuclein and
pathologies in dopaminergic processes are important, as are
dopamine-related treatments. However, focusing entirely upon
dopamine seems to be an error of omission. Pathology in the locus
coeruleus and in noradrenergic processes not only are important but
may precede and (in many cases) initiate subsequent pathology in the
substantia nigra and in brain locales affected in dementia. The
locus coeruleus, noradrenergic, and norepinephrine do not appear in
the latest ScienceOfParkinsons essay.
scienceofparkinsons.com/201...
For instance, consider two recent cites.
Targeting the norepinephrinergic system in Parkinson's disease and
related disorders: The locus coeruleus story.
ncbi.nlm.nih.gov/pubmed/278...
In this regard, recent evidence suggests that LP in the locus
coeruleus (LC), the brain's main source of norepinephrine (NE),
precedes that of the SN, and, may be one of the very first
etiological events in PD. Interestingly, oxidized NE has
neuroprotective properties and may even prevent the formation of
toxic and higher molecular weight α-synuclein oligomers associated
with PD. Moreover, norepinephrinergic neurons directly innervate the
SN, and, LC lesioning causes more severe dopaminergic cell loss and
supplementary motor manifestations, as shown in preclinical
research. In fact, the LC may be considered one of the main
orchestrators that controls the other major monoaminergic nuclei,
such as the SN and raphe nuclei. Apart from its regulating function,
disruption of such a sustainable but vulnerable LC-NE system has
been linked to the cognitive pathophysiology of dementia as well.
Consequently, LC neuronal loss and the accompanying
norepinephrinergic deficiency constitute an important
pharmacological target for the (symptomatic) treatment of
PD/DLB/PDD. This review, therefore, summarizes and discusses all
relevant neurochemical research, including the intriguing link with
(prodromal) dementia....
The underlying mechanism of prodromal PD: insights from the
parasympathetic nervous system and the olfactory system.
ncbi.nlm.nih.gov/pubmed/282...
Even though not emphasized in this review, the sympathetic nervous
system may deserve more attention in attempting to understand
mechanisms of prodromal PD, as there is evidences for pre-motor
involvement of peripheral noradrenergic depletion [109], while the
noradrenergic nucleus locus coeruleus may be affected prior to the
substantia nigra in the prodromal stage.
Importantly, a search for coeruleus in SciOfPD retrieves only 1
essay (today, 2017-08-19)..
scienceofparkinsons.com/?s=...
IMO, ScienceOfParkinsons would be more scientific if
PD/DLB/PDD-findings related to the locus coeruleus and to
norepinephrine were included in at least some of the SOPD essays.