Recent neuropathological studies in PD have provided compelling evidence in favor of a topographically predictable spreading of degenerative changes over the brain (Braak et al., 2003). Based on the distribution of alpha-synuclein containing Lewy bodies and Lewy neurites, six different pathological stages of PD have been proposed. The most striking observation is that Lewy body pathology in a number of extranigral brain areas, including the olfactory bulb and tract, appears to precede degeneration of nigros-triatal dopaminergic neurons. Although the presence of neuropathological changes typical of PD in the olfactory bulb and tract has been described previously (Pearce et al., 1995), these novel data suggest that the anterior olfactory system may actually be one of the induction sites of the neuropathological process in PD.
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