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, n ot only the substantia nigra, but also extranigral components of the motor system, as well as numerous limbic system and autonomic centers undergo ser ious damage. Accordingly, Parkinson's disease is a multisystem disorder. On ly specific types of projection neurons fall victim to it. The first manife station of the pathological process which causes the disease are abnormalit ies of the neuronal cytoskeleton. Intracytoplasmic inclusions evolving in t he form of Lewy bodies in perikarya and Lewy neurites in the neuronal proce sses result in premature cell death of the affected neurons. On the basis o f this selective neuronal vulnerability, a categorization emerges of the pa thological changes within the nervous system and corresponding functional i mpairments.