Esophageal Lewy bodies associated with ganglion cell loss in achalasia

Qualman, Stephen J.; Haupt, Helen M.; Yang, Peter; Hamilton, Stanley R.

doi:10.1016/0016-5085(84)90079-9

Cited by 287 publications

(164 citation statements)

References 29 publications

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“…They occur predominantly in the esophageal myenteric plexuses, especially of the lower esophagus. They have also been found in the substantia nigra, the classical site for PD Lewy bodies [13]. Similar to achalasia, Lewy bodies have been noted in the esophageal myenteric plexuses in PD patients with dysphagia [14].…”

Section: Discussionmentioning

confidence: 66%

Repetitive Proximal Esophageal Contractions: A New Manometric Finding and a Possible Further Link Between Parkinson's Disease and Achalasia

Johnston

Colcher

et al. 2001

Dysphagia

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Repetitive, spontaneous contractions of the proximal esophagus have recently been identified as a feature of achalasia. This article documents similar findings in six patients with Parkinson's disease. Parkinson's disease and achalasia share many common features neurologically. Both have Lewy bodies in the esophageal myenteric plexuses and the substantia nigra, in addition to evidence of degeneration of the dorsal motor nucleus of the vagus. The esophageal features radiologically and manometrically are also similar. Repetitive proximal esophageal contractions may represent another link between these diseases. They have also been reported in scleroderma. We speculate that the common link between all three disease processes may be poor distensibility of the esophagus.

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Section: Discussionmentioning

confidence: 66%

Repetitive Proximal Esophageal Contractions: A New Manometric Finding and a Possible Further Link Between Parkinson's Disease and Achalasia

Johnston

Colcher

et al. 2001

Dysphagia

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“…A variety of autonomic nervous system symptoms may occur and sometimes symptoms such as bladder dysfunction, constipation or seborrheic dermatitis may predate IPD. In support of these clinical findings, Lewy bodies have been reported in sympathetic ganglia of subjects without parkinsonian signs during lifetime, assuming relevant damage of the postganglionic sympathetic nervous system in early phases of IPD [12,77] (see also the article by Braak in this issue).Apart from clinical testing the integrity of the adrenergic neurons and cells can be examined by scintigraphy with radio-labeled metaiodobenzylguanidine (MIBG). MIBG is actively transported into sympathetic neurons and adrenal cells and acts as a tracer not only for the localization but also for the functional integrity of the catecholaminergic structures [78].…”

Section: Visualization Of Postganglionic Sympathetic Cardiac Neurons mentioning

confidence: 90%

Early diagnosis of Parkinson's disease

Becker¹,

Müller²,

Braune³

et al. 2002

Journal of Neurology

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In idiopathic Parkinson's disease (IPD) approximately 60 % of the nigrostriatal neurons of the substantia nigra (SN) are degenerated before neurologists can establish the diagnosis according to the widely accepted clinical diagnostic criteria. It is conceivable that neuroprotective therapy starting at such an 'advanced stage' of the disease will fail to stop the degenerative process. Therefore, the identification of patients at risk and at earlier stages of the disease appears to be essential for any successful neuroprotection. The discovery of several genetic mutations associated with IPD raises the possibility that these, or other biomarkers, of the disease may help to identify persons at risk of IPD. Transcranial ultrasound have shown susceptibility factors for IPD related to an increased iron load of the substantia nigra. In the early clinical phase, a number of motor and particularly non-motor signs emerge, which can be identified by the patients and physicians years before the diagnosis is made, notably olfactory dysfunction, depression, or 'soft' motor signs such as changes in handwriting, speech or reduced ambulatory arm motion. These signs of the early, prediagnostic phase of IPD can be detected by inexpensive and easy-to-administer tests. As one single instrument will not be sensitive enough, a battery of tests has to be composed measuring independent parameters of the incipient disease. Subjects with abnormal findings in this test battery should than be submitted to nuclear medicine examinations to quantify the extent of dopaminergic injury and to reach the goal of a reliable, early diagnosis.

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“…Lewy bodies, the neuropathologic marker of PD, appear in central nervous system (CNS)-pigmented nuclei as well as in other CNS and peripheral nervous system nuclei [37]. Their presence in the dorsal motor nucleus of the vagus (DMNV), other nuclei of the medullary reticular activating system, and the esophageal myenteric plexus [38,39] has generated speculation that these regions are responsible for some aspects of the pharyngo-esophageal dysmotility in PD [4,13,30]. However, the significance of these intraneuronal inclusions is unknown.…”

Section: Discussionmentioning

confidence: 99%

Pharyngo-Esophageal Dysphagia in Parkinson's Disease

1997

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The radiologic characteristics of pharyngoesophageal (PE) dysfunction in Parkinson's disease (PD) are not well established, partly because most previous studies have examined only small numbers of patients. We administered a dynamic videofluoroscopic swallowing function study to 71 patients with idiopathic PD. Using the Hoehn and Yahr disease severity scale, patients were subdivided into those with mild/moderate disease, subgroup I (n = 38), and advanced PD disease, subgroup II (n = 33). From pharyngeal ingestion to gastric emptying, bolus transport was normal in only 2 patients. The most common abnormalities occurring during pharyngeal ingestion included impaired motility, vallecular and pyriform sinus stasis, supraglottic and glottic aspiration, and deficient epiglottic positioning and range of motion. Esophageal abnormalities were multiple but most commonly included delayed transport, stasis, bolus redirection, and tertiary contractions. Typical aberrations of lower esophageal sphincter (LES) function included an open or delayed opening of the LES and gastro-esophageal reflux. A pathogenesis linking PE with the pathology of PD is proposed.

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Esophageal Lewy bodies associated with ganglion cell loss in achalasia

Cited by 287 publications

References 29 publications

Repetitive Proximal Esophageal Contractions: A New Manometric Finding and a Possible Further Link Between Parkinson's Disease and Achalasia

Repetitive Proximal Esophageal Contractions: A New Manometric Finding and a Possible Further Link Between Parkinson's Disease and Achalasia

Early diagnosis of Parkinson's disease

Pharyngo-Esophageal Dysphagia in Parkinson's Disease

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