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Where does parkinson disease pathology begin in the brain?
Del Tredici K, Rüb U, De Vos RA, Bohl JR, Braak H.. Journal of neuropathology and experimental neurology, 2002-05-01
Topic: Brain proteins, microglia and lab models
The substantia nigra is not the induction site in the brain of the neurodegenerative process underlying Parkinson disease (PD). Instead, the results of this semi-quantitative study of 30 autopsy cases with incidental Lewy body pathology indicate that PD in the brain commences with the formation of the very first immunoreactive Lewy neurites and Lewy bodies in non-catecholaminergic neurons of the dorsal glossopharyngeus-vagus complex, in projection neurons of the intermediate reticular zone, and in specific nerve cell types of the gain setting system (coeruleus-subcoeruleus complex, caudal raphe nuclei, gigantocellular reticular nucleus), olfactory bulb, olfactory tract, and/or anterior olfactory nucleus in the absence of nigral involvement. The topographical parcellation of the nuclear grays described here is based upon known architectonic analyses of the human brainstem and takes into consideration the pigmentation properties of a few highly susceptible nerve cell types involved in PD. In this sample and in all 58 age- and gender-matched controls, Lewy bodies and Lewy neurites do not occur in any of the known prosencephalic predilection sites (i.e. hippocampal formation, temporal mesocortex, proneocortical cingulate areas, amygdala, basal nucleus of Meynert, interstitial nucleus of the diagonal band of Broca, hypothalamic tuberomamillary nucleus).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Del Tredici, K., Rüb, U., De Vos, R. A., Bohl, JR., & Braak, H. (2002). Where does parkinson disease pathology begin in the brain? Journal of neuropathology and experimental neurology. https://doi.org/10.1093/jnen/61.5.413
Vancouver
Del Tredici K, Rüb U, De Vos RA, Bohl JR, Braak H. Where does parkinson disease pathology begin in the brain? Journal of neuropathology and experimental neurology. 2002. doi:10.1093/jnen/61.5.413. PMID: 12030260.
BibTeX
@article{deltredici2002-12030260,
author = {Del Tredici, K. and Rüb, U. and De Vos, R. A. and Bohl, JR. and Braak, H.},
title = {{Where does parkinson disease pathology begin in the brain?}},
journal = {Journal of neuropathology and experimental neurology},
year = {2002},
doi = {10.1093/jnen/61.5.413},
pmid = {12030260},
url = {https://doi.org/10.1093/jnen/61.5.413}
}
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Key findings
- Instead, the results of this semi-quantitative study of 30 autopsy cases with incidental Lewy body pathology indicate that PD in the brain commences with the formation of the very first immunoreactive Lewy neurites and Lewy bodies in non-catecholaminergic neurons of the dorsal glossopharyngeus-vagus complex, in projection neurons of the intermediate reticular zone, and in specific nerve cell types of the gain setting system (coeruleus-subcoeruleus complex, caudal raphe nuclei, gigantocellular reticular nucleus), olfactory bulb, olfactory tract, and/or anterior olfactory nucleus in the absence of nigral involvement.
Why it matters
In 30 autopsy cases with incidental Lewy body pathology, the earliest Lewy neurites and bodies appeared in non-catecholaminergic brainstem and olfactory regions before any nigral involvement. This describes where Parkinson's pathology begins and tests no treatment.
Study details
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of neuropathology and experimental neurology) |
| Journal's citation record | 2 / 4 | Journal of Neuropathology & Experimental Neurology: journal h-index 239 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 777 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 29.9 citations a year over 26 year(s) since 2002 |
| Impact for its field and year | 4 / 6 | Cited 15.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 19 other studies in this library |
| Still being cited | 3 / 4 | Cited 68 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Heiko Braak: h-index 121 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Goethe University Frankfurt: institution h-index 958 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12030260) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 49 / 100 | — |
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