Neuronal Vulnerability in Parkinson Disease and Putative Therapeutics: Should the focus be on axonal and synaptic terminals?

• Published in: Movement disorders 2019-09, Vol.34 (10), p.1406-1422
• Main Authors: Wong, Yvette, Luk, Kelvin, Purtell, Kerry, Nanni, Samuel Burke, Stoessl, A. Jon, Trudeau, Louis-Eric, Yue, Zhenyu, Krainc, Dimitri, Oertel, Wolfgang, Obeso, Jose A., Volpicelli-Daley, Laura
• Format: Article
• Language: English
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.27823

While current effective therapies are available for the symptomatic control of Parkinsońs disease (PD), treatments to halt the progressive neurodegeneration still do not exist. Loss of dopamine neurons in the substantia nigra pars compacta and dopamine terminals in the striatum drive the motor features of PD. Multiple lines of research point to several pathways which may contribute to the dopaminergic neurodegeneration. These pathways include extensive axonal arborization, mitochondrial dysfunction, dopamine’s biochemical properties, abnormal protein accumulation of α-synuclein, defective autophagy and lysosomal degradation, and synaptic impairment. Thus, understanding the essential features and mechanisms of dopaminergic neuronal vulnerability is a major scientific challenge and highlights an outstanding need for fostering effective therapies against neurodegeneration in PD. This article, which arose from the Movement Disorders 2018 Conference , discusses and reviews the possible mechanisms underlying neuronal vulnerability and potential therapeutic approaches in PD.