SeriesParkinson's DiseaseVolume 403, Issue 10423p293-304January 20, 2024

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The pathogenesis of Parkinson's disease

Prof Huw R Morris, PhD
Correspondence
Correspondence to: Prof Huw R Morris, Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London NW3 2PF, UK
Affiliations
Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
University College London Movement Disorders Centre, University College London, London, UK
Aligning Science Across Parkinson's Collaborative Research Network, Chevy Chase, MD, USA
a,b,g h.morris@ucl.ac.uk
Prof Maria Grazia Spillantini, PhD
Affiliations
Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
Aligning Science Across Parkinson's Collaborative Research Network, Chevy Chase, MD, USA
c,g
Prof Carolyn M Sue, PhD
Correspondence
Prof Carolyn M Sue, Neuroscience Research Australia, Randwick 2031, NSW, Australia
Affiliations
Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
Department of Neurology, South Eastern Sydney Local Health District, Sydney, NSW, Australia
Aligning Science Across Parkinson's Collaborative Research Network, Chevy Chase, MD, USA
Neuroscience Research Australia, Randwick, NSW, Australia
d,e,g,h c.sue@neura.edu.au
Caroline H Williams-Gray, PhD
Affiliations
John Van Geest Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Summary

Parkinson's disease is a progressive neurodegenerative condition associated with the deposition of aggregated α-synuclein. Insights into the pathogenesis of Parkinson's disease have been derived from genetics and molecular pathology. Biochemical studies, investigation of transplanted neurons in patients with Parkinson's disease, and cell and animal model studies suggest that abnormal aggregation of α-synuclein and spreading of pathology between the gut, brainstem, and higher brain regions probably underlie the development and progression of Parkinson's disease. At a cellular level, abnormal mitochondrial, lysosomal, and endosomal function can be identified in both monogenic and sporadic Parkinson's disease, suggesting multiple potential treatment approaches. Recent work has also highlighted maladaptive immune and inflammatory responses, possibly triggered in the gut, that accelerate the pathogenesis of Parkinson's disease. Although there are currently no disease-modifying treatments for Parkinson's disease, we now have a solid basis for the development of rational neuroprotective therapies that we hope will halt the progression of this disabling neurological condition.

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