Pathophysiology

Although the etiology of PD is unknown, the disease is characterized by consistent CNS neuropathology. Cellular changes include the presence of cytoplasmic inclusions termed Lewy bodies. There are also extracellular pigment granules that stimulate macrophage activity. A disturbance in oxidative phosphorylation that causes the formation of free radicals is thought to be one possible mechanism for these changes.20

In the pigmented areas of the midbrain, especially the substantia nigra, there is depigmentation, dopaminergic neuron loss, and gliosis. These cellular changes result in the loss of functional dopaminergic receptors, causing a decrease in the overall level of striatal dopamine.

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