抄録
The age at onset of idiopathic Parkinson's disease is the 6th or 7th decade. The autonomic nervous dysfunctions in the cardiovascular system and control system of body temperature are also associated with the motor symptoms as main symptoms in idiopathic PD. The pathology of the brain is characterized by the degeneration of dopaminergic cells in the zona compacta of substantia nigra and of noradrenergic cells in the locus ceruleus, associated with the intracellular inclusion body so called Lewy body. The patients with early-onset parkinsonism (EOP) with the age at onset younger than 40 years account for about 10 per cent of all patients with PD. In the category of EOP, autosomal recessive juvenile parkinsonism (AR-JP) so called Park 2 is hereditary PD which has most frequent incidence. The clinical characteristics such as diurnal fluctuation of the symptoms, effectiveness by sleeping, levodopa-induced dyskinesia at the early stage, hyperreflexia, absence of autonomic nervous dysfunction, dystonia of the leg and foot, and slow progression are shown in Park 2. In this symposium, we will show the comparison of the clinical features, genetic back-ground, autonomic nervous function, and so on between idiopathic PD and EOP. And we will discuss the difference of brain-stem function between the two types of PD. By the contrast, it will be clarified that the brain-stem nuclei especially the dopaminergic cell group in the ventral tegmental area of the mid-brain have an important role in the central control of autonomic nervous function. [Jpn J Physiol 54 Suppl:S24 (2004)]
