奥尔胡斯大学Per Borghammer提出了在预诊断个体的死后组织中观察到的体优先路易体病的交感和副交感亚型。相关论文于2025年3月13日发表在《自然—神经科学》杂志上。

在本研究中，该课题组研究人员分析了两个尸检数据集，其中包括173和129例路易病理阳性病例。该课题组人员观察到在轻度路易氏病理的早期诊断前病例中，脑优先亚型和体优先亚型有明显的区别。脑优先病例在诊断前阶段表现出最小的外周器官病理，而体优先病例在诊断前阶段表现出明显的自主神经受累。利用SuStaIn机器学习算法，该课题组人员确定了两种不同的身体优先亚型，一种具有迷走神经优势，另一种具有交感神经优势，比例相等。他们的研究支持了三种诊断前LBD亚型的存在，并强调了交感神经系统和副交感神经系统在LBD的发病和发展中的作用。

据悉，最近的研究表明，在路易体障碍（LBD）谱系中存在脑优先和身体优先亚型，包括帕金森病。这些研究主要集中在α-突触核蛋白通过副交感迷走神经和嗅球途径的传播，而没有探索交感神经系统传播途径的可能性。

附：英文原文

Title: Sympathetic and parasympathetic subtypes of body-first Lewy body disease observed in postmortem tissue from prediagnostic individuals

Author: Andersen, Katrine B., Krishnamurthy, Anushree, Just, Mie Kristine, Van Den Berge, Nathalie, Skjrbk, Casper, Horsager, Jacob, Knudsen, Karoline, Vogel, Jacob W., Toledo, Jon B., Attems, Johannes, Polvikoski, Tuomo, Saito, Yuko, Murayama, Shigeo, Borghammer, Per

Issue&Volume: 2025-03-13

Abstract: Recent studies suggest the existence of brain-first and body-first subtypes within the Lewy body disorder (LBD) spectrum, including Parkinson’s disease. These studies primarily focused on α-synuclein propagation through the parasympathetic vagal and olfactory bulb routes, leaving the possibility of a sympathetic nervous system spreading route unexplored. In the present study, we analyzed two postmortem datasets, which included 173 and 129 cases positive for Lewy pathology. We observed a clear distinction between brain-first and body-first subtypes in early prediagnostic cases with mild Lewy pathology. Brain-first cases displayed minimal peripheral organ pathology in prediagnostic phases, contrasting with marked autonomic involvement in prediagnostic body-first cases. Utilizing the SuStaIn machine learning algorithm, we identified two distinct body-first subtypes, one with vagal predominance and another with sympathetic predominance, in equal proportions. Our study supports the existence of three prediagnostic LBD subtypes and highlights the sympathetic nervous system alongside the parasympathetic system in LBD onset and progression.

DOI: 10.1038/s41593-025-01910-9

Source: https://www.nature.com/articles/s41593-025-01910-9