I'm glad you found Braak. I had started to talk about him in the bacterial thread before I realized that you had this one going and I apologize for scattering the subject. But Braak is a key component. Here is his latest from last year:
1: Mov Disord. 2006 Dec;21(12):2042-51.
Stanley Fahn Lecture 2005: The staging procedure for the inclusion body
pathology associated with sporadic Parkinson's disease reconsidered.
Braak H, Bohl JR, Muller CM, Rub U, de Vos RA, Del Tredici K.
Institute for Clinical Neuroanatomy, JW Goethe University, Frankfurt/Main,
Germany.
braak@em.uni-frankfurt.de
The synucleinopathy known as sporadic Parkinson's disease (PD) is a multisystem
disorder that severely damages predisposed nerve cell types in circumscribed
regions of the human nervous system. A recent staging procedure for the
inclusion body pathology associated with PD proposes that, in the brain, the
pathological process (formation of proteinaceous intraneuronal Lewy bodies and
Lewy neurites) begins at two sites and continues in a topographically
predictable sequence in six stages, during which components of the olfactory,
autonomic, limbic, and somatomotor systems become progressively involved. In
stages 1 to 2, the Lewy body pathology is confined to the medulla
oblongata/pontine tegmentum and anterior olfactory structures. In stages 3 to 4,
the substantia nigra and other nuclei of the basal mid- and forebrain become the
focus of initially subtle and, then, severe changes. During this phase, the
illness probably becomes clinically manifest. In the final stages 5 to 6, the
lesions appear in the neocortex. This cross-sectional study originally was
performed on 168 autopsy cases using material from 69 incidental cases and 41
clinically diagnosed PD patients as well as 58 age- and gender-matched controls.
Here, the staging hypothesis is critically reconsidered and discussed. Copyright
2006 Movement Disorder Society.
PMID: 17078043 [PubMed - in process]