Involvement of the spinal cord in Parkinson's disease

Parkinson's disease (PD) has traditionally ascribed to alpha-synucleinopathy of the substantia nigra; however, several studies have showed widespread alpha-synucleinopathy inside and outside the brain. The potential role of the spinal cord in the genesis of some symptoms has been quite neglected despite the frequent and precocious presence of alpha-synucleinopathy in the spinal cord of PD patients. We examined the literature about the pathology of the spinal cord in PD and the possible relevance of this pathology in the genesis of some nonmotor symptoms including urinary, sexual, and gastrointestinal, as well as of some motor symptoms.