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Chapter 2 – Literature Review
examination of a total of 33 brains across a number of studies (Deuschl
& Elble, 2009), three main findings were noted; firstly that of changes to
and loss of Purkinje cells, secondly changes to the basket cell resulting in
the presence of “hairy baskets”; and finally the presence of Lewy bodies.
Controversy surrounds this neurodegenerative research, with factors
such as degeneration due to natural aging, comorbidities, sample size
and variation in methodology cited as possible reasons for the observed
results (Deuschl & Elble, 2009; A. H. Rajput, Robinson, Rajput, & Rajput,
2010).
Purkinje cells
Purkinje cells are found at the piriform layer and Purkinje cell dendrites
at the molecular layer of the cerebellum. These cells have an inhibitory
effect on the central nuclei of the cerebellum (Fitzgerald, Gruener, &
Mtui, 2007). In the ET brain, two changes may occur to these cells, that
of “torpedo” formation and cell loss. “Torpedoes” are described by
Louis, et al. (2009, p1.) as “rounded swelling of the proximal portion of
the Purkinje cell axon”. Upon closer investigation the authors found that
the torpedoes consisted of a disorganised congregation of
neurofilaments, smooth endoplasmic reticulum, mitochondria and were
immunoreactive. In a study by Louis, et al. (2009) comparisons of the
number of these torpedoes were made in brains from patients with ET,
Alzheimer’s and PD as well as age matched controls. The results showed
that there were significantly greater number of torpedoes in patients
with ET when compared to healthy controls (10.5 times greater),
Alzheimer’s (2.5 times greater) and PD (2.5 times greater).
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