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Coad Thomas Dow
Anatomic staging of PD progression suggests that an unidentified neurotropic pathogen in the intestinal lumen triggers abnormal synuclein aggregation that, in turn, initiates a ''prion-like'' process in the enteric nervous system (ENS) eventually achieving access to the central nervous system (CNS) via the vagus nerve (cranial nerve X). This protein aggregation, manifest as , targets and destroys dopamine producing cells resulting in both the classic motor and non-motor symptoms of PD; with the non-motor symptoms predating the motor symptoms by years, or even decades.