TY - JOUR
T1 - Parkinson's disease risk score
T2 - Moving to a premotor diagnosis
AU - Winkler, Jürgen
AU - Ehret, Reinhard
AU - Büttner, Thomas
AU - Dillmann, Ulrich
AU - Fogel, Wolfgang
AU - Sabolek, Michael
AU - Winkelmann, Juliane
AU - Kassubek, Jan
PY - 2011/5
Y1 - 2011/5
N2 - Early pre-motor symptoms (also frequently termed "non-motor" symptoms) in Parkinson's disease (PD), which precede the onset of motor symptoms, are being increasingly recognized by clinicians. Non-motor symptoms in the pre-motor phase of PD include impaired olfaction (hyposmia), sleep disturbances (i.e., radid eye movement sleep behavior disorder, daytime sleepiness), behavioral/emotional dysfunction (i.e., change of personality or change of core personal characteristics), dysautonomia (i.e., constipation, urinary dysfunction, orthostatic hypotension), depressive symptoms (i.e., fatigue, apathy, anxiety), and chronic pain (joint and muscle). The pre-motor phaseof PDis based on current pathophysiological concepts that relate these symptoms to early structural changes within lower brainstem nuclei and the peripheral nervous system including theautonomic and enteric ganglia. The perspectivetoidentify these symptoms as early as possible will enable neurologists to make a diagnosis at the pre-motor stage of PD. Thus, the development of a PD risk score will be the first means to identify individuals at risk who are most likely to develop the prototypical motor symptoms of PD later in life. More importantly, these individuals at risk will bethe firsttobenefit from disease-modifying strategies. In this workshop report, the elements of a PD risk score are proposed, including the stepwise sequence of escalating diagnostic measures to diagnose the pre-motor stage in PD.
AB - Early pre-motor symptoms (also frequently termed "non-motor" symptoms) in Parkinson's disease (PD), which precede the onset of motor symptoms, are being increasingly recognized by clinicians. Non-motor symptoms in the pre-motor phase of PD include impaired olfaction (hyposmia), sleep disturbances (i.e., radid eye movement sleep behavior disorder, daytime sleepiness), behavioral/emotional dysfunction (i.e., change of personality or change of core personal characteristics), dysautonomia (i.e., constipation, urinary dysfunction, orthostatic hypotension), depressive symptoms (i.e., fatigue, apathy, anxiety), and chronic pain (joint and muscle). The pre-motor phaseof PDis based on current pathophysiological concepts that relate these symptoms to early structural changes within lower brainstem nuclei and the peripheral nervous system including theautonomic and enteric ganglia. The perspectivetoidentify these symptoms as early as possible will enable neurologists to make a diagnosis at the pre-motor stage of PD. Thus, the development of a PD risk score will be the first means to identify individuals at risk who are most likely to develop the prototypical motor symptoms of PD later in life. More importantly, these individuals at risk will bethe firsttobenefit from disease-modifying strategies. In this workshop report, the elements of a PD risk score are proposed, including the stepwise sequence of escalating diagnostic measures to diagnose the pre-motor stage in PD.
KW - Diagnosis
KW - Neuroimaging
KW - Non-motor symptoms
KW - Parkinsonian syndrome
KW - Therapy
UR - http://www.scopus.com/inward/record.url?scp=79959933179&partnerID=8YFLogxK
U2 - 10.1007/s00415-011-5952-x
DO - 10.1007/s00415-011-5952-x
M3 - Article
C2 - 21560061
AN - SCOPUS:79959933179
SN - 0340-5354
VL - 258
SP - S311-S315
JO - Journal of Neurology
JF - Journal of Neurology
IS - SUPPL. 2
ER -