Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the presence of α-synuclein (α-Syn)-rich Lewy bodies (LBs) and the preferential loss of dopaminergic (DA) neurons in the substantia nigra (SN) pars compacta (SNpc). However, the widespread involvement of other central nervous systems (CNS) structures and peripheral tissues is now widely documented. The onset of the molecular and cellular neuropathology of PD likely occurs decades before the onset of the motor symptoms characteristic of PD, so early diagnosis of PD and adequate tracking of disease progression could significantly improve outcomes for patients. Because the clinical diagnosis of PD is challenging, misdiagnosis is common, which highlights the need for disease-specific and early-stage biomarkers. This review article aims to summarize useful biomarkers for the diagnosis of PD, as well as the biomarkers used to monitor disease progression. This review article describes the role of α-Syn in PD and how it could potentially be used as a biomarker for PD. Also, preclinical and clinical investigations encompassing genetics, immunology, fluid and tissue, imaging, as well as neurophysiology biomarkers are discussed. Knowledge of the novel biomarkers for preclinical detection and clinical evaluation will contribute to a deeper understanding of the disease mechanism, which should more effectively guide clinical applications.

Highlights

  • Parkinson’s disease (PD) is a complex, chronic, and progressive neurodegenerative disease characterized by the presence of Lewy bodies (LBs) in vulnerable populations of neurons

  • The current findings suggest that TLR2 and TLR4 play a modulatory role in microglial activation and proinflammatory responses triggered by α-Syn in PD

  • The emerging neurophysiological biomarkers sensitively reflect the specific syndromes in PD patients, which is well suited in developing the adaptive Deep brain stimulation (DBS) and predicting the prognosis

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Summary

INTRODUCTION

Parkinson’s disease (PD) is a complex, chronic, and progressive neurodegenerative disease characterized by the presence of Lewy bodies (LBs) in vulnerable populations of neurons. According to clinical and imaging findings, the neurodegenerative process of PD may begin 7–10 years before the appearance. Considerable progress has been made in understanding its pathogenesis, early and accurate diagnosis of PD is still a formidable challenge (Postuma et al, 2016). This is largely a result of the lack of well-established biomarkers for early diagnosis and monitoring of progression. Various biomarkers providing early diagnosis of the disease include clinical, imaging, pathological, physiological, biochemical, and genetic parameters. This review article describes various biomarkers available for PD, discusses recent advances in their development, and focuses on the roles of α-Syn in the neurodegenerative process during PD

GENETIC BIOMARKERS
Other Genes
Immune Inflammation in PD
FLUID AND TISSUE BIOMARKERS
Other Biomarkers in CSF and Blood
IMAGING BIOMARKERS
PHYSIOLOGICAL BIOMARKERS
Delta Band
Theta and Alpha Bands
Beta Band
Gamma Band
Findings
DISCUSSION
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