Abstract
Parkinson’s disease (PD) is a multi-attribute neurodegenerative disorder combining motor and nonmotor symptoms without well-defined diagnostic clinical markers. The presence of primary motor features (bradykinesia, rest tremor, rigidity and loss of postural reflexes) are the most characteristic signs of PD that are also utilized to identify patients in current clinical practice. The successful implementation of levodopa treatment revealed that nonmotor features are the main contributors of patient disability in PD, and their occurrence might be earlier than motor symptoms during disease progression. Targeted detection of prodromal PD symptoms can open up new possibilities in the identification of PD patients and provide potential patient populations for developing novel neuroprotective therapies. In this review, the evolution of critical features in PD diagnosis is described with special attention to nonmotor symptoms and their possible detection.
Highlights
The discovery of Parkinson’s disease (PD) originated from James Parkinson, who described this disorder as “paralysis agitans” in 1817 [1]
One of the main problems in PD diagnosis is that every patient is different regarding their symptoms, severity and progression; each person has their own version of PD, while cardinal features such as bradykinesia and rigidity can originate from normal aging or complex medical conditions as well [14]
The lack of definite clinical markers for PD diagnosis has initiated the development of symptom-based guidelines for the identification and classification of PD patients
Summary
The discovery of Parkinson’s disease (PD) originated from James Parkinson, who described this disorder as “paralysis agitans” in 1817 [1]. The monitoring of these cardinal features are the key decision markers of disease identification in the current clinical practice [12]. One of the main problems in PD diagnosis is that every patient is different regarding their symptoms, severity and progression; each person has their own version of PD, while cardinal features such as bradykinesia and rigidity can originate from normal aging or complex medical conditions as well [14]. Biology 2020, 9, 103 palsy (PSP) and dementia with Lewy bodies (DLB) [15] Another difficulty is that current therapies are only symptomatic, and even when the disease is identified, there are no available strategies to halt the neurodegeneration process. The critical features of PD and their use in clinical diagnostics are described, with special attention to the early symptoms and their detection
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