Abstract
Diagnostics and rehabilitation of Parkinson’s disease (PD) presents the current information pertaining to etiology, early biomarkers for diagnostics, novel methods to evaluate symptoms, multidisciplinary rehabilitation, new applications of brain imaging and invasive methods to the study of PD. Researchers have only recently begun to focus on the non-motor symptoms of PD, which are poorly recognized and inadequately treated by clinicians. The non-motor symptoms of PD have a significant impact on patient quality of life and mortality, and include cognitive impairments, autonomic, gastrointestinal, and sensory symptoms. Indepth discussion of the use of imaging tools to study disease mechanisms is also provided, with emphasis on the abnormal network organization in parkinsonism. Deep brain stimulation management is a paradigm-shifting therapy for PD, essential tremor and dystonia. In the recent years, new approaches of early diagnostics, training programmes and treatments have vastly improved the lives of people with PD, substantially reducing symptoms and significantly delaying disability. PD results primarily from the death of dopaminergic neurons in the substantia nigra. Current PD medications treat symptoms; none halt or retard dopaminergic neuron degeneration. The main obstacle to developing neuroprotective therapies is a limited understanding of the key molecular mechanisms that provoke neurodegeneration. The discovery of PD genes has led to the hypothesis that misfolding of proteins and dysfunction of the ubiquitin-proteasome pathway are pivotal to PD pathogenesis. Previously implicated culprits in PD neurodegeneration, mitochondrial dysfunction and oxidative stress, may also act in part by causing the accumulation of misfolded proteins, in addition to producing other deleterious events in dopaminergic neurons. Neurotoxin-based models have been important in elucidating the molecular cas-cade of cell death in dopaminergic neurons. PD models based on the manipulation of PD genes should prove valuable in elucidating important aspects of the disease, such as selective vulnerability of substantia nigra dopaminergic neurons to the degenerative process.
Highlights
We have based this review on the philosophy that one has control over how Parkinson’s disease (PD) affects the life of a person who will fight believing that through support and maximizing personal strengths, life will continue to have meaning and richness
We have designed this review in modules, each dealing with a different aspect of PD and be selective in what topics is pertinent to symptoms and health-care decisions
The review deals with practical issues that are critical for the invasive methods examined in patients with PD and describe all aspects of both clinical as pathophysiological and therapeutic concerning PD, as well as an update on the innovative aspects of the disease primarily focused on identifying new pathophysiological
Summary
We have based this review on the philosophy that one has control over how PD affects the life of a person who will fight believing that through support and maximizing personal strengths, life will continue to have meaning and richness. The fighting begins in partnership with the physicians with the understanding as much as possible about PD, medications, and non-drug therapies so that a person can be participate in the health-care decisions that uniquely affect the self. We have designed this review in modules, each dealing with a different aspect of PD and be selective in what topics is pertinent to symptoms and health-care decisions. The review deals with practical issues that are critical for the invasive methods examined in patients with PD and describe all aspects of both clinical as pathophysiological and therapeutic concerning PD, as well as an update on the innovative aspects of the disease primarily focused on identifying new pathophysiological. The review spans the experience of scientists from different fields and to be useful for clinicians who take health care for people with PD and their families. It should appeal to a multidisciplinary audience and help people cope with medical, emotional, and practical challenges
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