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- W2022295603 abstract "Traditionally, Parkinson's disease (PD) has been deemed a motor disorder, but that notion changed definitively in 2012. The clinical spectrum of PD has now expanded to encompass non-motor features, even in the early stages of disease. Thus, hyposmia, rapid-eye-movement behaviour disorder, depression, and constipation are well established symptoms that precede the clinical diagnosis of PD. The present focus of research is shifting towards improved understanding of this earlier, non-motor disease phase, now labelled the presymptomatic or prodromal stage of PD. 1 Siderowf A Lang AE Premotor Parkinson's disease: concepts and definitions. Mov Disord. 2012; 27 (15;): 608-616 Crossref PubMed Scopus (122) Google Scholar Establishment of highly specific predictive risk factors will be crucial for identification of susceptible individuals during early disease stages and for putative neuroprotective therapies to be put in place. One especially relevant issue is the need for development of specific biomarkers to differentiate between atypical syndromes and to predict, with a low margin of error, which individuals will go on to develop PD. An emerging area of interest is the possibility of detection of synuclein aggregates in gastrointestinal tissue through biopsy samples taken during gastroscopy or colonoscopy. Results of one study 2 Pouclet H Lebouvier T Coron E et al. Synuclein deposits in the rectum. A comparison between rectal and colonic biopsies to detect Lewy pathology in Parkinson's disease. Neurobiol Dis. 2012; 45: 305-309 Crossref PubMed Scopus (108) Google Scholar showed that the distribution of pathological changes in the gastrointestinal tract follows a rostrocaudal gradient, with the lower oesophagus showing more involvement than the colon and rectum. Importantly, Shannon and colleagues 3 Shannon KM Keshavarzian A Dodiya HB Jakate S Kordower JH Is alpha-synuclein in the colon a biomarker for premotor Parkinson's disease? Evidence from 3 cases. Mov Disord. 2012; 27: 716-719 Crossref PubMed Scopus (294) Google Scholar showed the presence of such synuclein deposits in colon biopsy samples from three patients taken 2–5 years before the diagnosis of PD was established. These findings strongly suggest that abnormal protein aggregation occurs long before classic motor features become noticeable." @default.
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- W2022295603 date "2013-01-01" @default.
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- W2022295603 title "Movement disorders: improved understanding of early disease" @default.
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- W2022295603 doi "https://doi.org/10.1016/s1474-4422(12)70302-2" @default.
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