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Review
. 2014 Aug;27(4):434-41.
doi: 10.1097/WCO.0000000000000112.

Premotor and nonmotor features of Parkinson's disease

Jennifer G Goldman  1 , Ron Postuma
Affiliations
Review

Premotor and nonmotor features of Parkinson's disease

Jennifer G Goldman et al. Curr Opin Neurol. 2014 Aug.

Abstract

Purpose of review: This review highlights recent advances in premotor and nonmotor features in Parkinson's disease, focusing on these issues in the context of prodromal and early-stage Parkinson's disease.

Recent findings: Although Parkinson's disease patients experience a wide range of nonmotor symptoms throughout the disease course, studies demonstrate that nonmotor features are not solely a late manifestation. Indeed, disturbances of smell, sleep, mood, and gastrointestinal function may herald Parkinson's disease or related synucleinopathies and precede these neurodegenerative conditions by 5 or more years. In addition, other nonmotor symptoms such as cognitive impairment are now recognized in incident or de-novo Parkinson's disease cohorts. Many of these nonmotor features reflect disturbances in nondopaminergic systems and early involvement of peripheral and central nervous systems, including olfactory, enteric, and brainstem neurons as in Braak's proposed pathological staging of Parkinson's disease. Current research focuses on identifying potential biomarkers that may detect persons at risk for Parkinson's disease and permit early intervention with neuroprotective or disease-modifying therapeutics.

Summary: Recent studies provide new insights into the frequency, pathophysiology, and importance of nonmotor features in Parkinson's disease as well as the recognition that these nonmotor symptoms occur in premotor, early, and later phases of Parkinson's disease.

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Conflict of interest statement

Conflicts of interest

There are no conflicts of interest

References

    1. Berg D, Postuma RB, Bloem B, Chan P, Dubois B, Gasser T, et al. Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson’s disease. Mov Disord. 2014;29(4):454–62. This article provides a thought-provoking discussion on redefining Parkinson’s disease. - PMC - PubMed
    1. Siderowf A, Lang AE. Premotor Parkinson’s disease: concepts and definitions. Mov Disord. 2012;27(5):608–16. This review describes different phases of classifying premotor Parkinson’s disease and potential diagnostic issues. - PMC - PubMed
    1. Schenck CH, Boeve BF, Mahowald MW. Delayed emergence of a parkinsonian disorder or dementia in 81% of older males initially diagnosed with idiopathic REM sleep behavior disorder (RBD): 16year update on a previously reported series. Sleep Med. 2013 - PubMed
    1. Iranzo A, Tolosa E, Gelpi E, Molinuevo JL, Valldeoriola F, Serradell M, et al. Neurodegenerative disease status and post-mortem pathology in idiopathic rapid-eye-movement sleep behaviour disorder: an observational cohort study. Lancet Neurol. 2013;12(5):443–53. This study demonstrates that most idiopathic RBD patients develop a Lewy body disorder and that this sleep disturbance is a candidate for studying prodromal Parkinson’s disease with accompanying imaging biomarkers and pathological studies. - PubMed
    1. Postuma RB, Gagnon JF, Vendette M, Fantini ML, Massicotte-Marquez J, Montplaisir J. Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder. Neurology. 2009;72(15):1296–300. - PMC - PubMed

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