Diagnosis and Neuroprotection in Parkinson's Disease
Insidious onset of mild, unspecific vegetative, psychopathological, cognitive and perceptive disturbances with a resulting change of personal behavior often precede the initially intermittend occurring motor symptoms in patients with Parkinson's disease (
- PDF / 114,149 Bytes
- 9 Pages / 467.716 x 710.929 pts Page_size
- 71 Downloads / 191 Views
Diagnosis and Neuroprotection in Parkinson’s Disease
T. Mu¨ller
1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 2 Do Some Mild Depressive Symptoms Indicate the Onset of Neurodegeneration? . . . . . . . . . . . . . . . . . 22 3 The Need for Tools for Early Diagnosis Before Onset of Motor Symptoms in PD . . . . . . . . . . . . . . . . 23 4 Neuroprotection Should Start in the Premotor Phase of PD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 5 Neuroprotection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 6 Neuroprotection Within the Dopaminergic System may Depend on Its Modulation . . . . . . . . . . . . . 25 7 Did the Recent Trials on Neuroprotection Compare Physiologic Conditions? . . . . . . . . . . . . . . . . . . . . . 26 8 Conclusion and Future Aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
#
Springer-Verlag Berlin Heidelberg 2007
22
2
Diagnosis and neuroprotection in Parkinson’s disease
Abstract: Insidious onset of mild, unspecific vegetative, psychopathological, cognitive and perceptive disturbances with a resulting change of personal behavior often precede the initially intermittend occurring motor symptoms in patients with Parkinson’s disease (PD). Thus the current available diagnostic tools and concepts do not enable such an early diagnosis of Parkinson’s disease. However they are necessary to perform an effective neuroprotective treatment regimes, since neuronal dopaminergic death is advanced at the clinical treshold of onset of motor symptoms. Treatment of these symptoms should be formed in a more continuous fashion, in order to imitate and provide more physiological conditions of dopaminergic neurotransmission. This delays onset of motor complications, which may be interpreted as a certain neuroprotective effect from the clinical point of view. List of Abbreviations: 5‐HT, 5‐hydroxytryptamine; PD, Parkinson’s disease
1 Introduction James Parkinson’s original 1817 description of the ‘‘shaking palsy’’ is a remarkable, accurate account of the disease, which now bears his name. He focused his essay on akinesia, tremor, and rigidity as cardinal motor symptoms of Parkinson’s disease (PD), but he also reported on an array of further more secondary clinical signs, which are not directly related to the dysfunction of the motor system (Parkinson, 1817). These nonmotor symptoms also affect quality of life in PD patients. The self‐description of onset of PD by Wilhelm von Humboldt or Michael J. Fox also initially mentions motor symptoms as a guiding clinical feature (Horowski et al., 1995; Fox, 2003). But both of them also report apathy and anhedonia‐like depressive symptoms, which occur initially and la
Data Loading...
