Department of Neurology, Columbia University College of Physicians and Surgeons, New York, New York, USA.
Mov Disord. 2010;25 Suppl 1:S2-14. doi: 10.1002/mds.22796.
Many people with Parkinson's disease (PD) and their family members ask their physicians "What is happening in research on Parkinson's disease? Is there anything new?" As the initial speaker at the symposium organized by the Parkinson's Disease Foundation in celebration of its 50th anniversary, I sought to address these questions, focusing on research published between the years 1997 and 2007. I cataloged the advances I considered most important in the field, recognizing my viewpoint is a subjective one and most likely differs from similar listings that others would put together. Space limitation allows me to discuss only a tiny fraction of the remarkable new findings that have been discovered during this 10-year span. Nevertheless, I expect the readers of this summation of advances in the field to be as impressed as I am on the wealth, breadth, and excitement stirring in the field of PD research. Included in this overview are highlights in both laboratory science and clinical science of PD research. In the former category are advances in knowledge on the genetics of PD; potential etiologic and pathogenic causes, especially the better understanding of endogenous factors within dopaminergic neurons; pathologic changes including deposition of alpha-synuclein aggregates; and the consequences of altered alpha-synuclein on the degradation of proteins by both the ubiquitin-proteasomal pathway and the lysosome. Clinical science has also been very active and impressively productive with important clinical advances. In this category are new information on the epidemiology of PD, including awareness of additional factors (besides smoking) that might slow the onset and worsening of PD, such as caffeine and urate; neuroimaging with positron emission tomography and single photon emission tomography; keener awareness of nonmotor features of PD and their impact on quality of life for the persons with PD and their family; recognition of behavioral complications of medications utilized to treat PD, such as impulse control problems; appreciation of the natural history of PD with the increasing impairments as the disease relentlessly worsens over time; the many controlled clinical trials attempting to slow the progression of the disease and to provide new symptomatic therapies; and surgical approaches to alleviate symptoms and progression, including cellular and gene therapy as well as deep brain stimulation.
许多帕金森病（PD）患者及其家属会询问他们的医生：“帕金森病的研究有什么新进展？有什么新发现？”作为帕金森病基金会成立 50 周年研讨会的首位演讲者，我试图回答这些问题，重点关注 1997 年至 2007 年期间发表的研究。我列出了我认为该领域最重要的进展，我承认我的观点是主观的，很可能与其他人列出的类似清单有所不同。篇幅限制使我只能讨论在这 10 年期间发现的令人瞩目的新发现中的一小部分。尽管如此，我希望读者对该领域的进展综述留下深刻的印象，就像我对 PD 研究领域的丰富、广泛和令人兴奋的研究成果留下深刻的印象一样。这一综述包括 PD 研究的实验室科学和临床科学的亮点。前者包括对 PD 遗传学知识的进展；潜在的病因和发病机制，特别是对内源性多巴胺能神经元因素的更好理解；病理性变化，包括α-突触核蛋白聚集体的沉积；以及改变的α-突触核蛋白对泛素-蛋白酶体途径和溶酶体的蛋白质降解的影响。临床科学也非常活跃，成果令人印象深刻，取得了重要的临床进展。在这一类别中，有关于 PD 流行病学的新信息，包括对除吸烟以外可能减缓 PD 发病和恶化的其他因素（如咖啡因和尿酸）的认识；正电子发射断层扫描和单光子发射断层扫描的神经影像学；对 PD 非运动特征及其对 PD 患者及其家属生活质量的影响的认识更加深入；对用于治疗 PD 的药物的行为并发症的认识，如冲动控制问题；对 PD 自然史的认识，随着时间的推移，疾病不断恶化，患者的功能障碍逐渐增加；许多旨在减缓疾病进展和提供新的对症治疗的对照临床试验；以及减轻症状和进展的手术方法，包括细胞和基因治疗以及深部脑刺激。
