Department of Neurodegeneration, Hertie Institute of Clinical Brain Research, Tübingen, Germany.
Mov Disord. 2011 Mar;26(4):653-8. doi: 10.1002/mds.23499. Epub 2011 Mar 2.
Before the occurrence of motor symptoms permits the clinical diagnosis of Parkinson's disease (PD), about or even more than 50% of the dopaminergic neurons of the substantia nigra have degenerated. This time be called the prodromal phase of PD.
To evaluate the time span from onset of first prodromal symptoms to the initial diagnosis of PD as well as the order of symptom occurrence.
Retrospective study of 93 consecutively interviewed PD patients without dementia and 93 sex and age matched controls free of neurodegenerative disorders. A standardized in-house telephone worksheet assessing 19 nonmotor and six early motor signs was used.
A total of 98.8% of all patients interviewed reported to have experienced prodromal symptoms prior to receiving the initial diagnosis of PD. Patients noticed an average of 7.6 different symptoms during this time interval. The mean time span between the recalled onset of any one symptom and PD diagnosis was 10.2 years. In both groups, the course of prodromal sign onset was associated with early neuropathological disease stages proposed by Braak.
These retrospectively gathered data confirm the existence of a long prodromal phase for PD that is consistent with neuropathological staging. A standardized questionnaire assessing such early symptoms may be helpful in identifying subjects at high risk for PD while they are still in the prodromal phase of the disorder.
在运动症状出现之前，允许帕金森病（PD）的临床诊断，黑质中的多巴胺能神经元已经退化了约 50%甚至更多。这段时间被称为 PD 的前驱期。
评估从首次前驱症状出现到 PD 初始诊断的时间跨度以及症状发生的顺序。
对 93 例连续接受访谈的无痴呆 PD 患者和 93 例性别和年龄匹配的无神经退行性疾病的对照者进行回顾性研究。使用了一种标准化的内部电话工作表，评估了 19 项非运动和 6 项早期运动征象。
所有接受访谈的患者中，98.8%的患者报告在接受 PD 初始诊断之前经历过前驱症状。在此期间，患者平均注意到 7.6 种不同的症状。从回忆起的任何一种症状出现到 PD 诊断的平均时间间隔为 10.2 年。在两组中，前驱症状出现的过程都与 Braak 提出的早期神经病理学疾病阶段有关。
这些回顾性收集的数据证实了 PD 存在一个长的前驱期，与神经病理学分期一致。评估这些早期症状的标准化问卷可能有助于在疾病的前驱期识别处于 PD 高风险的受试者。
