Penn Comprehensive Neuroscience Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Neurol. 2011 Aug;24(4):309-17. doi: 10.1097/WCO.0b013e3283461723.
This review enumerates recent developments in the early diagnosis of Parkinson's disease, with an emphasis on detection of preclinical Parkinson's disease.
Several clinical, laboratory, and imaging tests are now being investigated as potential early markers of Parkinson's disease. These include various nonmotor features that predate the motor manifestations of Parkinson's disease, including sleep abnormalities, neurobehavioral symptoms, and olfactory dysfunction. Tests of the autonomic nervous system, such as cardiac functional imaging, allow for a measure of cardiac sympathetic denervation. Cerebrospinal fluid and serum tests, including α-synuclein and DJ-1, are being developed and refined. Various imaging modalities have contributed to the diagnostic armamentarium in Parkinson's disease, including transcranial Doppler ultrasonography, radiolabeled tracer imaging, and magnetic resonance imaging. Early Parkinson's disease detection will pave the way for major advances in disease modifying therapies.
Various diagnostic modalities hold promise for the early and preclinical diagnosis of Parkinson's disease. It is likely that the future diagnosis of Parkinson's disease will rely on a combination of clinical, laboratory, imaging, and genetic data.
本文列举了帕金森病早期诊断的最新进展,重点介绍了临床前期帕金森病的检测。
目前正在研究几种临床、实验室和影像学检查,作为帕金森病的潜在早期标志物。这些标志物包括各种在帕金森病运动表现之前出现的非运动特征,包括睡眠异常、神经行为症状和嗅觉功能障碍。自主神经系统的检查,如心脏功能成像,可以评估心脏交感神经支配的丧失。脑脊液和血清检查,包括α-突触核蛋白和 DJ-1,正在开发和完善中。各种成像方式也为帕金森病的诊断提供了新的手段,包括经颅多普勒超声、放射性示踪剂成像和磁共振成像。早期帕金森病的检测将为疾病修饰治疗的重大进展铺平道路。
各种诊断方式有望实现帕金森病的早期和临床前期诊断。未来帕金森病的诊断可能依赖于临床、实验室、影像学和遗传学数据的综合分析。