Department of Neurodegeneration, Hertie-Institute of Clinical Brain Research and German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
Parkinsonism Relat Disord. 2012 Jan;18 Suppl 1:S195-8. doi: 10.1016/S1353-8020(11)70061-X.
The increasing knowledge about an ongoing neurodegenerative process long before the diagnosis of Parkinson's disease (PD) can be made according to the current diagnostic criteria urges the need for an earlier diagnosis with the final aim of neuromodulatory and neuroprotective therapies. A number of risk, pre-motor and early motor markers are being discussed as potential markers to identify individuals who will develop the full picture of clinical PD. In Europe, studies like the PRIPS study (Prospective validation of Risk factors for the development of Parkinson Syndromes) are performed to determine the sensitivity and predictive value of markers. In enriched risk cohorts like cohorts of individuals with RBD (Rem sleep Behaviour Disorder) or the TREND study (Tübinger evaluation of Risk factors for Early detection of NeuroDegeneration) specificity of markers is determined and further markers are evaluated. Moreover, progression of markers in the pre-motor period is being evaluated in these studies; for example, in the PMPP study (Progression Markers in the suspected Pre-motor Phase) assessments are performed at shorter time intervals. Establishing sensitivity, specificity, predictive value and progression of markers in yet healthy individuals are hoped to lay the basis for future interventional trials before the onset of motor-PD.
根据目前的诊断标准，在帕金森病 (PD) 诊断之前，人们对正在进行的神经退行性过程的了解越来越多，这促使人们需要进行更早的诊断，最终目标是进行神经调节和神经保护治疗。目前正在讨论许多风险、前驱期和早期运动标志物，作为识别将出现完整临床 PD 患者的潜在标志物。在欧洲，正在进行 PRIPS 研究（帕金森综合征发病风险因素的前瞻性验证）等研究，以确定标志物的敏感性和预测值。在 RBD（快速眼动睡眠行为障碍）或 TREND 研究（图宾根神经退行性早期检测风险因素评估）等丰富的风险队列中，确定了标志物的特异性，并进一步评估了其他标志物。此外，这些研究还评估了前驱期标志物的进展情况；例如，在 PMPP 研究（疑似前驱期进展标志物）中，会在更短的时间间隔进行评估。在运动型 PD 发病之前，在尚未患病的个体中建立标志物的敏感性、特异性、预测值和进展情况，有望为未来的干预试验奠定基础。
