Visanji Naomi, Marras Connie
a Toronto Western Hospital, Morton and Gloria Shulman Movement Disorders Centre, 399 Bathurst Street, Toronto, Ontario, Canada.
Expert Rev Neurother. 2015 Oct;15(10):1205-17. doi: 10.1586/14737175.2015.1083423. Epub 2015 Sep 1.
Parkinson's disease (PD) has a wide range of non-motor symptoms including; constipation, sleep disturbance, deficits in vision and olfaction, mood disorders and cardiac autonomic dysfunction. Several of these non-motor symptoms can manifest prior to the onset of motor symptoms. Recognizing these pre-motor symptoms may enable early diagnosis of PD. Currently, no single pre-motor symptom is able to predict the development of PD with 100% sensitivity or specificity. Ongoing studies in several independent at-risk cohorts should reveal the potential of combinations of pre-motor symptoms and multi-stage screening strategies to identify individuals at increased risk of PD. PD progression may be governed by a prion-like spread of a-syn throughout the nervous system. Identifying individuals at the earliest stage will likely be critical to preventing the pathological progression of PD, highlighting the relevance of pre-motor symptoms in the future treatment of the disease.
帕金森病（PD）有多种非运动症状，包括便秘、睡眠障碍、视力和嗅觉减退、情绪障碍以及心脏自主神经功能障碍。其中一些非运动症状可能在运动症状出现之前就已表现出来。识别这些运动前症状可能有助于帕金森病的早期诊断。目前，没有单一的运动前症状能够以100%的敏感性或特异性预测帕金森病的发展。正在对几个独立的高危队列进行的研究应能揭示运动前症状组合和多阶段筛查策略在识别帕金森病风险增加个体方面的潜力。帕金森病的进展可能受α-突触核蛋白在整个神经系统中类似朊病毒的传播所控制。尽早识别个体对于预防帕金森病的病理进展可能至关重要，这突出了运动前症状在该疾病未来治疗中的相关性。
