Getz Sarah J, Levin Bonnie
Department of Neurology, Division of Neuropsychology, University of Miami Miller School of Medicine, Miami, FL, USA.
Arch Clin Neuropsychol. 2017 Nov 1;32(7):769-785. doi: 10.1093/arclin/acx091.
The clinical definition of Parkinson's disease (PD) is based on cardinal motor features including bradykinesia as well as an additional symptom of tremor, postural instability, or rigidity. Evidence from neuropathological, imaging, and clinical research suggests a premotor, early phase of PD pathology. Further understanding of the earliest biomarkers of PD is crucial for the development of neuroprotective, disease modifying, cognitive, and psychiatric interventions. Recent research has explored early non-motor markers of PD pathology. This issue is especially timely as the International Parkinson and Movement Disorder Society has recently provided a research definition for prodromal PD which includes combinations of prodromal markers and risk factors aimed at identifying target populations for disease-prevention trials. In this review of early PD, we will outline early non-motor symptoms, early cognitive and neuropsychiatric features, neuropsychological assessment strategies, emerging evidence for early biomarkers, and treatment recommendations.
帕金森病（PD）的临床定义基于主要运动特征，包括运动迟缓以及震颤、姿势不稳或肌强直等附加症状。神经病理学、影像学和临床研究的证据表明，PD 病理存在运动前的早期阶段。进一步了解 PD 最早的生物标志物对于开发神经保护、疾病修饰、认知和精神方面的干预措施至关重要。最近的研究探索了 PD 病理的早期非运动标志物。这个问题尤为及时，因为国际帕金森和运动障碍协会最近为前驱期 PD 提供了一个研究定义，其中包括前驱标志物和风险因素的组合，旨在识别疾病预防试验的目标人群。在这篇关于早期 PD 的综述中，我们将概述早期非运动症状、早期认知和神经精神特征、神经心理学评估策略、早期生物标志物的新证据以及治疗建议。
