Chahine Lana M, Stern Matthew B
Department of Neurology Parkinson's Disease and Movement Disorders Center Perelman School of Medicine University of Pennsylvania Philadelphia PA.
Mov Disord Clin Pract. 2017 Oct 2;4(6):796-805. doi: 10.1002/mdc3.12545. eCollection 2017 Nov-Dec.
Objective measures of Parkinson's disease (PD) are needed for purposes of diagnosis and prognostication, as well as identification of those at risk of PD. In this qualitative review, we provide an overview of the current state of the field of PD biomarker development, delineate challenges, and discuss how the field is evolving.
A search of PubMed was conducted for articles pertaining to objective biomarkers for PD. Articles were selected based on relevance and methodology; where available, meta-analyses, systematic reviews, and comprehensive qualitative review articles were preferentially referenced.
There are several potential sources of objective PD biomarkers including biofluids, peripheral tissue, imaging, genetics, and technology based objective motor testing. Approaches to biomarker identification include the candidate biomarker approach and unbiased discovery methods, each of which has advantages and disadvantages. Several emerging techniques hold promise in each of these areas. Advances in technology and bioinformatics, and the increasing availability of biobanks, are expected to facilitate future PD biomarker development.
The field of objective biomarkers for PD has made great progress but much remains to be done in translating putative biomarkers into tools useful in the clinic and for research. Multimodal biomarker platforms have the potential to capitalize on the utility and strengths of individual biomarkers. Rigorous methodology and standards for replication of findings will be key to meaningful progress in the field.
帕金森病（PD）的客观测量对于诊断、预后评估以及识别PD风险人群都很有必要。在这项定性综述中，我们概述了PD生物标志物开发领域的现状，阐述了面临的挑战，并讨论了该领域的发展趋势。
在PubMed上搜索与PD客观生物标志物相关的文章。根据相关性和方法选择文章；如有可用的荟萃分析、系统评价和全面的定性综述文章，则优先引用。
PD客观生物标志物有几个潜在来源，包括生物流体、外周组织、成像、遗传学和基于技术的客观运动测试。生物标志物识别方法包括候选生物标志物方法和无偏发现方法，每种方法都有优缺点。几种新兴技术在这些领域都有前景。技术和生物信息学的进步以及生物样本库可用性的增加，有望促进未来PD生物标志物的开发。
PD客观生物标志物领域已经取得了很大进展，但在将假定的生物标志物转化为临床和研究中有用的工具方面仍有许多工作要做。多模式生物标志物平台有可能利用单个生物标志物的效用和优势。严格的方法和结果复制标准将是该领域取得有意义进展的关键。
