Chahine Lama M, Stern Matthew B
Penn Parkinson's Disease and Movement Disorders Center Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA.
Mov Disord Clin Pract. 2014 Jul 8;1(4):299-306. doi: 10.1002/mdc3.12062. eCollection 2014 Dec.
Increasingly, it has been recognized that in order to affect underlying neurodegeneration in Parkinson's disease (PD), individuals must be identified before onset of the classic motor symptoms. Thus, for research purposes, a redefinition of PD has been proposed into preclinical, premotor, and motor phases. In the preclinical phase, no clinical signs or symptoms of PD are present. In the premotor phase, nonmotor manifestations are detectable. These include olfactory, neuropsychiatric, sleep, gastrointestinal, and autonomic changes. A multi-modal approach is needed to maximize both sensitivity and specificity of any assessment of the premotor phase. To that end, several objective markers, such as dopaminergic imaging and electrophysiologic techniques, exist and are of potential utility. This review discusses the candidate nonmotor features and potential objective measures that may be used to define the premotor phase of PD.
越来越多的人认识到，为了影响帕金森病（PD）潜在的神经退行性变，必须在经典运动症状出现之前识别个体。因此，出于研究目的，有人提议将PD重新定义为临床前期、运动前期和运动期。在临床前期，不存在PD的临床体征或症状。在运动前期，可检测到非运动表现。这些表现包括嗅觉、神经精神、睡眠、胃肠道和自主神经方面的变化。需要采用多模式方法来最大限度地提高运动前期任何评估的敏感性和特异性。为此，存在几种客观标志物，如多巴胺能成像和电生理技术，并且具有潜在用途。本综述讨论了可能用于定义PD运动前期的候选非运动特征和潜在客观测量方法。
