Dommershuijsen Lisanne J, Boon Agnita J W, Ikram M Kamran
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Department of Neurology, Erasmus MC University Medical Center, Rotterdam, Netherlands.
Front Neurol. 2021 Jul 1;12:702502. doi: 10.3389/fneur.2021.702502. eCollection 2021.
Parkinson's disease covers a wide spectrum of symptoms, ranging from early non-motor symptoms to the characteristic bradykinesia, tremor and rigidity. Although differences in the symptomatology of Parkinson's disease are increasingly recognized, there is still a lack of insight into the heterogeneity of the pre-diagnostic phase of Parkinson's disease. In this perspective, we highlight three aspects regarding the role of population-based studies in providing new insights into the heterogeneity of pre-diagnostic Parkinson's disease. First we describe several specific advantages of population-based cohort studies, including the design which overcomes some common biases, the broad data collection and the high external validity. Second, we draw a parallel with the field of Alzheimer's disease to provide future directions to uncover the heterogeneity of pre-diagnostic Parkinson's disease. Finally, we anticipate on the emergence of prevention and disease-modification trials and the potential role of population-based studies herein. In the coming years, bridging gaps between study designs will be essential to make vital advances in elucidating the heterogeneity of pre-diagnostic Parkinson's disease.
帕金森病涵盖了广泛的症状，从早期非运动症状到典型的运动迟缓、震颤和僵硬。尽管帕金森病症状学上的差异越来越受到认可，但对于帕金森病诊断前阶段的异质性仍缺乏深入了解。从这个角度来看，我们强调基于人群的研究在为帕金森病诊断前阶段的异质性提供新见解方面的三个作用。首先，我们描述了基于人群的队列研究的几个具体优势，包括克服一些常见偏倚的设计、广泛的数据收集以及较高的外部效度。其次，我们将其与阿尔茨海默病领域进行对比，以提供未来揭示帕金森病诊断前阶段异质性的方向。最后，我们预期预防和疾病修饰试验的出现以及基于人群的研究在其中的潜在作用。在未来几年，弥合研究设计之间的差距对于在阐明帕金森病诊断前阶段的异质性方面取得重大进展至关重要。
