Peña-Zelayeta Laura, Delgado-Minjares Karen M, Villegas-Rojas Marcos M, León-Arcia Karen, Santiago-Balmaseda Alberto, Andrade-Guerrero Jesús, Pérez-Segura Isaac, Ortega-Robles Emmanuel, Soto-Rojas Luis O, Arias-Carrión Oscar
Unidad de Trastornos del Movimiento y Sueño, Hospital General Dr. Manuel Gea González, Ciudad de México 14080, Mexico.
Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico.
J Pers Med. 2025 Apr 26;15(5):172. doi: 10.3390/jpm15050172.
Parkinson's disease involves widespread neurodegeneration that extends far beyond the basal ganglia, giving rise to a diverse range of non-motor symptoms that frequently emerge before motor onset. These include autonomic dysfunction, cognitive decline, neuropsychiatric disturbances, sleep-related disorders, and sensory deficits. Here, we synthesize current evidence on the anatomical, neurochemical, and network-level mechanisms that drive these symptoms, and we examine how they shape disease progression and clinical heterogeneity. We highlight the limitations of dopamine-centric models and advocate for a framework that treats non-motor symptoms as the disorder's primary, mechanistically distinct features. We also discuss how emerging technologies-such as multi-omic profiling, artificial intelligence, and network neuroscience-enable earlier identification, stratification of non-motor phenotypes, and the development of precision-based therapeutic strategies. Recognizing non-motor symptoms as central to Parkinson's disease redefines how the disorder should be diagnosed, studied, and treated.
帕金森病涉及广泛的神经退行性变,其范围远远超出基底神经节,导致多种非运动症状,这些症状常常在运动症状出现之前就已出现。这些症状包括自主神经功能障碍、认知衰退、神经精神障碍、睡眠相关紊乱以及感觉缺陷。在此,我们综合了关于驱动这些症状的解剖学、神经化学和网络水平机制的现有证据,并研究它们如何影响疾病进展和临床异质性。我们强调以多巴胺为中心的模型的局限性,并倡导一个将非运动症状视为该疾病主要的、机制上不同的特征的框架。我们还讨论了诸如多组学分析、人工智能和网络神经科学等新兴技术如何能够实现早期识别、非运动表型分层以及基于精准医学的治疗策略的开发。将非运动症状视为帕金森病的核心重新定义了该疾病的诊断、研究和治疗方式。
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