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Early diagnosis of Parkinson’s disease has the potential to lead to earlier treatment aimed at preventing neurodegeneration, thereby improving quality of life of those suffering from this debilitating disease. A recent study has aimed to identify early symptoms of Parkinson’s disease as a first step to prevention.

Parkinson’s disease is a neurodegenerative disease that is classically associated with a tremor. It is the second most common neurodegenerative disease, and current treatments are targeted primarily at reducing the symptoms. However, recent research is aiming to prevent the neurodegenerative effects of the disease in order to prevent disease progression; earlier diagnosis prior to neuron degeneration is necessary. Identification of earlier diagnostic markers and/or symptoms would identify those at greater risk of developing Parkinson’s disease, and who might benefit from preventive treatment.

A study recently published in the Lancet set out to identify early symptoms of Parkinson’s disease. The study made use of a database of patients in the UK with prospectively recorded clinical data. Patients that went on to develop Parkinson’s disease were compared with those who did not develop Parkinson’s disease, and the data was assessed for potential pre-diagnostic symptoms.

The classic presentation of tremor was seen approximately 2 years before the diagnosis of Parkinson’s disease. Balance impairments and shoulder pain or stiffness were also noted at 2 years prior to diagnosis. In addition, depression was also more frequently seen in the group that went on to develop Parkinson’s disease compared with the group who did not.

Several symptoms were noted at 5 years prior to diagnosis in the patients who later developed Parkinson’s disease, including: balance impairment, constipation, hypotension, erectile dysfunction, urinary dysfunction, dizziness, fatigue, depression, and anxiety. The results also revealed that tremor and constipation were more prevalent in the group of patients that developed Parkinson’s disease at 10 years pre-diagnosis.

The results of the study suggest that there is a pre-diagnostic window in which symptoms may already be occurring. Combined with genetic risk markers, these symptoms may provide the opportunity for prevention of neurodegeneration in patients at high-risk of developing Parkinson’s disease.

In contrast to current medication that is only able to treat the symptoms of Parkinson’s disease, neuroprotective therapy would aim to slow or prevent the progression of the disease by reducing the damage to the neurons at early stages of the disease. To date, there remains no neuroprotective therapy for Parkinson’s disease. Future studies that clearly define the pre-diagnostic criteria for Parkinson’s disease would open the doors for clinical trials to begin assessing the efficacy of treatments to delay or prevent the onset of Parkinson’s disease.

 

Schrag, A, Horsfall, L, Walters, K, Noyce, A, Petersen, I. “Prediagnostic presentations of Parkinson’s disease in primary care: a case-control study” The Lancet Neurology, early online publication DOI: http://dx.doi.org/10.1016/S1474-4422(14)70287-X Published Online: 26 November 2014.

“Neuroprotective therapy for Parkinson disease” http://www.uptodate.com/contents/neuroprotective-therapy-for-parkinson-disease

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

 

 

Written by Deborah Tallarigo, PhD

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