Diagnosis and Management in Parkinson's Disease

The Neuroscience of Parkinson's Disease, Volume 1

Colin R Martin, Victor R Preedy, Colin R. Martin, Victor R. Preedy

• Publisher: Academic Press
• Year: 2020
• Print ISBN: 9780128159460
• eBook ISBN: 9780128159477
• Topic: Medicine
• Subtopic: Physiology

Diagnosis and Management in Parkinson's Disease: The Neuroscience of Parkinson's, Volume 1 provides a single source of material covering different scientific domains of neuropathology underlying this condition. The book covers a wide range of subjects and unravels the complex relationships between genetics, molecular biology, pharmaceutical chemistry, neurobiology, imaging, assessments, and treatment regimens. It fills a much-needed gap as a "one-stop" synopsis of everything concerning the neurology and neuroscience related to Parkinson's disease, from chemicals and cells to individuals. The book is an invaluable resource for neuroscientists, neurologists, and anyone in the field.- Offers the most comprehensive coverage of a broad range of topics related to Parkinson's disease- Serves as a foundational collection for neuroscientists and neurologists on the biology of disease and brain dysfunction- Contains in each chapter an abstract, key facts, mini dictionary of terms, and summary points to aid in understanding- Features preclinical and clinical studies to help researchers map out key areas for research and further clinical recommendations- Serves as a "one-stop" source for everything you need to know about Parkinson's disease

Part I

Introductory chapters and setting the scene

Outline

Chapter 1. Progression of symptoms in Parkinson’s disease

Chapter 2. Cellular pathophysiology and basal ganglia dysfunction in Parkinson’s disease: an overview

Chapter 3. The role of environmental toxins and inflammation in Parkinson’s disease pathophysiology: a historical perspective and research-based evidence

Chapter 4. Environmental and genetic risk factors for Parkinson’s disease

Chapter 5. Recent developments in the etiology, treatment, and potential therapeutic targets for Parkinson’s disease: a focus on biochemistry

Chapter 6. Facial emotion recognition in Parkinson’s disease: methodological, clinical, and pathophysiological factors

Chapter 7. Diurnal patterns and circadian aspects of Parkinson’s disease: retinal, hypothalamic/midbrain, and pineal participation

Chapter 8. Parkinson’s disease and social media

Chapter 9. Sleep disturbances in Parkinson’s disease

Chapter 10. Recurrent falls in people with Parkinson’s disease

Chapter 11. Medical decision-making in patients with Parkinson’s disease

Chapter 12. Visual impairment in Parkinson’s disease

Chapter 13. Autonomic problems in Parkinson’s disease: a focus on the bladder

Chapter 14. Dementia and bladder dysfunction: a focus on treatments with anticholinergics

Chapter 15. Linking and comparing non-motor symptoms in aging and Parkinson’s disease

Chapter 16. Progression of motor symptoms in Parkinson’s disease

Chapter 17. The stigma of Parkinson’s disease: development and implications

Chapter 1: Progression of symptoms in Parkinson's disease

Federico Paolini Paoletti ¹ , Lucia Farotti ² , and Lucilla Parnetti ^{2 1} Center for Movement Disorders, Section of Neurology, University of Perugia, Perugia, Italy ² Center for Memory Disturbances, Laboratory of Clinical Neurochemistry, Section of Neurology, University of Perugia, Perugia, Italy

Abstract

Whereas the diagnostic criteria for clinical Parkinson's disease (PD) remain centered on the motor syndrome, it is well-known that PD is a multisystemic disorder characterized by a broad spectrum of motor and non-motor features encompassing neuropsychiatric, dysautonomic, and gastrointestinal disturbances. Non-motor disturbances can appear early in the disease course, often preceding the development of classical motor signs. In view of etiological treatments, early diagnosis is needed; accordingly, the concept of prodromal PD has also been introduced. Different clinical PD subtypes based on age at onset (early versus late onset) and baseline motor profile (postural instability or gait difficulty versus tremor-dominant) are probably insufficient to provide a complete prognostic characterization. By combining motor and non-motor features, cluster analysis has been used to provide a better definition of PD subtypes according to their different prognostic profiles. Regardless of PD subtype classifications, prognosis of patients is mainly determined by motor progression and cognitive impairment. Motor progression includes development of motor fluctuations and dyskinesia. Falls also have a greatly negative impact on quality of life. Older age, symmetrical involvement, cognitive impairment, and longer disease duration have been reported as the strongest predictive factors for motor progression. Established prognostic factors for cognitive impairment and dementia include advanced age and more severe parkinsonism, especially with predominant gait involvement. Reduced cerebrospinal fluid Aβ₄₂ levels have consistently been shown to predict the development of cognitive impairment. Genetic factors also influence the risk for developing PD, phenotypic features, and disease course. α-Synuclein gene point mutations and triplications correlate with motor and cognitive impairment. Glucocerebrosidase gene mutations lead to early dementia and psychosis. A better knowledge of prognostic factors in PD will allow physicians to personalize treatment when disease-modifying drugs will be available.

Keywords

Cerebrospinal fluid biomarker; Cluster analysis; Cognitive impairment; Disease-modifying therapy; Genetic risk; Motor progression; Parkinson's disease subtype; Prognosis

List of abbreviations

AD Alzheimer's Disease

CSF Cerebrospinal fluid

EOPD Early-onset Parkinson's disease

GWAS Genome-wide association studies

LID Levodopa-induced dyskinesia

LOPD Late-onset Parkinson's disease

MCI Mild cognitive impairment

PD Parkinson's disease

RBD Rapid eye movement sleep behavior disorders

Minidictionary of terms

Prognosis The expectation about the outcome of disease. It includes the clinical course of disease, its progression, and the possible development of complications.

Dysautonomia A dysfunction of the autonomic nervous system. The most common presentations of dysautonomia in PD patients include orthostatic hypotension, erectile disturbances, urinary incontinence, or other bladder dysfunctions.

Cerebrospinal fluid The liquid found in the central nervous system. It is produced by specialized cells in the choroid plexuses of brain ventricles and absorbed by the arachnoid granulations.

Aβ₄₂ A 42–amino acid molecule deriving from proteolysis of amyloid precursor protein. It takes part in the constitution of amyloid plaques.

Tau A protein abundant in the central nervous system, where it is physiologically associated with microtubules. It can be prefixed by t- (t-tau) or p- (p-tau) to indicate the total or phosphorylated protein, respectively. It is the main component of neurofibrillary tangles.

α-synuclein A protein encoded by SNCA gene and greatly expressed in the central nervous system, where it is primarily involved in...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• Contributors
• Foreword
• Preface
• Part I. Introductory chapters and setting the scene
• Part II. Biomarkers, instruments, diagnosis and assessments
• Part III. Pharmacological treatments, other agents and strategies
• Part IV. Non-pharmacological, novel and other treatment procedures
• Index