Parkinson's disease--the debate on the clinical phenomenology, aetiology, pathology and pathogenesis.
The definition of Parkinson's disease (PD) is changing with the expansion of clinical phenomenology and improved understanding of environmental and genetic influences that impact on the pathogenesis of the disease at the cellular and molecular level. This had led to debate and discussion with as yet, no general acceptance of the direction that change should take either at the level of diagnosis or of what should and should not be sheltered under an umbrella of PD. This article is one contribution to this on-going discussion. There are two different themes running through the article--widening the definition of PD/LBD/synucleinopathies and the heterogeneity that exists within PD itself from a clinical, pathological and genetic perspective. The conclusion reached is that in the future, further diagnostic categories will need to be recognized. These are likely to include--Parkinson's syndrome, Parkinson's syndrome likely to be Lewy body PD, clinical PD (defined by QSBB criteria), Lewy body disease (PD, LBD, REM SBD) and synucleinopathies (including LBD, MSA).
Neurodegenerative Diseases Research Group, Institute of Pharmaceutical Sciences, School of Biomedical Sciences, King's College, London, UK. peter.jenner@kcl.ac.uk
Peter
P
Jenner
Huw R
HR
Morris
Trevor W
TW
Robbins
Michel
M
Goedert
John
J
Hardy
Yoav
Y
Ben-Shlomo
Paul
P
Bolam
David
D
Burn
John V
JV
Hindle
David
D
Brooks
D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D042241:Early Diagnosis; D006579:Heterozygote; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000209:etiology; D009154:Mutation / Q000235:genetics; D010300:Parkinson Disease / Q000175:diagnosis* / Q000209:etiology; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000209:etiology; D051843:Synucleins / Q000502:physiology
D051843:Synucleins