title: Reasons for mild parkinsonian signs - which constellation may indicate neurodegeneration?
abstract: BACKGROUND
  Mild parkinsonian signs (MPS) are common in the elderly population. Several factors including physical decline and comorbidities in addition to neurodegeneration may be possible sources for MPS. The objective was to examine whether MPS are associated with a history of orthopedic disturbances, vascular diseases or prodromal markers for neurodegeneration.
  
  
  METHODS
  The TREND study is a prospective longitudinal cohort study in individuals >50 years with biennial assessments designed to identify prodromal markers for neurodegeneration. In this substudy, 1091 elderly individuals were evaluated for a possible association of MPS with prodromal markers for neurodegeneration, orthopedic disturbances, vascular diseases, as well as cerebral abnormalities. These factors were assessed by self-administered questionnaires, with a structured health interview, a neurological examination and by transcranial sonography.
  
  
  RESULTS
  82 participants showed MPS. They were found to have more often hyposmia and RBD, had a higher autonomic dysfunction score and they more frequently showed hyperechogenicity of the substantia nigra compared to controls. Neither orthopedic disturbances nor vascular diseases were significantly associated with the prevalence of MPS.
  
  
  CONCLUSIONS
  MPS might be a sign of early neurodegeneration rather than caused by other motor influencing diseases.
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany. Electronic address: Stefanie.lerche@uni-tuebingen.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lerche
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Brockmann
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Wurster
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gaenslen
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Roeben
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Holz
authors.affiliation: Geriatric Center and Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Germany.
authors.forename: Gerhard W
authors.initials: GW
authors.lastname: Eschweiler
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Maetzler
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Berg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000453:epidemiology; D000857:Olfaction Disorders / Q000175:diagnosis / Q000453:epidemiology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology; D062706:Prodromal Symptoms; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: Mild motor signs; Parkinson's disease; Prodromal marker