title: The relevance of pre-motor symptoms in Parkinson's disease.
abstract: Parkinson's disease (PD) has a wide range of non-motor symptoms including; constipation, sleep disturbance, deficits in vision and olfaction, mood disorders and cardiac autonomic dysfunction. Several of these non-motor symptoms can manifest prior to the onset of motor symptoms. Recognizing these pre-motor symptoms may enable early diagnosis of PD. Currently, no single pre-motor symptom is able to predict the development of PD with 100% sensitivity or specificity. Ongoing studies in several independent at-risk cohorts should reveal the potential of combinations of pre-motor symptoms and multi-stage screening strategies to identify individuals at increased risk of PD. PD progression may be governed by a prion-like spread of a-syn throughout the nervous system. Identifying individuals at the earliest stage will likely be critical to preventing the pathological progression of PD, highlighting the relevance of pre-motor symptoms in the future treatment of the disease.
authors.affiliation: a Toronto Western Hospital, Morton and Gloria Shulman Movement Disorders Centre, 399 Bathurst Street, Toronto, Ontario, Canada.
authors.forename: Naomi
authors.initials: N
authors.lastname: Visanji
authors.forename: Connie
authors.initials: C
authors.lastname: Marras
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D003248:Constipation / Q000175:diagnosis / Q000209:etiology; D042241:Early Diagnosis; D006801:Humans; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology; D000857:Olfaction Disorders / Q000175:diagnosis / Q000209:etiology; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology
keywords: Parkinson’s disease; alpha synuclein; autonomic dysfunction; constipation; depression; excessive daytime sleepiness; olfactory dysfunction; pre-motor; rem behaviour disorder