Clinical prediction of Parkinson's disease: planning for the age of neuroprotection
Identifieur interne : 000583 ( Main/Corpus ); précédent : 000582; suivant : 000584Clinical prediction of Parkinson's disease: planning for the age of neuroprotection
Auteurs : R B Postuma ; J F Gagnon ; J. MontplaisirSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2010-09.
Abstract
As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. The ability to identify this preclinical stage may be critical in the development and eventual use of neuroprotective therapy. Recently proposed staging systems of PD have suggested that degeneration may occur initially in areas outside the substantia nigra, suggesting that non-motor manifestations may be markers of presymptomatic PD. Decreased olfaction has recently been demonstrated to predict PD in prospective pathological studies, although the lead time may be relatively short, and the positive predictive value is low. Idiopathic RBD has a very high predictive value, with approximately 50% of affected individuals developing PD or dementia within 10 years. This implies that idiopathic RBD patients are ideal candidates to test potential preclinical markers. However, the specificity of symptom screens for RBD is not established, not all persons with PD develop RBD, and there are only limited ways to predict which RBD patients will develop PD. Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.
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DOI: 10.1136/jnnp.2009.174748
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Montplaisir</name><affiliation><mods:affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</mods:affiliation></affiliation><affiliation><mods:affiliation>Département de psychiatrie, Université de Montréal, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2010-09">2010-09</date><biblScope unit="volume">81</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1008">1008</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">BB55C749FE4F99EFA48E8968C7286E7159E3AE22</idno><idno type="DOI">10.1136/jnnp.2009.174748</idno><idno type="href">jnnp-81-1008.pdf</idno><idno type="ArticleID">jnnp174748</idno><idno type="PMID">20562452</idno><idno type="local">jnnp;81/9/1008</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. The ability to identify this preclinical stage may be critical in the development and eventual use of neuroprotective therapy. Recently proposed staging systems of PD have suggested that degeneration may occur initially in areas outside the substantia nigra, suggesting that non-motor manifestations may be markers of presymptomatic PD. Decreased olfaction has recently been demonstrated to predict PD in prospective pathological studies, although the lead time may be relatively short, and the positive predictive value is low. Idiopathic RBD has a very high predictive value, with approximately 50% of affected individuals developing PD or dementia within 10 years. This implies that idiopathic RBD patients are ideal candidates to test potential preclinical markers. However, the specificity of symptom screens for RBD is not established, not all persons with PD develop RBD, and there are only limited ways to predict which RBD patients will develop PD. Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>R B Postuma</name><affiliations><json:string>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</json:string><json:string>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</json:string><json:string>E-mail: ronald.postuma@mcgill.ca</json:string></affiliations></json:item><json:item><name>J F Gagnon</name><affiliations><json:string>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</json:string><json:string>Département de psychiatrie, Université de Montréal, Canada</json:string></affiliations></json:item><json:item><name>J Montplaisir</name><affiliations><json:string>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</json:string><json:string>Département de psychiatrie, Université de Montréal, Canada</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Review</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>prediction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>neuroprotection</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>autonomic</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PET</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sleep</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ultrasound</value></json:item></subject><language><json:string>eng</json:string></language><abstract>As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. The ability to identify this preclinical stage may be critical in the development and eventual use of neuroprotective therapy. Recently proposed staging systems of PD have suggested that degeneration may occur initially in areas outside the substantia nigra, suggesting that non-motor manifestations may be markers of presymptomatic PD. Decreased olfaction has recently been demonstrated to predict PD in prospective pathological studies, although the lead time may be relatively short, and the positive predictive value is low. Idiopathic RBD has a very high predictive value, with approximately 50% of affected individuals developing PD or dementia within 10 years. This implies that idiopathic RBD patients are ideal candidates to test potential preclinical markers. However, the specificity of symptom screens for RBD is not established, not all persons with PD develop RBD, and there are only limited ways to predict which RBD patients will develop PD. Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.</abstract><qualityIndicators><score>8.308</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>8</keywordCount><abstractCharCount>1624</abstractCharCount><pdfWordCount>5549</pdfWordCount><pdfCharCount>37543</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>234</abstractWordCount></qualityIndicators><title>Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</title><pmid><json:string>20562452</json:string></pmid><genre><json:string>review-article</json:string></genre><host><volume>81</volume><pages><first>1008</first></pages><issn><json:string>0022-3050</json:string></issn><issue>9</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1136/jnnp.2009.174748</json:string></doi><id>BB55C749FE4F99EFA48E8968C7286E7159E3AE22</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/BB55C749FE4F99EFA48E8968C7286E7159E3AE22/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/BB55C749FE4F99EFA48E8968C7286E7159E3AE22/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/BB55C749FE4F99EFA48E8968C7286E7159E3AE22/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2010-06-20</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</title><author corresp="yes"><persName><forename type="first">R B</forename><surname>Postuma</surname></persName><email>ronald.postuma@mcgill.ca</email><affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</affiliation><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation></author><author><persName><forename type="first">J F</forename><surname>Gagnon</surname></persName><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation><affiliation>Département de psychiatrie, Université de Montréal, Canada</affiliation></author><author><persName><forename type="first">J</forename><surname>Montplaisir</surname></persName><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation><affiliation>Département de psychiatrie, Université de Montréal, Canada</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2010-09"></date><biblScope unit="volume">81</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1008">1008</biblScope></imprint></monogr><idno type="istex">BB55C749FE4F99EFA48E8968C7286E7159E3AE22</idno><idno type="DOI">10.1136/jnnp.2009.174748</idno><idno type="href">jnnp-81-1008.pdf</idno><idno type="ArticleID">jnnp174748</idno><idno type="PMID">20562452</idno><idno type="local">jnnp;81/9/1008</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010-06-20</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. 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Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.</p></abstract><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>prediction</term></item><item><term>neuroprotection</term></item><item><term>autonomic</term></item><item><term>PET</term></item><item><term>sleep</term></item><item><term>ultrasound</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-06-20">Created</change><change when="2010-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/BB55C749FE4F99EFA48E8968C7286E7159E3AE22/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="review-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp174748</article-id><article-id pub-id-type="doi">10.1136/jnnp.2009.174748</article-id><article-id pub-id-type="other">jnnp;81/9/1008</article-id><article-id pub-id-type="other">jnnp;jnnp.2009.174748</article-id><article-id pub-id-type="pmid">20562452</article-id><article-id pub-id-type="other">1008</article-id><article-id pub-id-type="other">jnnp.2009.174748</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Review</subject></subj-group></article-categories><title-group><article-title>Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Postuma</surname><given-names>R B</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Gagnon</surname><given-names>J F</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Montplaisir</surname><given-names>J</given-names></name><xref ref-type="aff" rid="aff2">2</xref><xref ref-type="aff" rid="aff3">3</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</aff><aff id="aff2"><label>2</label>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</aff><aff id="aff3"><label>3</label>Département de psychiatrie, Université de Montréal, Canada</aff><author-notes><corresp><label>Correspondence to</label> Dr Ronald B Postuma, Department of Neurology, L7-312 Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada; <email>ronald.postuma@mcgill.ca</email></corresp></author-notes><pub-date pub-type="epub-original"><day>20</day><month>6</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>9</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>20</day><month>6</month><year>2010</year></pub-date><volume>81</volume><volume-id pub-id-type="other">81</volume-id><volume-id pub-id-type="other">81</volume-id><issue>9</issue><issue-id pub-id-type="other">jnnp;81/9</issue-id><issue-id pub-id-type="other">9</issue-id><issue-id pub-id-type="other">81/9</issue-id><fpage>1008</fpage><history><date date-type="received"><day>5</day><month>2</month><year>2009</year></date><date date-type="rev-recd"><day>18</day><month>12</month><year>2009</year></date><date date-type="accepted"><day>23</day><month>12</month><year>2009</year></date></history><permissions><copyright-statement>© 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2010</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-81-1008.pdf"></self-uri><abstract><p>As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. The ability to identify this preclinical stage may be critical in the development and eventual use of neuroprotective therapy. Recently proposed staging systems of PD have suggested that degeneration may occur initially in areas outside the substantia nigra, suggesting that non-motor manifestations may be markers of presymptomatic PD. Decreased olfaction has recently been demonstrated to predict PD in prospective pathological studies, although the lead time may be relatively short, and the positive predictive value is low. Idiopathic RBD has a very high predictive value, with approximately 50% of affected individuals developing PD or dementia within 10 years. This implies that idiopathic RBD patients are ideal candidates to test potential preclinical markers. However, the specificity of symptom screens for RBD is not established, not all persons with PD develop RBD, and there are only limited ways to predict which RBD patients will develop PD. Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.</p></abstract><kwd-group><kwd>Parkinson's disease</kwd><kwd>prediction</kwd><kwd>neuroprotection</kwd><kwd>autonomic</kwd><kwd>PET</kwd><kwd>sleep</kwd><kwd>ultrasound</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Clinical prediction of Parkinson's disease: planning for the age of neuroprotection</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">R B</namePart><namePart type="family">Postuma</namePart><affiliation>Department of Neurology, McGill University, Montreal General Hospital, Montreal, Quebec, Canada</affiliation><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation><affiliation>E-mail: ronald.postuma@mcgill.ca</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J F</namePart><namePart type="family">Gagnon</namePart><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation><affiliation>Département de psychiatrie, Université de Montréal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J</namePart><namePart type="family">Montplaisir</namePart><affiliation>Centre d'etude du sommeil, Hopital du Sacre-Coeur, Montreal, Canada</affiliation><affiliation>Département de psychiatrie, Université de Montréal, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="review-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2010-09</dateIssued><dateCreated encoding="w3cdtf">2010-06-20</dateCreated><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>As a chronic progressive disease, Parkinson's disease (PD) has a presymptomatic interval; that is, a period during which the pathological process has begun, but motor signs required for the clinical diagnosis are absent. The ability to identify this preclinical stage may be critical in the development and eventual use of neuroprotective therapy. Recently proposed staging systems of PD have suggested that degeneration may occur initially in areas outside the substantia nigra, suggesting that non-motor manifestations may be markers of presymptomatic PD. Decreased olfaction has recently been demonstrated to predict PD in prospective pathological studies, although the lead time may be relatively short, and the positive predictive value is low. Idiopathic RBD has a very high predictive value, with approximately 50% of affected individuals developing PD or dementia within 10 years. This implies that idiopathic RBD patients are ideal candidates to test potential preclinical markers. However, the specificity of symptom screens for RBD is not established, not all persons with PD develop RBD, and there are only limited ways to predict which RBD patients will develop PD. Other simple screens based upon autonomic symptoms, depression and personality changes, quantitative motor testing and other sleep disorders may also be useful markers, but have not been extensively tested. Other more expensive measures such as detailed autonomic testing, cardiac MIBG-scintigraphy, dopaminergic imaging and transcranial ultrasound may be especially useful in defining disease risk in those identified through primary screening.</abstract><subject><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>prediction</topic><topic>neuroprotection</topic><topic>autonomic</topic><topic>PET</topic><topic>sleep</topic><topic>ultrasound</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>81</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>1008</start></extent></part></relatedItem><identifier type="istex">BB55C749FE4F99EFA48E8968C7286E7159E3AE22</identifier><identifier type="DOI">10.1136/jnnp.2009.174748</identifier><identifier type="href">jnnp-81-1008.pdf</identifier><identifier type="ArticleID">jnnp174748</identifier><identifier type="PMID">20562452</identifier><identifier type="local">jnnp;81/9/1008</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2010, Published by the BMJ Publishing Group Limited. 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