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Can we image premotor Parkinson disease?
Neurology. 2009 Feb 17; 72(7 Suppl):S21-6.Neur

Abstract

Pathology and imaging studies have shown that patients with Parkinson disease (PD) have a prolonged period of uncertain duration when vulnerable neuronal populations are degenerating, but typical motor symptoms have not yet developed. This provides both an opportunity-it may be best to test new medications and, ultimately, treat PD patients during this early phase of disease--and a challenge--how to find these premotor PD subjects? Imaging biomarkers targeting the premotor period are critical to elucidate both the onset and progression of premotor PD. Widespread data have demonstrated that dopaminergic imaging can detect PD subjects at the motor symptom threshold. Novel strategies combining dopaminergic imaging with known genetic mutations for PD or early clinical signs and PD-associated symptoms, such as olfactory loss and sleep disturbances like REM behavior disorder, have begun to be used to identify individuals at risk for PD before motor symptoms become manifest. Early studies also have used imaging targeting norepinephrine, serotonin, cholinergic, or other neuronal systems to focus on early cardiac, cognitive, and behavioral symptoms. Imaging of nondopaminergic targets such as inflammation or alpha-synuclein deposition may provide further insight into the etiology of PD. Given the multiple genetic etiologies for PD already identified, the marked variability in the loss of dopaminergic markers measured by imaging at motor symptom onset, and the clear heterogeneity of clinical symptoms at PD onset, it is certain that many imaging biomarkers with a focus ranging from clinical symptoms to PD pathobiology to molecular genetic mechanisms, will be necessary to fully map PD risk.

Authors+Show Affiliations

Institute for Neurodegenerative Disorders, New Haven, CT, USA. kmarek@indd.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19221310

Citation

Marek, Kenneth, and Danna Jennings. "Can We Image Premotor Parkinson Disease?" Neurology, vol. 72, no. 7 Suppl, 2009, pp. S21-6.
Marek K, Jennings D. Can we image premotor Parkinson disease? Neurology. 2009;72(7 Suppl):S21-6.
Marek, K., & Jennings, D. (2009). Can we image premotor Parkinson disease? Neurology, 72(7 Suppl), S21-6. https://doi.org/10.1212/WNL.0b013e318198df97
Marek K, Jennings D. Can We Image Premotor Parkinson Disease. Neurology. 2009 Feb 17;72(7 Suppl):S21-6. PubMed PMID: 19221310.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can we image premotor Parkinson disease? AU - Marek,Kenneth, AU - Jennings,Danna, PY - 2009/2/18/entrez PY - 2009/3/3/pubmed PY - 2009/3/13/medline SP - S21 EP - 6 JF - Neurology JO - Neurology VL - 72 IS - 7 Suppl N2 - Pathology and imaging studies have shown that patients with Parkinson disease (PD) have a prolonged period of uncertain duration when vulnerable neuronal populations are degenerating, but typical motor symptoms have not yet developed. This provides both an opportunity-it may be best to test new medications and, ultimately, treat PD patients during this early phase of disease--and a challenge--how to find these premotor PD subjects? Imaging biomarkers targeting the premotor period are critical to elucidate both the onset and progression of premotor PD. Widespread data have demonstrated that dopaminergic imaging can detect PD subjects at the motor symptom threshold. Novel strategies combining dopaminergic imaging with known genetic mutations for PD or early clinical signs and PD-associated symptoms, such as olfactory loss and sleep disturbances like REM behavior disorder, have begun to be used to identify individuals at risk for PD before motor symptoms become manifest. Early studies also have used imaging targeting norepinephrine, serotonin, cholinergic, or other neuronal systems to focus on early cardiac, cognitive, and behavioral symptoms. Imaging of nondopaminergic targets such as inflammation or alpha-synuclein deposition may provide further insight into the etiology of PD. Given the multiple genetic etiologies for PD already identified, the marked variability in the loss of dopaminergic markers measured by imaging at motor symptom onset, and the clear heterogeneity of clinical symptoms at PD onset, it is certain that many imaging biomarkers with a focus ranging from clinical symptoms to PD pathobiology to molecular genetic mechanisms, will be necessary to fully map PD risk. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/19221310/Can_we_image_premotor_Parkinson_disease L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=19221310 DB - PRIME DP - Unbound Medicine ER -