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Predicting Parkinson’s disease: worthwhile but are we there yet?

¹ Consultant Neurologist & Honorary, Senior Lecturer, Essex Neuroscience Centre, Essex, UK
² Neurology Research Fellow, Essex Neuroscience Centre, Essex, UK

Correspondence to:
Correspondence to:
Dr C H Hawkes, Essex Neuroscience Centre, Oldchurch, Hospital, Romford, Essex RM7 0BE, UK;
chrishawkes@msn.com

The first 150 words of the full text of this article appear below.

Current opinion suggests there is a preclinical phase in idiopathic Parkinson’s disease (PD) with a latent period somewhere between 6 and 40 years. ^1,2 This prodrome, sometimes also termed the presymptomatic or pre-motor phase of PD, needs to be distinguished from non-motor features such as neuropsychiatric symptoms, dysautonomia, fatigue, and so on,³ only some of which start before the classical motor triad of PD (tremor, rigidity, and bradykinesia). Clearly, prediction of PD would be straight forward in those few parkinsonian patients with monogenetic disorder that in theory may be identified from birth, but most such mutations are very rare. A variety of predictive biochemical tests⁴ are proposed but as yet none is sufficiently reliable. Fluorodopa positron emission tomography (PET) or dopamine transporter imaging (DATScan) will detect deficiency of striatal dopamine but by this stage the motor phase–at least neurochemically–has probably begun. So might symptoms or signs foretell PD, and . . . [Full text of this article]