Early diagnosis of Parkinson's disease

Abstract

In idiopathic Parkinson's disease (IPD) approximately 60 % of the nigrostriatal neurons of the substantia nigra (SN) are degenerated before neurologists can establish the diagnosis according to the widely accepted clinical diagnostic criteria. It is conceivable that neuroprotective therapy starting at such an 'advanced stage' of the disease will fail to stop the degenerative process. Therefore, the identification of patients at risk and at earlier stages of the disease appears to be essential for any successful neuroprotection. The discovery of several genetic mutations associated with IPD raises the possibility that these, or other biomarkers, of the disease may help to identify persons at risk of IPD. Transcranial ultrasound have shown susceptibility factors for IPD related to an increased iron load of the substantia nigra. In the early clinical phase, a number of motor and particularly non-motor signs emerge, which can be identified by the patients and physicians years before the diagnosis is made, notably olfactory dysfunction, depression, or 'soft' motor signs such as changes in handwriting, speech or reduced ambulatory arm motion. These signs of the early, prediagnostic phase of IPD can be detected by inexpensive and easy-to-administer tests. As one single instrument will not be sensitive enough, a battery of tests has to be composed measuring independent parameters of the incipient disease. Subjects with abnormal findings in this test battery should than be submitted to nuclear medicine examinations to quantify the extent of dopaminergic injury and to reach the goal of a reliable, early diagnosis.

2-Year Natural Decline of Cardiac Sympathetic Innervation in Idiopathic Parkinson Disease Studied with 11C-Hydroxyephedrine PET

“…Just over half of the patients showed extensive denervation with a regional pattern of sympathetic neuronal loss, preferentially involving the inferior and lateral LV walls, and relatively sparing the anterior and septal walls, confirming our earlier observations (11). This regional pattern of involvement was found also with 18 F-fluorodopamine PET imaging, with relatively lower sympathetic innervation in the lateral wall, with sparing of the septum (22,23).…”

Peripheral nerve involvement and severity of motor disorder in Parkinson\'s disease: a correlational study

“…According to Braak et al, the neurodegenerative process in Parkinson's disease also affects other CNS structures than those contained in the corticostriatal, nigrostriatal or olivonigral systems 1-4. Other studies published several years ago suggest that in a relatively high percentage of patients suffering from neurodegenerative diseases, both the cortex and peripheral nerve system are affected. 1,5,6,7 Parkinson's disease is where this involvement is most frequently documented.…”

Fabrication of Chitosan-gold Nanocomposites Combined with Optical Fiber as SERS Substrates to Detect Dopamine Molecules

“…[1][2][3][4][5][6] One of the causes of Parkinson's disease is closely related to levels of dopamine (DA) in the brain cortex. Lack of DA can lead to the development of Parkinson's disease, while excessive amounts of DA contribute to a type of schizophrenia called Bleuler disease.…”

“…Finally, chitosan-gold nanocomposites combined with the optical fiber was prepared and employed as a SERS substrate to detect dopamine levels in aqueous solution. Amplified Raman signals of DA were obtained from the optical fiber and calibrated over concentration ranges (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) O 3 NSi, 97%) were purchased from Sigma Aldrich (USA). HPLC water was bought from J. T. Baker.…”