Research on the premotor symptoms of Parkinson's disease: Clinical and etiological implications

Authors

Honglei Chen, National Institute of Environmental Health Sciences (NIEHS)
Edward A. Burton, University of Pittsburgh School of Medicine
G. Webster Ross, VA Medical Center
Xuemei Huang, Penn State Health Milton S. Hershey Medical Center
Rodolfo Savica, Mayo Clinic
Robert D. Abbott, University of Virginia School of Medicine
Alberto Ascherio, Harvard T.H. Chan School of Public Health
John N. Caviness, Mayo Clinic Scottsdale-Phoenix, Arizona
Xiang Gao, Harvard T.H. Chan School of Public Health
Kimberly A. Gray, National Institute of Environmental Health Sciences (NIEHS)
Jau Shyong Hong, National Institute of Environmental Health Sciences (NIEHS)
Freya Kamel, National Institute of Environmental Health Sciences (NIEHS)
Danna Jennings, Institute for Neurodegenerative Disorders
Annette Kirshner, National Institute of Environmental Health Sciences (NIEHS)
Cindy Lawler, National Institute of Environmental Health Sciences (NIEHS)
Rui Liu, National Institute of Environmental Health Sciences (NIEHS)
Gary W. Miller, Emory University
Robert Nussbaum, University of California, San Francisco
Shyamal D. Peddada, National Institute of Environmental Health Sciences (NIEHS)
Amy Comstock Rick, Parkinson's Action Network
Beate Ritz, University of California, Los Angeles
Andrew D. Siderowf, Avid Radiopharmaceuticals, Inc
Caroline M. Tanner, Parkinson's Institute
Alexander I. Tröster, Barrow Neurological Institute
Jing Zhang, University of Washington

Document Type

Article

Abstract

Background: The etiology and natural history of Parkinson's disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. Objectives: We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. Methods: This review was based on a workshop, Parkinson's Disease Premotor Symptom Symposium, held 7-8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Discussion: Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. Conclusion: This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis.

Publication Date

11-1-2013

Publication Title

Environmental Health Perspectives

ISSN

00916765

E-ISSN

15529924

Volume

121

Issue

11-12

First Page

1245

Last Page

1252

PubMed ID

23933572

Digital Object Identifier (DOI)

10.1289/ehp.1306967

Recommended Citation

Chen, Honglei; Burton, Edward A.; Ross, G. Webster; Huang, Xuemei; Savica, Rodolfo; Abbott, Robert D.; Ascherio, Alberto; Caviness, John N.; Gao, Xiang; Gray, Kimberly A.; Hong, Jau Shyong; Kamel, Freya; Jennings, Danna; Kirshner, Annette; Lawler, Cindy; Liu, Rui; Miller, Gary W.; Nussbaum, Robert; Peddada, Shyamal D.; Rick, Amy Comstock; Ritz, Beate; Siderowf, Andrew D.; Tanner, Caroline M.; Tröster, Alexander I.; and Zhang, Jing, "Research on the premotor symptoms of Parkinson's disease: Clinical and etiological implications" (2013). Clinical Neuropsychology. 118.
https://scholar.barrowneuro.org/neuropsychology/118