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Prodromal non-motor symptoms of Parkinson’s disease

Authors Clelia Pellicano, Dario Benincasa, Vincenzo Pisani, Francesca R Buttarelli, Morena Giovannelli, Francesco E Pontieri

Published 15 March 2007 Volume 2007:3(1) Pages 145—151


Clelia Pellicano, Dario Benincasa, Vincenzo Pisani, Francesca R Buttarelli, Morena Giovannelli, Francesco E Pontieri

Dipartimento di Scienze Neurologiche, II Facoltà di Medicina e Chirurgia; Università degli Studi di Roma “La Sapienza”, Italy

Abstract: The motor symptoms of Parkinson’s disease (PD), bradykinesia, muscular rigidity, and tremor depend upon degeneration of the dopaminergic neurons in the substantia nigra pars compacta. Recent neuropathological studies show that the Lewy bodies, the intraneuronal landmark of PD, accumulate in several neuronal cell types in the brain. An ascending gradient of pathological involvement, from the medulla oblongata to neocortical areas has been reported. Thus the original view of PD as a disease characterized by selective damage of the dopaminergic neurons in the mesencephalon should be updated into the concept of a severe multisystemic neurodegenerative disorder. Additionally, the neuropathological alterations outside the substantia nigra are soundly correlated with the non-motor symptoms of PD. As a result of these findings, interest is growing in the identification of  prodromal non-motor symptoms of PD. Indeed, data from the literature suggest that autonomic disturbances, olfactory dysfunctions, depression and sleep disorders (in particular REM-sleep behavior disorder) may represent prodromal non-motor symptoms of PD. Several tests are available to detect most of these symptoms. Thus, the identification of prodromal non-motor symptoms may contribute to the precocious diagnosis of PD, and might be useful in the future to test the efficacy of neuroprotective agents.

Keywords: Parkinson’s disease, non-motor symptoms, autonomic dysfunction, olfactory dysfunction, depression, RBD

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