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Papers > Literature on "Parkinson's Disease" in the Last Decade

Parkinson's disease. ​

Literature Information ​

PMID25904081
JournalLancet (London, England)
Publication Year2015
Times Cited2635
KeywordsParkinson's disease, neurodegenerative disorder, motor symptoms, non-motor symptoms, genetic factors
Literature TypeJournal Article, Review
ISSN0140-6736
Pages896-912
Issue386(9996)
AuthorsLorraine V Kalia, Anthony E Lang

TL;DR ​

This seminar reviews the complexities of Parkinson's disease, highlighting its heterogeneous symptomatology that extends beyond classic motor features to include significant non-motor symptoms, and the intricate interplay of genetic and environmental factors that contribute to its pathology. The findings underscore the clinical challenges in early diagnosis and symptom management, as well as the absence of treatments that can slow the neurodegenerative process.

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Parkinson's disease · neurodegenerative disorder · motor symptoms · non-motor symptoms · genetic factors

Abstract ​

Parkinson's disease is a neurological disorder with evolving layers of complexity. It has long been characterised by the classical motor features of parkinsonism associated with Lewy bodies and loss of dopaminergic neurons in the substantia nigra. However, the symptomatology of Parkinson's disease is now recognised as heterogeneous, with clinically significant non-motor features. Similarly, its pathology involves extensive regions of the nervous system, various neurotransmitters, and protein aggregates other than just Lewy bodies. The cause of Parkinson's disease remains unknown, but risk of developing Parkinson's disease is no longer viewed as primarily due to environmental factors. Instead, Parkinson's disease seems to result from a complicated interplay of genetic and environmental factors affecting numerous fundamental cellular processes. The complexity of Parkinson's disease is accompanied by clinical challenges, including an inability to make a definitive diagnosis at the earliest stages of the disease and difficulties in the management of symptoms at later stages. Furthermore, there are no treatments that slow the neurodegenerative process. In this Seminar, we review these complexities and challenges of Parkinson's disease.

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Primary Questions Addressed ​

  1. What are the latest advancements in understanding the non-motor symptoms of Parkinson's disease?
  2. How do genetic factors influence the progression of Parkinson's disease compared to environmental factors?
  3. What are the challenges in early diagnosis of Parkinson's disease and how can they be addressed?
  4. How do different neurotransmitter systems interact in the pathology of Parkinson's disease?
  5. What potential therapeutic approaches are being explored to slow the neurodegenerative process in Parkinson's disease?

Key Findings ​

Key Insights on Parkinson's Disease ​

  1. Research Background and Purpose: Parkinson's disease (PD) is a progressive neurological disorder traditionally recognized for its motor symptoms, prominently characterized by the presence of Lewy bodies and the degeneration of dopaminergic neurons in the substantia nigra. However, recent insights reveal that PD is marked by a heterogeneous symptom profile, which includes significant non-motor features. The purpose of this research is to explore the evolving complexities of Parkinson's disease, including its pathophysiology, symptomatology, and the interplay of genetic and environmental factors, while identifying the clinical challenges faced in diagnosis and treatment.

  2. Main Methods and Findings: This Seminar involved a comprehensive literature review that synthesizes current understanding of Parkinson’s disease. Key findings indicate that the pathology of PD is not confined to dopaminergic neuron loss and Lewy bodies; rather, it encompasses a wider spectrum of neuroanatomical regions, neurotransmitter systems, and diverse protein aggregates. The research also highlights that the etiology of PD is multifactorial, with genetic predispositions and environmental exposures contributing to the disease's development. Crucially, the study emphasizes the challenges in early diagnosis and symptom management, as there is currently no therapeutic intervention that can halt the neurodegenerative processes in PD.

  3. Core Conclusions: The study concludes that Parkinson's disease presents a multi-dimensional challenge characterized by a complex interplay of motor and non-motor symptoms, extensive neuropathology, and an unclear etiology. While environmental factors were once considered primary risk contributors, the current understanding suggests that genetic factors play a significant role, complicating the disease's pathogenesis. Moreover, the inability to definitively diagnose PD in its earliest stages and the lack of disease-modifying treatments pose significant hurdles in patient care.

  4. Research Significance and Impact: The insights gained from this research carry profound implications for future studies and clinical practices regarding Parkinson's disease. Understanding the heterogeneous nature of PD and its multifaceted origins can guide the development of more targeted therapeutic strategies and improve diagnostic frameworks. By recognizing the non-motor symptoms and broader neural involvement, healthcare providers can adopt a more holistic approach to patient care. Ultimately, this research underscores the urgent need for innovative therapies that can modify the disease course, thereby enhancing the quality of life for individuals affected by Parkinson’s disease. The findings advocate for a paradigm shift in how PD is perceived and treated, integrating genetic, environmental, and symptomatic dimensions into future research and clinical applications.

Literatures Citing This Work ​

  1. Common therapeutic mechanisms of pallidal deep brain stimulation for hypo- and hyperkinetic movement disorders. - Kevin W McCairn;Atsushi Iriki;Masaki Isoda - Journal of neurophysiology (2015)
  2. Regulation of ABC efflux transporters at blood-brain barrier in health and neurological disorders. - Hisham Qosa;David S Miller;Piera Pasinelli;Davide Trotti - Brain research (2015)
  3. α-Synuclein and nonhuman primate models of Parkinson's disease. - Scott C Vermilyea;Marina E Emborg - Journal of neuroscience methods (2015)
  4. Dissecting the role of Engrailed in adult dopaminergic neurons--Insights into Parkinson disease pathogenesis. - Hocine Rekaik;François-Xavier Blaudin de Thé;Alain Prochiantz;Julia Fuchs;Rajiv L Joshi - FEBS letters (2015)
  5. Neurology--the next 10 years. - Ralf Baron;Donna M Ferriero;Giovanni B Frisoni;Chetan Bettegowda;Ziya L Gokaslan;John A Kessler;Annamaria Vezzani;Stephen G Waxman;Sven Jarius;Brigitte Wildemann;Michael Weller - Nature reviews. Neurology (2015)
  6. Effects of Auditory Rhythm and Music on Gait Disturbances in Parkinson's Disease. - Aidin Ashoori;David M Eagleman;Joseph Jankovic - Frontiers in neurology (2015)
  7. Common Polymorphisms in the Solute Carrier SLC30A10 are Associated With Blood Manganese and Neurological Function. - Karin Wahlberg;Maria Kippler;Ayman Alhamdow;Syed Moshfiqur Rahman;Donald R Smith;Marie Vahter;Roberto G Lucchini;Karin Broberg - Toxicological sciences : an official journal of the Society of Toxicology (2016)
  8. Cardiac 123I-MIBG scintigraphy: A window into the brain in Parkinsonism? - Lamotte Guillaume;Agostini Denis - Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (2017)
  9. Parkinson disease in 2015: Evolving basic, pathological and clinical concepts in PD. - Lorraine V Kalia;Anthony E Lang - Nature reviews. Neurology (2016)
  10. p11 modulates L-DOPA therapeutic effects and dyskinesia via distinct cell types in experimental Parkinsonism. - Nicoletta Schintu;Xiaoqun Zhang;Alexandra Alvarsson;Roberta Marongiu;Michael G Kaplitt;Paul Greengard;Per Svenningsson - Proceedings of the National Academy of Sciences of the United States of America (2016)

... (2625 more literatures)

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