Conference Proceeding

Parkinson & Other Movement Disorders Center UC San Diego USA

Irene Litvan

Our better understanding of the risks factors for Parkinson disease, where does the disease start and how it progresses has significantly changed over the past few years. These advances are based on the confluence of neuropathologic, clinical and experimental transgenic mice models’ data. These breakthroughs have allowed us to redefine Parkinson disease and divide its course in four stages: Preclinical, Prodromal, Early and Advanced disease. It has also allowed us to search for novel diagnostic biomarkers and innovative therapeutic approaches.

Parkinson disease is no longer considered only a motor disorder affecting dopaminergic pathways. It is clear that it affects multiple pathways and systems and that in addition to motor dysfunction, lead to cognitive, mood and autonomic disturbances. This knowledge has allowed clinicians to treat these important symptoms which cause major disturbance and affect the quality of life of some Parkinson disease patients. The non-motor features have also helped to redefine Parkinson disease and define Prodromal Parkinson disease, a stage in which patients are at an early disease stage, when therapies are supposed to be more effective.

Therefore, patients with Prodromal Parkinson disease are an ideal group to participate in neuroprotective therapeutic studies. One of the major prodromal Parkinson disease clinical features is REM sleep behavior disorder. In fact, REM sleep behavior disorder precedes or associates with Parkinson disease and other synucleinopathies such as dementia with Lewy bodies and less frequently multiple system atrophy. These disorders are considered synucleinopathies because phosphorylated synuclein aggregates in affected areas. It is estimated that the risk of patients with REM sleep behavior to phenoconvert to a synucleinopathy is approximately 33% at 5 years, 76% at 10 years, and 91% at 14 years. It is hoped that when novel disease modifying therapies will slow the progression of the synucleinopathies, new efforts will be placed in identifying patients with REM sleep behavior, Prodromal or early Parkinson disease.

Published: 17 October 2017


Copyright: © 2017 Irene Litvan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.