Prodromal Parkinson's disease

抄録

Parkinson's disease is a neurodegenerative disease characterized by the cardinal motor features, which is clinically evident and diagnosed when the motor symptoms appear. Pathological or neuroimaging researches have already revealed that pathobiological initiation of Parkinson's disease is several years prior to motor manifestations. In the Parkinson's disease at–risk syndrome study, Parkinson's disease before clinically evident is divided into 4 phases. The phase illustrated by the cardinal motor features but without clinical diagnosis of parkinsonism is defined as the pre–diagnostic phase. The phase before showing motor features is defined as the pre–motor phase and the pre–clinical phase, which are illustrated by only nonmotor symptoms and only neuroimaging evidence, respectively. Recent advances in therapeutic innovation can target the disease modifying effect in Parkinson's disease. In order to define at–risk individuals of Parkinson's disease and enable to recruit appropriate subjects to clinical trials developing the disease modifying therapy of Parkinson's disease, the concept of prodromal Parkinson's disease is proposed. Prodromal Parkinson's disease is regarded as individuals in the pre–motor phase and the pre–clinical phase. Some clinical researches aiming to detect biomarkers of prodromal Parkinson's disease are ongoing in the world. In 2015, the Movement Disorder Society reported a research criteria of prodromal Parkinson's disease. Brand–new therapeutic candidates are also reported in the international congresses. This review summarizes the recent developments in understanding the concept of prodromal Parkinson's disease.