Autonomic disorders predicting Parkinson's disease.
Autonomic disorders predicting Parkinson's disease.
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DOI：
10.1016/s1353-8020(13)70024-5
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发表时间：
2014-01
影响因子：
4.1
通讯作者：
Kaufmann, Horacio
中科院分区：
文献类型：
--
作者：
Palma, Jose-Alberto;Kaufmann, Horacio
帕金森病的运动前阶段是由中枢神经系统特异性神经元变性引起的嗅觉减退和REM睡眠行为障碍。大多数PD患者在诊断时描述了自主神经症状，这表明这些特征可能具有潜在的敏感性，可作为运动前阶段的临床生物标志物。认识到外周自主神经元的损伤存在于帕金森病的早期阶段，导致寻找可以作为预测生物标志物的自主神经功能的特定异常。有证据表明，便秘，排尿和性功能障碍，以及最近在运动过程中心脏变时性反应降低，是运动前帕金森病表型的一部分。这些特征的敏感性和特异性还有待准确评估。我们简要回顾了自主神经功能障碍作为运动前PD生物标志物的证据。
It is now well recognized that there is a premotor phase of Parkinson disease with hyposmia and REM sleep behavior disorder caused by degeneration of specific CNS neurons. Most patients with PD describe autonomic symptoms at the time of diagnosis suggesting that these features may have potential sensitivity as clinical biomarkers of the premotor phase. The recognition that damage to peripheral autonomic neurons is present in the early stages of Parkinson disease has led to a search for specific abnormalities in autonomic function that could serve as predictive biomarkers. There is evidence that constipation, urinary and sexual dysfunction and more recently decreased cardiac chronotropic response during exercise, are part of the premotor parkinsonian phenotype. The sensitivity and specificity of these features has yet to be accurately assessed. We briefly review the evidence for autonomic dysfunction as biomarkers of premotor PD.