OBJECTIVE TEST FOR EARLY PARKINSONS SYNDROME

描述：（申请人摘要）拟议项目的目标是 开发一组测试（PD电池），可以提供一个廉价的 和客观的帮助，首先，帕金森综合征的早期诊断 (PS)第二，有助于鉴别诊断，如特发性 帕金森氏病（iPD）;帕金森综合征（P-Plus），如 黑质纹状体变性;和特发性震颤（ET）， 震颤型帕金森综合征等。 PD电池已 在初步研究中，它清楚地区分了正常的 对照（NC）受试者和早期轻度推定iPD患者（95 94%的灵敏度，94%的特异性和 受试者-操作者曲线[ROC]为0.98）。 该电池包括测试， 运动功能、嗅觉和情感状态（即，抑郁症）。 当 在一项前瞻性研究中，对额外的NC受试者和iPD患者进行了研究。 以这种方式，测试组合正确地识别了48名NC受试者中的44名和10名NC受试者中的10名。 11例iPD患者 此外，9例ET患者中有7例有检测结果 在正常范围内，这表明电池可以帮助 鉴别震颤为主的iPD和ET。 下一步是通过前瞻性测试验证PD电池 疑似PS但诊断不确定的患者（ 不确定PS组）。 这些患者将接受PD组合，统一 帕金森病评定量表（PDRS）。 两 几年后，MRI扫描和运动测试前后， 将进行左旋多巴给药。 这些测试应该确定哪些 这些患者可能变得正常，可能是iPD或可能是P-Plus。 这些评价的结果将与其在 进入研究时的PD电池。 为了进一步验证 组合，更多的NC受试者和患者：1）新诊断和轻度 受累PS; 2）P-Plus综合征; 3）ET; 4）轻度阿尔茨海默病（AD） 和5）将测试具有帕金森特征的AD（AD/PD）。 如果成功，PD电池可以帮助确保适当的患者接受 适当的护理，从而最大限度地减少医疗费用和残疾。 在 未来，PD电池可以允许早期或临床前检测 处于危险中的人。 这种电池用于早期检测， 神经保护疗法，可以进一步降低健康成本， 残疾。 此外，该试验电池将来可用于 帮助研究iPD的可能遗传和/或环境原因。

DESCRIPTION: (Applicant's Abstract) The goal of the proposed project is to develop a battery of tests (PD Battery) that could provide an inexpensive and objective aid for, first, the early diagnosis of Parkinson's syndrome (PS) and second, to aid in its differential diagnosis, such as idiopathic Parkinson's disease (iPD); Parkinson-Plus syndromes (P-Plus) such as striato-nigral degeneration; and essential tremor (ET) as distinguished from tremor predominant parkinsonism and others. The PD Battery has been developed that, in preliminary studies, clearly distinguishes between normal control (NC) subjects and patients with early mild presumptive iPD (95 percent sensitivity, 94 percent specificity and the area under the receiver-operator curve [ROC] of 0.98). The battery incorporates tests of motor function, olfaction, and affective state (i.e., depression). When additional NC subjects and iPD patients were studied in a prospective manner, the test battery correctly identified 44 of 48 NC subjects and 10 of the 11 iPD patients. In addition, 7 of 9 patients with ET had test results in the normal range suggesting that the battery can aid in the differentiation of tremor predominant iPD and ET. The next step is to validate the PD Battery by prospectively testing patients in whom PS is suspected but the diagnosis is uncertain (the Uncertain PS group). These patients will undergo the PD Battery, Unified Parkinson Disease Rating Scale (UPDRS) upon entrance into the study. Two years later, a MRI scan and the UPDRS and motor testing before and after levodopa administration will be done. These tests should identify which of these patients become probably normal, probably iPD or Probable P-Plus. Results of these evaluations will be correlated with their results from the PD Battery at time of entrance into the study. To further validate the battery, more NC subjects and patients with: 1) newly diagnosed and mildly affected PS; 2) P-Plus syndromes; 3) ET; 4) mild Alzheimer's disease (AD) and 5) AD with parkinsonian features (AD/PD) will be tested. If successful, the PD Battery could help assure appropriate patients receive appropriate care, thus, minimizing health costs and disability. In the future, the PD Battery could allow early or pre-clinical detection of persons at risk. this battery for early detection, coupled with future neuro-protective therapies, could further reduce health costs and disability. In addition , the test battery could be used in the future to aid research into the possible genetic and/or environmental causes of iPD.