Research on the premotor symptoms of Parkinson's disease: Clinical and etiological implications

Honglei Chen, Edward A. Burton, G. Webster Ross, Xuemei Huang, Rodolfo Savica, Robert D. Abbott, Alberto Ascherio, John Nathaniel Caviness, Xiang Gao, Kimberly A. Gray, Jau Shyong Hong, Freya Kamel, Danna Jennings, Annette Kirshner, Cindy Lawler, Rui Liu, Gary W. Miller, Robert Nussbaum, Shyamal D. Peddada, Amy Comstock RickBeate Ritz, Andrew D. Siderowf, Caroline M. Tanner, Alexander I. Tröster, Jing Zhang

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: The etiology and natural history of Parkinson's disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. Objectives: We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. Methods: This review was based on a workshop, Parkinson's Disease Premotor Symptom Symposium, held 7-8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Discussion: Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. Conclusion: This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis.

Original languageEnglish (US)
Pages (from-to)1245-1252
Number of pages8
JournalEnvironmental Health Perspectives
Volume121
Issue number11-12
DOIs
StatePublished - Nov 2013

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Parkinson Disease
Research
National Institute of Environmental Health Sciences (U.S.)
REM Sleep Behavior Disorder
Prodromal Symptoms
Olfactory Bulb
Constipation
Gastrointestinal Tract
Viruses
Education

ASJC Scopus subject areas

  • Health, Toxicology and Mutagenesis
  • Public Health, Environmental and Occupational Health

Cite this

Research on the premotor symptoms of Parkinson's disease : Clinical and etiological implications. / Chen, Honglei; Burton, Edward A.; Ross, G. Webster; Huang, Xuemei; Savica, Rodolfo; Abbott, Robert D.; Ascherio, Alberto; Caviness, John Nathaniel; Gao, Xiang; Gray, Kimberly A.; Hong, Jau Shyong; Kamel, Freya; Jennings, Danna; Kirshner, Annette; Lawler, Cindy; Liu, Rui; Miller, Gary W.; Nussbaum, Robert; Peddada, Shyamal D.; Rick, Amy Comstock; Ritz, Beate; Siderowf, Andrew D.; Tanner, Caroline M.; Tröster, Alexander I.; Zhang, Jing.

In: Environmental Health Perspectives, Vol. 121, No. 11-12, 11.2013, p. 1245-1252.

Research output: Contribution to journalArticle

Chen, H, Burton, EA, Ross, GW, Huang, X, Savica, R, Abbott, RD, Ascherio, A, Caviness, JN, Gao, X, Gray, KA, Hong, JS, Kamel, F, Jennings, D, Kirshner, A, Lawler, C, Liu, R, Miller, GW, Nussbaum, R, Peddada, SD, Rick, AC, Ritz, B, Siderowf, AD, Tanner, CM, Tröster, AI & Zhang, J 2013, 'Research on the premotor symptoms of Parkinson's disease: Clinical and etiological implications', Environmental Health Perspectives, vol. 121, no. 11-12, pp. 1245-1252. https://doi.org/10.1289/ehp.1306967
Chen, Honglei ; Burton, Edward A. ; Ross, G. Webster ; Huang, Xuemei ; Savica, Rodolfo ; Abbott, Robert D. ; Ascherio, Alberto ; Caviness, John Nathaniel ; Gao, Xiang ; Gray, Kimberly A. ; Hong, Jau Shyong ; Kamel, Freya ; Jennings, Danna ; Kirshner, Annette ; Lawler, Cindy ; Liu, Rui ; Miller, Gary W. ; Nussbaum, Robert ; Peddada, Shyamal D. ; Rick, Amy Comstock ; Ritz, Beate ; Siderowf, Andrew D. ; Tanner, Caroline M. ; Tröster, Alexander I. ; Zhang, Jing. / Research on the premotor symptoms of Parkinson's disease : Clinical and etiological implications. In: Environmental Health Perspectives. 2013 ; Vol. 121, No. 11-12. pp. 1245-1252.
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abstract = "Background: The etiology and natural history of Parkinson's disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. Objectives: We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. Methods: This review was based on a workshop, Parkinson's Disease Premotor Symptom Symposium, held 7-8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Discussion: Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. Conclusion: This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis.",
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AU - Chen, Honglei

AU - Burton, Edward A.

AU - Ross, G. Webster

AU - Huang, Xuemei

AU - Savica, Rodolfo

AU - Abbott, Robert D.

AU - Ascherio, Alberto

AU - Caviness, John Nathaniel

AU - Gao, Xiang

AU - Gray, Kimberly A.

AU - Hong, Jau Shyong

AU - Kamel, Freya

AU - Jennings, Danna

AU - Kirshner, Annette

AU - Lawler, Cindy

AU - Liu, Rui

AU - Miller, Gary W.

AU - Nussbaum, Robert

AU - Peddada, Shyamal D.

AU - Rick, Amy Comstock

AU - Ritz, Beate

AU - Siderowf, Andrew D.

AU - Tanner, Caroline M.

AU - Tröster, Alexander I.

AU - Zhang, Jing

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N2 - Background: The etiology and natural history of Parkinson's disease (PD) are not well understood. Some non-motor symptoms such as hyposmia, rapid eye movement sleep behavior disorder, and constipation may develop during the prodromal stage of PD and precede PD diagnosis by years. Objectives: We examined the promise and pitfalls of research on premotor symptoms of PD and developed priorities and strategies to understand their clinical and etiological implications. Methods: This review was based on a workshop, Parkinson's Disease Premotor Symptom Symposium, held 7-8 June 2012 at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. Discussion: Research on premotor symptoms of PD may offer an excellent opportunity to characterize high-risk populations and to better understand PD etiology. Such research may lead to evaluation of novel etiological hypotheses such as the possibility that environmental toxicants or viruses may initiate PD pathogenesis in the gastrointestinal tract or olfactory bulb. At present, our understanding of premotor symptoms of PD is in its infancy and faces many obstacles. These symptoms are often not specific to PD and have low positive predictive value for early PD diagnosis. Further, the pathological bases and biological mechanisms of these premotor symptoms and their relevance to PD pathogenesis are poorly understood. Conclusion: This is an emerging research area with important data gaps to be filled. Future research is needed to understand the prevalence of multiple premotor symptoms and their etiological relevance to PD. Animal experiments and mechanistic studies will further understanding of the biology of these premotor symptoms and test novel etiological hypothesis.

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