The Changing Face of Parkinsonian Neurodegeneration

Czech version

Authors: K. Menšíková ¹; P. Kaňovský ¹; M. Kaiserová ¹; I. Nestrašil ²; M. Bareš ³
Authors‘ workplace: Neurologická klinika LF UP a FN Olomouc ¹; Department of Neurology and Brain Sciences Center, University of Minnesota, MN, USA ²; I. neurologická klinika LF MU a FN u sv. Anny v Brně ³
Published in: Cesk Slov Neurol N 2013; 76/109(1): 26-34
Category: Review Article

Overview

Parkinson’s disease continues to be described as a relatively homogenous nosological entity, characterised by the presence of four cardinal signs – bradykinesia, rigidity, tremor and postural instability – with a variable presence of other motor and non-motor symptoms (cognitive, behavioral, vegetative etc.); its pathological basis being the continuous progression of brain alpha-synucleinopathy. It seemed that this clinical entity might be relatively easily diagnosed using the United Kingdom Parkinson’s Disease Brain Bank (UK--PDBB) clinical diagnostic criteria that are based on the results of a retrospective clinical and pathological study. However, substantial opinion shift occurred as a result of the recent intensive field research. A distinction has arbitrarily been made between Dementia with Lewy bodies and Parkinson’s disease dementia. Several next mutations (PARK10–PARK13, PARK16–PARK18) encoding the manifestation of “sporadic“, late-onset and typical Parkinson’s disease have been added to the existing spectrum of familiar Parkinson’s disease. Therefore, the term “Parkinson’s disease” should be used for the “sporadic” form of the disease only. However, for the “definite” or “highly probable” level of diagnostic accuracy, the UK-PDBB criteria are less useful. The term “neurodegenerative Parkinsonism” would probably better reflect current level of diagnostic certainty referring to Parkinson’s disease.

Key words:
Parkinson’s disease – hereditary parkinsonism – neurodegenerative parkinsonism

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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