Related Background Brief:

EARLY DIAGNOSIS OF PARKINSON'S DISEASE. In idiopathic Parkinson's
disease (IPD) approximately 60 % of the nigrostriatal neurons of
the substantia nigra (SN) are degenerated before neurologists can
establish the diagnosis according to the widely accepted clinical
diagnostic criteria. It is conceivable that neuroprotective
therapy starting at such an 'advanced stage' of the disease will
fail to stop the degenerative process. Therefore, the
identification of patients at risk and at earlier stages of the
disease appears to be essential for any successful
neuroprotection. The discovery of several genetic mutations
associated with IPD raises the possibility that these, or other
biomarkers, of the disease may help to identify persons at risk
of IPD. Transcranial ultrasound have shown susceptibility factors
for IPD related to an increased iron load of the substantia
nigra. In the early clinical phase, a number of motor and
particularly non-motor signs emerge, which can be identified by
the patients and physicians years before the diagnosis is made,
notably olfactory dysfunction, depression, or 'soft' motor signs
such as changes in handwriting, speech or reduced ambulatory arm
motion. These signs of the early, prediagnostic phase of IPD can
be detected by inexpensive and easy-to-administer tests. As one
single instrument will not be sensitive enough, a battery of
tests has to be composed measuring independent parameters of the
incipient disease. Subjects with abnormal findings in this test
battery should than be submitted to nuclear medicine examinations
to quantify the extent of dopaminergic injury and to reach the
goal of a reliable, early diagnosis. G. Becker et al: J Neurol
2002 249:III-40.