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Vol. 5, No. 3-4, 2008
Issue release date: March 2008

Biomarkers for the Early Detection of Parkinson’s and Alzheimer’s Disease

Berg D.
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Abstract

In the aging population of many countries in the world, neurodegenerative diseases like Parkinson’s disease (PD) are becoming an increasing burden. Therefore, early therapy and ultimately disease prevention is essential, which is only possible with an early diagnosis. Besides a genetic predisposition, a number of biomarkers are being discussed to indicate vulnerability to PD, some of them many years before disease manifestation. These include hyperechogenicity of the substantia nigra as well as premotor symptoms like olfactory and autonomic dysfunction, depression, REM sleep behavior disorder, and neuropsychological impairment. Moreover, first signs of affection of the substantia nigra like PET and SPECT abnormalities and slight motor signs can be included, as they may be detected before a definite diagnosis according to motor symptoms can be made. Interestingly, other frequent neurodegenerative disorders like Alzheimer’s disease (AD) are also characterized by a long preclinical period, with several biomarkers discussed as indicative for disease vulnerability including cerebrospinal fluid, serum, and neuroimaging biomarkers, olfactory dysfunction as well as subtle neuropsychological deficits. However, future studies are necessary, which establish the predictive value of these markers singularly and in combination to detect a subgroup of the population at risk for PD and AD not only to accelerate research on etiology and pathophysiology but also to promote testing for neuroprotective strategies.



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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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References

  1. Berg D:Marker for a preclinical diagnosis of Parkinson’s disease as a basis for neuroprotection. J Neural Transm Suppl 2006;71:123–132.

    External Resources

  2. Siderowf A, Stern MB: Preclinical diagnosis of Parkinson’s disease: are we there yet? Curr Neurol Neurosci Rep 2006;6:295–301.
  3. Berg D, Behnke S, Walter U: Application of transcranial sonography in extrapyramidal disorders: updated recommendations. Ultraschall Med 2006;27:12–19.
  4. Berg D, Merz B, Reiners K, Naumann M, Becker G: Five-year follow-up study of hyperechogenicity of the substantia nigra in Parkinson’s disease. Mov Disord 2005;20:383–385.
  5. Berg D: Transcranial sonography in the early and differential diagnosis of Parkinson’s disease. J Neural Transm Suppl 2006;70:249–254.

    External Resources

  6. Schweitzer KJ, Behnke S, Liepelt I, Wolf B, Grosser C, Godau J, Gaenslen A, Bruessel T, Wendt A, Abel F, Müller A, Gasser T, Berg D: Cross-sectional study discloses a positive family history for Parkinson’s disease and male gender as epidemiological risk factors for substantia nigra hyperechogenicity. J Neural Transm 2007;114:1167–1171.
  7. Berg D, Hochstrasser H, Schweitzer KJ, Riess O: Disturbance of iron metabolism in Parkinson’s disease – Ultrasonography as a biomarker. Neurotox Res 2006;9:1–13.
  8. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308.
  9. Modrego PJ: Predictors of conversion to dementia of probable Alzheimer type in patients with mild cognitive impairment. Curr Alzheimer Res 2006;3:161–170.
  10. de Leon MJ, DeSanti S, Zinkowski R, Mehta PD, Pratico D, Segal S, Rusinek H, Li J, Tsui W, Saint Louis LA, Clark CM, Tarshish C, Li Y, Lair L, Javier E, Rich K, Lesbre P, Mosconi L, Reisberg B, Sadowski M, DeBernadis JF, Kerkman DJ, Hampel H, Wahlund LO, Davies P: Longitudinal CSF and MRI biomarkers improve the diagnosis of mild cognitive impairment. Neurobiol Aging 2006;27:394–401.
  11. Wang QS, Tian L, Huang YL, Qin S, He LQ, Zhou JN: Olfactory identification and apolipoprotein E epsilon 4 allele in mild cognitive impairment. Brain Res 2002;951:77–81.


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