Journal
LANCET NEUROLOGY
Volume 12, Issue 5, Pages 514-524Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S1474-4422(13)70047-4
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Funding
- Michael J Fox Foundation
- Bundesministerium fur Bildung und Forschung (BmBF)
- dPV (German Parkinson's disease association)
- Abbott
- Center of Integrative Neurosciences
- Internationale Parkinson Fonds
- Janssen
- TEVA
- UCB Pharma
- Canadian Institutes of Health Research
- Dystonia Medical Research Foundation
- National Parkinson Foundation
- Parkinson Society of Canada
- Ontario Problem Gambling Research Center
- Saunders
- Wiley-Blackwell
- Johns Hopkins Press
- Cambridge University Press
- Novartis
- Fonds de la Recherche en Sante du Quebec
- Webster Foundation
- Robert Bosch Foundation
- EU
- University of Tubingen
- Orion
- Lundbeck
- Pfizer
- Thieme publishers
- German Ministry of Education and Health
- Medtronic
- Cefalon Pharma
- Merck-Serono
- Boehringer Ingelheim
- Valeant Pharma
- Federal Ministry of Education and Research
- Helmholtz Association
- European Community
- German Ministry of Education and Research
- Spanish Science and Education Ministry
- European Union (REPLACES)
- AstraZeneca
- GlaxoSmithKline
- UCB
- Orion Pharma
- Merck Serono
- Merz Pharmaceuticals
Ask authors/readers for more resources
Recent findings question our present understanding of Parkinson's disease and suggest that new research criteria for the diagnosis of Parkinson's disease are needed, similar to those recently defined in Alzheimer's disease. However, our ability to redefine Parkinson's disease is hampered by its complexity and heterogeneity in genetics, phenotypes, and underlying molecular mechanisms; the absence of biochemical markers or ability to image Parkinson's disease-specific histopathological changes; the long prodromal period during which non-motor manifestations might precede classic motor manifestations; and uncertainty about the status of disorders diagnosed clinically as Parkinson's disease but without Lewy pathology. Although it is too early to confidently redefine Parkinson's disease, the time has come to establish a research framework that could lead to new diagnostic criteria. We propose the establishment of three tiers encompassing clinical features, pathological findings, and genetics or molecular mechanisms. Specific advances in each tier, bridged by neuroimaging and biochemical data, will eventually lead to a redefinition of Parkinson's disease.
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