Frühsymptome und neuropsychiatrische symptome bei der parkinson-erkrankung

At the time of diagnosis of Parkinson's disease (PD), more than 50% of the dopaminergic neurons in the substantia nigra are lost. The identification of phases preceding manifest PD is an important aim. Non-motor symptoms (NMS) are an integral part of the PD phenotype and may serve as markers for prediagnostic PD phases. Characterization of prediagnostic PD may enable neuroprotective therapies and facilitate research of causal factors. We summarize the literature on early symptoms and the associated risk for future PD. Information required to use NMS as markers of early disease is identified. Lastly, we summarize current knowledge on NMS frequency in PD patients as compared to the general population and list the recommended diagnostic instruments for NMS. Possible implications of NMS and early markers are discussed and next steps to use this knowledge for improved therapy and new research applications are considered.