帕金森病早期诊断的生物学标志物

帕金森病是一种慢性进行性中枢神经系统退行性疾病.早在临床前期尚未出现典型临床症状时,帕金森病患者即已出现神经系统退行性病变.因此,如果能在退行性病变早期及时明确诊断并予以治疗,将会减缓疾病进程,提高患者生活质量.虽然目前尚未发现早期诊断帕金森病的理想标志物,但是已有许多生物学标志物具有研究和应用前景.     

帕金森病认知障碍的早期识别

认知功能障碍是帕金森病非运动症状的最常见表现之一,特定基因的突变与多态性、血浆及脑脊液中的某些生物标记物以及脑组织及功能改变的影像学表现均可能与帕金森病认知障碍的发生、发展相关.现从遗传学、血浆及脑脊液中的生物标记物以及影像学改变三方面对帕金森病认知障碍早期识别的研究现状及前景作一综述.     

帕金森病早期诊断技术新进展

帕金森病早期临床表现不典型 ,目前尚缺乏早期确诊的诊断工具。如何早期确诊帕金森病 ,抑制其进一步发展 ,是目前研究本病的热门课题。本文就最近几年国外对本病早期诊断技术的新进展作一综述。     

应重视帕金森病的诊断与治疗

运动障碍性疾病(movement disorders)是一组以随意运动迟缓、不自主运动、肌张力异常、姿势步态障碍等运动症状为主要表现的神经变性疾病、主要分为肌张力增高运动减少[帕金森病(PD)]和肌张力降低-运动过多[亨廷顿病(HD)]两大症候群。随着人口老龄化,帕金森病作为典型的运动障碍性疾病,其发病率和患病率在全球尤其是我国老年人群中呈现明显增长趋势。该病是由于脑深部黑质     

应重视帕金森病的诊断与治疗

运动障碍性疾病（movement disorders）是一组以随意运动迟缓、不自主运动、肌张力异常、姿势步态障碍等运动症状为主要表现的神经变性疾病。主要分为肌张力增高．运动减少[帕金森病（PD）]和肌张力降低一运动过多[亨廷顿病（HD）]两大症候群。     

帕金森病抑郁的治疗新进展

抑郁是帕金森病（PD）常见的非运动症状，其严重影响患者的生活质量，增加照料者的负 担。然而，PD 抑郁往往不易识别，治疗率较低。PD 抑郁的治疗虽不乏可选择的药物和方法，但尚缺乏 高质量的循证医学证据。现从药物、重复经颅磁刺激、脑深部刺激、电休克、认知行为疗法等方面阐述 PD抑郁的治疗进展。     

帕金森病认知障碍的生物学指标研究进展

帕金森病认知障碍是严重影响老年人社会功能和生活质量的疾病,早期发现、早期诊断及早期治疗可明显改善其预后,并提高患者生活质量,因此对帕金森病认知障碍的早期识别尤为重要。本文就有关帕金森病认识障碍早期相关生物学指标的研究进展做一综述,以探讨其在帕金森病认知障碍早期诊断中的价值及意义。     

从文献分析看我国帕金森病及运动障碍性疾病研究进程

运动障碍性疾病曾称锥体外系疾病,由锥体外系结构异常和功能障碍所致,主要表现为随意运动调节障碍,而对肌力、感觉和小脑功能无明显影响.临床症状分为肌张力降低和(或)运动过多症候群以及肌张力增高和(或)运动减少症候群,前者表现为异常不自主运动,后者则以运动贫乏为特征.     

CSF biomarkers in different phenotypes of Parkinson disease

CSF biomarker studies were performed in 6 patients each with tremor-dominant (TD) and non-tremor-dominant (NT) Parkinson disease (PD) patients, 27 Alzheimer disease (AD) and 17 age-matched controls. In both NT-PD and AD patients total tau levels and the cortex tau/Aβ-42 were significantly increased compared to both TD-PD patients and controls (p < 0.01). These data in a small cohort confirm previous studies, corroborating the opinion that CSF levels of tau protein and the index total-tau/Aβ-42 may be potential markers of the severity of neurodegeneration in PD.     

Neuroimaging biomarkers for Parkinson disease: Facts and fantasy

In this grand rounds, we focus on development, validation, and application of neuroimaging biomarkers for Parkinson disease (PD). We cover whether such biomarkers can be used to identify presymptomatic individuals (probably yes), provide a measure of PD severity (in a limited fashion, but frequently done poorly), investigate pathophysiology of parkinsonian disorders (yes, if done carefully), play a role in differential diagnosis of parkinsonism (not well), and investigate pathology underlying cognitive impairment (yes, in conjunction with postmortem data). Along the way, we clarify several issues about definitions of biomarkers and surrogate endpoints. The goal of this lecture is to provide a basis for interpreting current literature and newly proposed clinical tools in PD. In the end, one should be able to critically distinguish fact from fantasy. Ann Neurol 2014;76:769–783     

经脑间质给药治疗帕金森病的研究新进展

帕金森病（PD）是一种常见的神经系统变性疾病,其致病因素除细胞功能紊乱及有毒物质作用外,细胞外微环境异常也逐渐受到关注,与此相关的前沿治疗方法主要包括对流增强给药和简单扩散给药,尤其后者的高效性及安全性已在多项研究中得到证实。现以脑间质治疗手段为基础,重点介绍国内学者研发的简单扩散给药在PD治疗领域的全新应用。     

Seeking progress in disease modification in Parkinson disease

ObjectiveDisease modification in Parkinson disease (PD) has remained an elusive goal, in spite of large investments over several decades. Following a large meeting of experts, this review article discusses the state of the science, possible reasons for past PD trials’ failures to demonstrate disease-modifying benefit, and potential solutions.MethodsThe National Institute of Neurological Disorders and Stroke (NINDS) convened a meeting including leaders in the field and representatives of key stakeholder groups to discuss drug therapy with the goal of disease modification in PD.ResultsImportant lessons can be learned from previous attempts, as well as from other fields. The selection process for therapeutic targets and agents differs among various organizations committed to therapeutic development. The areas identified as critical to target in future research include the development of relevant biomarkers, refinements of the targeted patient populations, considerations of novel trial designs, and improving collaborations between all stakeholders.ConclusionsWe identify potential barriers to progress in disease modification for Parkinson's and propose a set of research priorities that may improve the likelihood of success.