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首页> 外文期刊>The European Journal of Neuroscience >The clinical heterogeneity of Parkinson's disease and its therapeutic implications
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The clinical heterogeneity of Parkinson's disease and its therapeutic implications

机译：帕金森病的临床异质性及其治疗意义

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ABSTRACT: Although Parkinson's disease (PD) is primarily a movement disorder, there are a range of associated nonmotor symptoms, including cognitive impairment, depression and sleep disturbance. These can occur throughout the disease course, even predating the motor syndrome. However, both motor and nonmotor symptoms are variable between individual patients. Rate of disease progression is also heterogenous: although 50% have reached key milestones of either postural instability or dementia within 4 years from diagnosis, almost a quarter have a good prognosis at 10 years. In this review we discuss how a range of different factors including clinical features, pathology and genetics, have been used to describe the heterogeneity of PD. We explore the value of longitudinal studies of incident PD cohorts, based on our own experience in Cambridgeshire, to define differences in rates of disease progression and predictors of outcome, including how such studies have informed the development of prognostic models which can be used at an individual patient level. Finally, we discuss the benefits of better understanding the basis of heterogeneity of PD in terms of implications for the development and trialling of more targeted therapies for different subgroups of patients, including regenerative approaches. ? 2018 Federation of European Neuroscience Societies and John Wiley & Sons Ltd
机译：摘要：虽然帕金森病（PD）主要是运动障碍，但有一系列相关的非运动症状，包括认知障碍，抑郁和睡眠障碍。这些可以在整个疾病过程中发生，甚至可以预测电机综合症。然而，在各个患者之间，电机和非运动症状都是可变的。疾病进展率也异源性：虽然50％达到了诊断4年内患者不稳定或痴呆的关键里程碑，但几乎四分之一在10年内具有良好的预后。在本文中，我们讨论了一系列不同因素，包括临床特征，病理和遗传学，用于描述PD的异质性。我们探讨事件PD队列的纵向研究的价值，基于我们在剑桥郡的自己的经验，以定义疾病进展和结果预测因子的差异，包括这些研究如何了解可以在疾病的开发个体患者水平。最后，我们讨论了更好地理解PD的异质性基础的益处，在对患者的不同亚组的更多有针对性疗法的开发和试验中的影响，包括再生方法。还2018年欧洲神经科学协会联合会和约翰瓦里＆SONS LTD

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