1. Links
1.1. Recognition and Management of Parkinson's Disease during the Premotor (Prodromal) Phase --> http://www.medscape.com/viewarticle/705802
1.2. Prospective association between emotional health and clinical evidence of Parkinson's disease --> http://cmk-proxy.mf.uni-lj.si:2068/pubmed/18795943
1.3. Nonmotor symptoms as presenting complaints in Parkinson's disease: a clinicopathological study --> http://cmk-proxy.mf.uni-lj.si:2068/pubmed/17994582
1.4. Symptoms and duration of the prodromal phase in parkinson's disease --> http://www3.interscience.wiley.com/journal/109747690/abstract?CRETRY=1&SRETRY=0
1.5. The prodromal phase of sporadic Parkinson's disease: Does it exist and if so how long is it? --> http://www3.interscience.wiley.com/journal/121392121/abstract
1.5.1. Estimates for the duration of the prodromal phase vary from months to decades. It is concluded that there probably is an early phase in the disease where a variety of nonmotor features develop, but the sequence and time of onset of such features is not well established.
1.6. Olfactory testing combined with dopamine transporter imaging as a method to detect prodromal Parkinson’s disease -->
1.7. Parkinson's at risk syndrome: can Parkinson's disease be predicted? --> http://cmk-proxy.mf.uni-lj.si:2068/pubmed/20187248
1.8. When Does Parkinson Disease Start? --> http://archneur.ama-assn.org/cgi/content/short/67/7/798
2. known prodromal symptoms
2.1. autonomic disorders
2.1.1. Gastrointestinal dysfunction
2.1.1.1. One group of healthy individuals and One group of people PD -> ask them about GIT dysfunction
2.1.1.1.1. Is the prevalence of GIT dysfunction higher in PD patients?
2.1.1.1.2. Cause? Dopaminergic receptors in GIT?
2.1.2. cardiovascular dysfunction
2.1.3. New insights into the pathology of Parkinson's disease: does the peripheral autonomic system become central? http://www.ncbi.nlm.nih.gov/pubmed/18353130
2.2. sleep disorders
2.2.1. Does Heart Rate variability differ from patients with a sleep behavior disorder and various PD risk factors with PD patients with a REM sleep behavior disorder?
2.2.1.1. Part of Answer!
2.2.2. What's the effect of arousal in sleep on heartrate?
2.2.2.1. Is there a difference in PD patients?
2.2.2.2. Is this a measure for autonomic nerve system involvement in prodromal phase?
2.2.3. Definition of REM sleep Behavior Disorder
2.2.4. Measurements for REM Sleep behavior disorder
2.2.4.1. Polysomnography
2.2.4.2. Simple Heart rate monitoring
2.2.4.2.1. Measure: heartrate variability as sign of autonomic nervous system function
2.3. sensory dysfunctions
2.3.1. Anosmia
2.3.1.1. Study participant selection
2.3.1.1.1. Olfactory testing of partners of PD patients
2.3.1.1.2. Additional tests on patients with lowest scores and same number of normal scores as control
2.3.1.1.3. Questionnaire evaluation after 5 years for full group
2.4. neuropsychiatric disordes
2.4.1. Apathy
2.4.2. anxiety and panic attacks
2.4.3. mood disturbances
2.4.4. mild cognitive impairment
2.4.5. psychosis
2.5. H. pylori: http://www.ncbi.nlm.nih.gov/pubmed/10971237
2.5.1. DOPAMINERGIC NEUROTRANSMITION OUTSIDE CNS: http://en.wikipedia.org/wiki/Dopamine_receptor ;)
3. Why this topic?
3.1. Make a connection with prodromal symptoms and pathophysiological mechanisms
3.2. To find possibility to delay onset of motor symptoms
3.3. Identify possibilities to start monitoring progress of the disease in an early stage
3.4. Sth triggers the process that at first leads to non motor then motor symptoms -> WHAT are the TRIGGERS?
3.4.1. Virus??
3.4.2. Lack of a vitamins??
3.4.3. Autoimmune disease??
3.4.4. prion like protein activity
3.4.4.1. Where does this protein cause initial damage?
3.4.4.2. Which neurons are affected?
3.4.4.2.1. Dopamine loss a cause or a result?
3.4.4.3. Infectious particle or an accidental misfolding which induces prion behaviour
4. why early recognition
4.1. Can we start treating non motor symptoms?
4.1.1. Do we need to?
4.1.2. There's no disease modifying drug
4.1.3. Would physicial exercise be a way to delay motor symptom onset?
4.2. Can we start studying PD earlier?
4.3. Can we identify causal relations with next disease phases?
5. What is the relative contributing value of each of these symptoms to PD or other dieases
6. Pre-motor Pathophysiology
6.1. There MAY be dopamine loss in this phase
6.1.1. Hypothesis: dopaminergic cell loss is a cause of the pathology
6.2. There may not be dopamine loss
6.2.1. Hypothesis: dopaminergic cell loss is a result of pathology