Recent advances in the pathology of prodromal non-motor symptoms olfactory deficit and depression in Parkinson’s disease: clues to early diagnosis and effective treatment

다국어 초록 (Multilingual Abstract)

Parkinson’s disease (PD) is a progressive neurodegenerativedisease characterized by movement dysfunctiondue to selective degeneration of dopaminergic neuronsin the substantia nigra pars compacta. Non-motor symptomsof PD (e.g., sensory dysfunction, sleep disturbance, constipation,neuropsychiatric symptoms) precede motor symptoms,appear at all stages, and impact the quality of life,but they frequently go unrecognized and remain untreated.
Even when identifi ed, traditional dopamine replacementtherapies have little eff ect. We discuss here the pathologyof two PD-associated non-motor symptoms: olfactory dysfunctionand depression. Olfactory dysfunction is one ofthe earliest non-motor symptoms in PD and predates theonset of motor symptoms. It is accompanied by early depositionof Lewy pathology and neurotransmitter alterations.
Because of the correlation between olfactory dysfunctionand an increased risk of progression to PD, olfactory testingcan potentially be a specifi c diagnostic marker of PD in theprodromal stage. Depression is a prevalent PD-associatedsymptom and is often associated with reduced quality oflife. Although the pathophysiology of depression in PD isunclear, studies suggest a causal relationship with abnormalneurotransmission and abnormal adult neurogenesis. Here,we summarize recent progress in the pathology of the nonmotorsymptoms of PD, aiming to provide better guidancefor its eff ective management.

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