LAUSR

Parkinson’s disease (PD) is the second most common neurodegenerative disorder affecting more than 1% of the older population. Histopathologically, PD is characterized by a severe loss of dopaminergic neurons in the substantia nigra and cytoplasmic inclusions composed of insoluble protein aggregates (Lewy bodies), which lead to a progressive movement disorder including the classic triad of tremor, bradykinesia, and rigidity. Significant motor impairments are the core symptoms of this disease but usually occur at the middle to late stage after the majority of dopaminergic neuronal loss. Therefore, the diagnosis of this disease is largely delayed, causing difficulty in its management. Early pre-motor diagnosis seems to be essential to prevent the disease or delay its onset. Current research interest is therefore to optimize diagnosis in the prodromal stage and to propose personalized therapeutic solutions to individual patients. The new clinical diagnostic procedure combining various biological, clinical, and imaging biomarkers is a major step toward a ‘‘precise’’ diagnosis and predicts the prognosis. However, many challenging issues are still subjects of debate, providing future research directions: