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Parkinson’s Disease: Premotor Features, Diagnosis, and Early Management 

Parkinson’s Disease: Premotor Features, Diagnosis, and Early Management
Parkinson’s Disease: Premotor Features, Diagnosis, and Early Management

Anthony H.V. Schapira

and David Gallagher

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date: 27 October 2021

Parkinson’s disease (PD) is a neurodegenerative disease, the initial clinical features of which are the result of loss of dopaminergic neurons in the substantia nigra pars compacta of the midbrain. As the disease progresses the involvement of additional brain areas in the degenerative process produces predominantly non-dopaminergic, non-motor features (e.g cognitive decline and autonomic dysfunction). Although the classic clinical triad of bradykinesia, rigidity, and tremor still defines PD and enables a diagnosis, it is recognized that the disease process has evolved for many years, if not decades, before these clinical features appear. Certain non-motor symptoms may appear before a diagnosis of PD can be made, and these may represent risk factors for the disease or even prodromal PD. These features include hyposmia, rapid eye movement sleep behaviour disorder, depression, and constipation.

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