What are the early signs of Parkinson's disease?


Les signes précoces qui favorisent l'apparition de la maladie de Parkinson

Following the recent publication of a Canadian study on REM sleep disorders as an early sign of Parkinson's disease, we decided to broaden your view on these early disorders.

Why study these early signs?

Motor symptoms allowing the diagnosis of the disease are observed when 80% of the neurons have been lost (Cheng et al., 2010). It is therefore important to detect neuronal degeneration as early as possible and to initiate treatment as soon as possible.



What are the four main early signs of Parkinson's disease?


A decrease in the writing amplitude

This symptom is called micrographia. It results in a reduction in the size of letters and an aggregation of words together. In 2017, a team of Australian researchers proposed a test to detect these changes in writing ability. By drawing a simple spiral on a tablet and analyzing the pressure and speed of execution, they were able to detect early signs of micrographia, pointing to Parkinson's disease. (Zham et al., 2017)

Constipation

This symptom is one of the most common in Parkinson's disease, about 85% of patients are affected. This symptom is often perceived several years before seeing the motor disorders described in Parkinson's disease (tremors, bradykinesia, rigidity). However, it remains difficult to predict the disease with this symptom alone, as it can have very diverse causes. People with Parkinson's disease are advised to increase their fiber intake, eat several meals in small quantities during the day and increase their water intake.

Loss of smell

Also called hyposmia. It is similar to constipation, this symptom will be found early but many conditions can cause its emergence: allergy, nasal polyps, viral infections ...

It is often rare that this symptom is detected by the patient before testing.

These last two early symptoms support Braak's hypothesis, suggesting that Parkinson's disease takes shape in the gastrointestinal tract and the olfactory bulb. (Braak et al., 2003)

Sleep-related disorders

It is already widely accepted that patients with Parkinson's disease exhibit behavioral disturbances during REM sleep. This phase of sleep is described as the "dream" phase, during which the body is normally still. During this phase, the person screams or moves excessively, disrupting sleep. In 80% of cases, people with this symptom develop a neurodegenerative disease. (Schenck et al., 2013)



It is important to remind that some of these symptoms can be predictive of the disease but can of course have multiple origins. In the case of the occurrence of one or more of these symptoms, it is advisable to consult a doctor in order to confirm or reject the suspicion of Parkinson's disease.


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References

  • Braak, H., Del Tredici, K., Rüb, U., de Vos, R.A.I., Jansen Steur, E.N.H., Braak, E., 2003. Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol. Aging 24, 197–211.

  • Cheng, H.-C., Ulane, C.M., Burke, R.E., 2010. Clinical Progression in Parkinson’s Disease and the Neurobiology of Axons. Ann Neurol 67, 715–725.

  • Schenck, C.H., Boeve, B.F., Mahowald, M.W., 2013. Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: a 16-year update on a previously reported series. Sleep Med. 14, 744–748.

  • Zham, P., Kumar, D.K., Dabnichki, P., Poosapadi Arjunan, S., Raghav, S., 2017. Distinguishing Different Stages of Parkinson’s Disease Using Composite Index of Speed and Pen-Pressure of Sketching a Spiral. Front Neurol 8.


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