Early Diagnosis and Preventive Therapy in Parkinson’s Disease

At the time when "Parkinson's Disease" is diagnosed in a patient, roughly two thirds of dopaminergic neurons of substantia nigra are already degenerated. The onset of the disease must, therefore, be much earlier. This book deals with early diagnosis and early preventive treatment which may sustain the process underlying the disease. By use of psychometric, kinesiologic, physiologic, histologic, biochemical, endocrinologic, pharmacologic and imaging techniques, including positron-emission tomography and brain mapping, specialists tried to focus on new diagnostic criteria. New methods including psychometric evaluation, apparative measurement of movement, analysis of peripheral blood and urinary constituents have supplemented this approach. It has been agreed that early preventive therapy consists of low dosis of L-DOPA plus benserazide, L-deprenyl and dopaminergic agonists. Expert clinicians and basic scientists with a special interest in Parkinson s disease review the current state of science and clinical therapeutics of the disease. Therefore these articles represent an authorative review of the current state of knowledge regarding preclinical course and symptomatology, subtypes with their impact on the pathology, genetic alterations, novel mechanisms of neuronal cell death, diagnostic tools and old and novel therapeutic approaches with respect to neuroprotection and neuroregeneration in Parkinson s disease. Particular emphasis has been placed on a novel antiparkinsonian drug called budipine with various modes of action also influencing altered non dopaminergic systems in Parkinson s disease. It is evident, that many questions on the cause, course and treatment of Parkinson s disease are still unanswered and therefore the ideal way to treat a parkinsonian patient remains to be defined.