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Updated: Jun 11, 2026

Ole Isacson: Development of New Therapies for Parkinson's Disease

Ole Isacson: Development of New Therapies for Parkinson's Disease

Published on: April 29, 2007

When does Parkinson disease start?

Rodolfo Savica¹, Walter A Rocca, J Eric Ahlskog

¹Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA.

Archives of Neurology

|July 14, 2010

Summary

This summary is machine-generated.

The Parkinson disease preclinical phase, marked by nonmotor symptoms like constipation and sleep disorders, can begin over 20 years before motor symptoms appear, suggesting a longer disease course.

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Area of Science:

Neuroscience
Neurology
Epidemiology

Background:

Parkinson disease (PD) neurodegeneration begins years before motor symptoms.
Previous estimates of the preclinical period were 5-6 years based on nigral pathology.
Emerging evidence indicates a significantly longer preclinical phase.

Purpose of the Study:

To review evidence on the duration of the preclinical phase in Parkinson disease.
To highlight the role of nonmotor manifestations in extending the preclinical period.
To emphasize the implications for biomarker and risk factor research.

Main Methods:

Review of epidemiologic studies on nonmotor manifestations of Parkinson disease.
Analysis of neuropathological and imaging data related to early PD.
Synthesis of findings on the temporal relationship between nonmotor and motor symptoms.

Main Results:

Nonmotor symptoms, including constipation, anxiety, and REM sleep behavior disorder (RBD), suggest a preclinical period of at least 20 years.
Olfactory impairment and depression may also precede motor symptoms, but with potentially shorter lag times.
Lewy body pathology may affect extra-nigral neuronal populations early in the disease process.

Conclusions:

The preclinical phase of Parkinson disease is significantly longer than previously estimated, potentially exceeding 20 years.
Early nonmotor signs are crucial indicators of the extended preclinical period.
Recognizing this prolonged preclinical phase is vital for identifying predictive biomarkers and risk/protective factors for Parkinson disease.