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01-08-2012 | Movement Disorders - Review article

The significance of neuronal lateralisation in Parkinson’s disease

Authors: P. Riederer, J. Sian-Hülsmann

Published in: Journal of Neural Transmission | Issue 8/2012

Abstract

The destruction of the dopaminergic neurons in the substantia nigra (SN) and consequent depletion of striatal dopamine elicits the main movement deficits related to Parkinson’s disease (PD). In the early stages of the illness, the motor symptoms are often exhibited asymmetrically. Thus, the onset of PD features starts on either the right or left side. The side of onset appears to determine the prognosis of the disorder and other features, such as right-side tremor dominance has a better prognosis in contrast to left-side dominant bradykinesia-rigidity. In addition, left-side onset of motor features is associated with cognitive decline. Therefore, an intricate relation appears to exist between the side of disease onset and progression/severity and other non-motor symptoms. Unilateral PD in turn corresponds to neuronal nigrostriatal degeneration in the contralateral hemisphere. Indeed positron emission tomography has demonstrated a positive correlation between symptom asymmetry and brain function (Hoorn et al. Parkinsonism Relat Disord 17:58–60, 2011), which corresponds to a unilateral pattern of degeneration. This phenomenon appears to be exclusive to PD. Additionally, the variation in motor symptom(s) dominance exhibited in the disorder conforms to the notion that PD is a spectrum disease with many sub-groups. Thus, clinical and post mortem studies on “lateralisation” may serve as a vital tool in understanding the mechanism(s) eliciting the characteristic destruction of the SN neurons. Additionally, it may be employed as a predictive indicator for the symptomology and prognosis of the illness thus allowing selective treatment strategies targeted at the pronounced hemispheric degeneration.

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Title: The significance of neuronal lateralisation in Parkinson’s disease
Authors: P. Riederer
J. Sian-Hülsmann
Publication date: 01-08-2012
Publisher: Springer Vienna
Published in: Journal of Neural Transmission / Issue 8/2012
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI: https://doi.org/10.1007/s00702-012-0775-1

At a glance: The STEP trials

Springer Medicine

The significance of neuronal lateralisation in Parkinson’s disease

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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