Parkinson disease (PD) is thought to develop gradually over many years. As neurodegeneration begins and advances, an asymptomatic preclinical phase gives way to a prodromal syndrome, followed by clinically manifested PD. Autonomic dysfunction, hyposmia, mood disorder, and sleep disorder—particularly rapid eye movement sleep behavior disorder—often precede clinical PD and are recognized prodromal features.1 Intervention in the prodromal stage may stop the neurodegenerative process before PD is fully manifest. Early and accurate identification of prodromal PD before neurodegeneration is advanced is a research priority, representing an essential step toward the overall goal of slowing disease progression.2
Brown EG, Tanner CM. Impaired Cognition and the Risk of Parkinson Disease: Trouble in Mind. JAMA Neurol. 2017;74(12):1398–1400. doi:10.1001/jamaneurol.2017.1474
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