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J Neural Transm (Vienna). 2019 Apr 4. doi: 10.1007/s00702-019-02001-3. [Epub ahead of print]

Biomarkers of Parkinson's disease: 20 years later.

Author information

1
Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany.
2
Department of Psychiatry and Psychotherapy, Klinikum der Universität München, University Hospital, LMU Munich, Munich, Germany.
3
Department of Neurology, Faculty of Medicine, University of Cologne, Cologne, Germany.
4
Department of Nuclear Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany.
5
German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.
6
Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany. d.berg@neurologie.uni-kiel.de.
7
Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany. d.berg@neurologie.uni-kiel.de.

Abstract

Despite intensive effort, biomarker research for the detection of prodromal stage, diagnosis and progression of Parkinson's disease (PD) falls short of expectations. This article reviews the attempts in the last 20 years to find a biomarker, addresses challenges along the biomarker search and suggests the steps that should be taken to overcome these challenges. Although several biomarkers are currently available, none of them is specific enough for diagnosis, prediction of future PD or disease progression. The main reason for the failure finding a strong biomarker seems to be drastic heterogeneity of PD, which exhibits itself in all domains; from the clinic to pathophysiology or genetics. The diversity in patient selection, assessment methods or outcomes in biomarker studies also limit the interpretation and generalizability of the data. In search of a reliable biomarker, consideration of novel approaches encompassing individual demographic, clinical, genetic, epigenetic and environmental differences, employment of strategies enabling marker combinations, designing multicenter studies with compatible assessment methods, integration of data from preclinical domains and utilization of novel technology-based assessments are necessary.

KEYWORDS:

Biomarker; Parkinson’s disease; Prodromal Parkinson’s disease

PMID:
30949837
DOI:
10.1007/s00702-019-02001-3

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