CPT funded researcher Professor Michele Hu has published an interesting article providing an overview of the 'prodromal phase' of Parkinson's - the period before diagnosis when the motor features of the condition have not appeared but other issues such as loss of sense of smell, sleep disturbances become apparent.

Prof. Hu (co-Principle Investigator of the Oxford Parkinson’s Disease Centre) - https://www.opdc.ox.ac.uk/michele-hu ) provided a scientific commentary regarding a recent research report. In addition to discussing the findings of that report, Prof Hu's write up provides an interesting update on our current understanding of some of the symptoms that people might show in the early development of Parkinson's.

Before a person is actually diagnosed with Parkinson's, they will pass through a phase called the "prodromal" period of Parkinson's. The term is derived from the Greek word 'prodromos', meaning "running before". Research into this pre-diagnosis phase is starting to highlight certain characteristics (or prodromes) which could help to identify individuals who are at risk of developing Parkinson's.

Prof. Hu starts by discussing the urgent need for early identification, noting the fact that the symptoms required for a clinical diagnosis of Parkinson's only become apparent when 50% of the dopamine in the brain has already been lost. Earlier detection could help to limit this loss and preserve more of this necessary chemical. This would provide better quality of life for the individual and result in less of a care cost burden for society.

One prodromal characteristic associated with an increased risk of developing Parkinson's is a condition called REM sleep behaviour disorder. Rapid eye movement (or REM) is the period of deep dream sleep during which our bodies usually enter a state of temporary paralysis in order for us not to 'act out' our dreams or harm ourselves. Individuals with REM sleep behaviour disorder, however, lose that tempory paralysis ability and begin physically acting out vivid dreams often with erratic sometimes violent arm and leg movements with vocal sounds. Individuals with REM sleep behaviour disorder have an increased risk of developing Parkinson's. Loss of a sense of smell and constipation are additional prodromes associated with Parkinson's.

Prof Hu however cautions the reader not to over interpret the findings in her discussion. She notes that the ratio of men to women with REM sleep behaviour disorder is a lot higher (8:1) than the ratio of men to woman with Parkinson's (2:1). Thus, we must be careful in what we take away from this research - just because an individual has a Parkinson's prodrome - does NOT necessarily mean that one will go on to develop the condition. The commentary provided by Prof Hu provides a brief, but useful overview on research in this field which will hopefully help to identify individuals at risk of developing Parkinson's at an earlier stage.