7 auxiliary examination methods to diagnose early-onset Parkinson's!

Parkinson's disease (PD) is a common neurodegenerative disease that increases in prevalence with age [1].

Although PD is currently more common in the elderly, recent studies have found that some patients have an onset age earlier than 50 years old, called early-onset PD (early-onset Parkinson's disease, EOPD), accounting for 5%~10% of PD [2-4].

To determine whether it is early-onset Parkinson's disease, the "Chinese Expert Consensus on the Diagnosis and Treatment of Early-onset Parkinson's Disease" points out the following 7 auxiliary examination methods, let's take a look! Early detection, early intervention!

• Serum copper, serum ceruloplasmin, etc.
  are helpful in differentiating
  Wilson disease (HLD).
  

• EMG tremor testing is helpful in the analysis and evaluation
  of tremor frequency, amplitude, and type.
  

• Sniffin's Sticks test assesses olfactory function
  .
  

▍1.
Structural brain CT and MRI routine sequence examination

• EOPD has no characteristic changes
  .
  

• It can distinguish HLD, spinal cerebellar ataxia (SCA), Huntington's disease (HD), and neurodegenerative disease of iron deposition in brain tissue (NBIA).
  
  

▍2, positron emission computed tomography (PET/PET-CT), single-photon emission computed tomography (SPECT)

• Dopamine transporter (DAT) tracer imaging showing decreased uptake in the basal ganglia suggests EOPD
  .
  

▍3.
Ultrasonic testing

• EOPD shows abnormal enhancement of substantia nigra echo (>20mm2), large substantia nigra echo volume, and significantly enhanced substantia nigra
  echo.
  

• May show cardiac desympathetic innervation, but EOPD may not be as suggestive as iPD
  .
  

• Useful in understanding the clinical symptoms and severity
  of EOPD patients.
  

• The International Society of Movement Disorders Parkinson's Disease Composite Rating Scale (MDS-UPDRS) and Hoehn-Yahr Staging Scale assess motor symptoms, motor complications, and disease severity
  .
  

• The Non-Motor Symptom Rating Scale (NMSS), the Mini-Mental State Assessment Scale (MMSE), the Montreal Cognitive Scale (MoCA), and the Hamilton Depression Scale (HAMD) assess non-motor symptoms
  .
  

• A specific type of rating scale may be used to assess a particular aspect in detail
  .
  

• It can identify the cause and assist in diagnosis and differential diagnosis
  .
  

• Genetic counseling is required before testing, including family history, age of onset, clinical phenotype, etc
  .
  

• Detection technology methods and strategies: Sanger sequencing, next-generation sequencing
  .
  

• For Parkin, SNCA and other genes, multiple ligation probe amplification (MLPA) must be used to complete gene copy number detection
  .
  

• Denatured polyacrylamide electrophoresis and capillary electrophoresis were used to detect polynucleotide repeat amplification mutations, which could exclude SCA and HD
  .
  

• Parkin, GBA, LRRK2, PLA2G6, PINK1, SNCA, VPS13C, ATP13A2, VPS35, DJ-1 and other tests were carried
  out.
  

What are the recommended medications for early-onset Parkinson's disease?

What are the precautions for using anti-Parkinson's drugs?

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