Tarek Elshourbagy, Alveena Batool Syed, James Robert Brasic
May 26, 2021
Introduction
Parkinson's disease (PD) is the second most common neurodegenerative disorder afflicting 10 million people worldwide and the fourteenth leading cause of death in the United States. PD is caused by the death of dopaminergic neurons that regulate movement in the substantia nigra pars compacta. Mechanisms contributing to the development of PD in vulnerable individuals include protein misfolding, protein aggregation, and mitochondrial dysfunction. We have developed algorithms for diagnosis and treatment based on review of available knowledge.
Methods
We reviewed the key literature on the pathogenesis of PD in order to propose guidelines for the development of diagnostic and therapeutic interventions for people with PD and related conditions.
We approximated qualitative ratings of the available tools in the form of categorical discrete measurements. We then utilized the discrete measurements to distinguish people with PD and other movement disorders, and healthy controls. We then correlated clinical ratings with output of instrumentation measuring the movements at the same time. We then utilized transforms of output signals and clinical measurements to apply machine learning to general proposed algorithms.
Results and Discussion
In about 25 percent of patients, clinicians incorrectly diagnose the PD. Causes of misdiagnosis include a lack of algorithm and inadequate use of diagnostic modalities. Four main mechanisms that may contribute to the development of PD (misfolding of alpha synuclein, mitochondrial dysfunction, dysfunctional ubiquitin proteosomal pathways, and abnormal autophagy) and specific diagnostic modalities (structured interview and examination, laboratory assessments, neuropathology, genetic testing, neuroimaging)) form the basis for our algorithm for the diagnosis and treatment of PD..
Clinicians, administrators, policy planners, advocates, and other concerned individuals will
benefit from the adoption of our guidelines for the diagnosis and treatment of Parkinson’s disease and related conditions.
Conclusion
Clinicians, administrators, policy planners, advocates, and other concerned individuals will benefit from the adoption of our guidelines for the diagnosis and treatment of Parkinson’s disease and related conditions.