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Idiopathic Parkinson disease (PD) is an α-synucleinopathy, one of several proteinopathies characterized by intracellular and extracellular accumulation of abnormal filament proteins.1 Relentless progression of neuropathologic changes, consisting of α-synuclein-positive Lewy bodies and Lewy neurites, and widespread neuronal loss closely correlate with clinical worsening of motor and nonmotor PD symptoms. Typically, unilateral onset of tremor, rigidity, or bradykinesia, the cardinal motor features, is followed by contralateral spread of disease signs. The presence of midline problems, such as gait disorder and balance impairment, generally represents a more advanced phase of the disease, used as the central criteria in Hoehn & Yahr staging.
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See page 1514
- © 2014 American Academy of Neurology
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