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A timeline for Parkinson's disease

  • Author Footnotes
    1 Conceived the timeline concept and was responsible for the main draft.
    Christopher H. Hawkes
    Correspondence
    Corresponding author. Tel.: +44 207 377 7000.
    Footnotes
    1 Conceived the timeline concept and was responsible for the main draft.
    Affiliations
    Neuroscience Centre, Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, 4 Newark Street, London E1 2AT, UK
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  • Author Footnotes
    2 Supplemented and improved the text, referencing and timeline figure.
    Kelly Del Tredici
    Footnotes
    2 Supplemented and improved the text, referencing and timeline figure.
    Affiliations
    Clinical Neuroanatomy Section, Center for Clinical Research, Department of Neurology, University of Ulm, Helmholtzstrasse 8/1, 89081 Ulm, Germany
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  • Author Footnotes
    2 Supplemented and improved the text, referencing and timeline figure.
    Heiko Braak
    Footnotes
    2 Supplemented and improved the text, referencing and timeline figure.
    Affiliations
    Clinical Neuroanatomy Section, Center for Clinical Research, Department of Neurology, University of Ulm, Helmholtzstrasse 8/1, 89081 Ulm, Germany
    Search for articles by this author
  • Author Footnotes
    1 Conceived the timeline concept and was responsible for the main draft.
    2 Supplemented and improved the text, referencing and timeline figure.

      Abstract

      It is reasonably well established that prior to the motor phase of classical Parkinson's disease (PD) there is a prodromal period of several years duration. Once typical motor features appear, the disease continues up to 20 years depending on multiple variables. The clinical features of the prodromal and motor phases may be correlated with pathological changes in the central and autonomic nervous systems to allow a sequential plan of disease progression. We present a ‘best guess’ for a typical individual presenting with PD in their sixties and speculate that the disease will last approximately 40 years from the earliest non-motor features to death. Appreciation of this concept may allow better strategies for slowing or halting disease progression.

      Keywords

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