Functional Impairment Preceding Parkinson Disease Diagnosis—What’s in a Prodrome?

Abstract

clinical observations and our current-growing but still incomplete-knowledge about the factors that contribute to disability accumulation suggest that we should revisit our traditional categorization of MS into relapsing and progressive courses. These previously devised clinical phenotypes have served their purpose in defining populations of patients that are most likely to be responsive to existing diseasemodifying treatments. As we are moving toward developing treatments to help prevent disability accumulation, a more personalized understanding of a given patient's disability status is needed to help guide individualized treatment decisions. This new approach should be based on the comprehensive characterization of the different constituents of the disease process using advanced laboratory and imaging methods together with more granular, comprehensive, and meaningful digital measures of the functional consequences of MS.