Journal
ACTA NEUROPATHOLOGICA
Volume 137, Issue 3, Pages 379-395Publisher
SPRINGER
DOI: 10.1007/s00401-018-01956-z
Keywords
Retina; Visual system; Biomarker; Alpha-synuclein; Parkinson's disease
Categories
Funding
- Research Foundation Flanders [1S51718N, 12I3817N]
- Ministerio de Educacion, Spain [FPU 14/03166]
- Ministerio de Economia y Competitividad, Spain [MINECO-FEDER-BFU2015-67139-R]
- Generalitat Valenciana [Prometeo 2016/158]
- Instituto Carlos III [ISCIII RETICS-FEDER RD16/0008/0016]
- National Institute of Neurological Disorders and Stroke [U24 NS072026]
- National Institute on Aging [P30 AG19610]
- Arizona Department of Health Services
- Arizona Biomedical Research Commission
- Michael J. Fox Foundation for Parkinson's Research
Ask authors/readers for more resources
Despite decades of research, accurate diagnosis of Parkinson's disease remains a challenge, and disease-modifying treatments are still lacking. Research into the early (presymptomatic) stages of Parkinson's disease and the discovery of novel biomarkers is of utmost importance to reduce this burden and to come to a more accurate diagnosis at the very onset of the disease. Many have speculated that non-motor symptoms could provide a breakthrough in the quest for early biomarkers of Parkinson's disease, including the visual disturbances and retinal abnormalities that are seen in the majority of Parkinson's disease patients. An expanding number of clinical studies have investigated the use of in vivo assessments of retinal structure, electrophysiological function, and vision-driven tasks as novel means for identifying patients at risk that need further neurological examination and for longitudinal follow-up of disease progression in Parkinson's disease patients. Often, the results of these studies have been interpreted in relation to -synuclein deposits and dopamine deficiency in the retina, mirroring the defining pathological features of Parkinson's disease in the brain. To better understand the visual defects seen in Parkinson's disease patients and to propel the use of retinal changes as biomarkers for Parkinson's disease, however, more conclusive neuropathological evidence for the presence of retinal -synuclein aggregates, and its relation to the cerebral -synuclein burden, is urgently needed. This review provides a comprehensive and critical overview of the research conducted to unveil -synuclein aggregates in the retina of Parkinson's disease patients and animal models, and thereby aims to aid the ongoing discussion about the potential use of the retinal changes and/or visual symptoms as biomarkers for Parkinson's disease.
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