Abstract

Laterality of motor symptom onset in Parkinson’s disease is both well-known and under-appreciated. Treatment of disorders that have asymmetric pathological features, such as stroke and epilepsy, demonstrate the importance of incorporating hemispheric lateralization and specialization into therapy and care planning. These practices could theoretically extend to Parkinson’s disease, providing increased diagnostic accuracy and improved treatment outcomes. Additionally, while motor symptoms have generally received the majority of attention, non-motor features (e.g., autonomic dysfunction) also decrease quality of life and are influenced by asymmetrical neurodegeneration. Due to the laterality of cognitive and behavioral processes in the two brain hemispheres, analysis of hemibody side of onset can potentially give insight into expected symptom profile of the patient and allow for increased predictive accuracy of disease progression and outcome, thus opening the door to personalized and improved therapy in treating Parkinson’s disease patients. This review discusses motor and non-motor symptoms (namely autonomic, sensory, emotional, and cognitive dysfunction) of Parkinson’s disease in respect to hemispheric lateralization from a theoretical perspective in hopes of providing a framework for future research and personalized treatment.

摘要

帕金森病运动症状发作的偏侧性是众所周知的，但未被充分认识。治疗具有不对称病理特征的疾病，例如中风和癫痫，证明了将半球偏侧化和专业化纳入治疗和护理计划的重要性。这些做法理论上可以扩展到帕金森病，提供更高的诊断准确性和改善治疗结果。此外，虽然运动症状通常受到大多数关注，但非运动特征（例如，自主神经功能障碍）也会降低生活质量并受到不对称神经变性的影响。由于两个大脑半球认知和行为过程的偏侧性，对发病侧半身的分析有可能深入了解患者的预期症状特征，并提高疾病进展和结果的预测准确性，从而为治疗帕金森氏病患者的个性化和改进疗法打开大门。本综述从理论角度讨论了帕金森病与半球侧化相关的运动和非运动症状（即自主神经、感觉、情绪和认知功能障碍），希望为未来的研究和个性化治疗提供框架。