Motor signs in the prodromal phase of Parkinson's disease


  • Walter Maetzler MD,

    Corresponding author
    1. Center of Neurology, Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
    2. German Center for Neurodegenerative Diseases (DZNE), University of Tuebingen, Tuebingen, Germany
    • Department of Neurodegeneration, University of Tuebingen Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany
    Search for more papers by this author
  • Jeffrey M. Hausdorff PhD

    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
    2. Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    3. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
    Search for more papers by this author

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.


Relatively subtle deterioration of the motor system likely occurs well before the patient meets established motor criteria for a clinical diagnosis of Parkinson's disease; ie, the occurrence of at least 2 of the cardinal motor deficits: bradykinesia, rigidity, tremor, and/or postural instability. Powerful compensatory mechanisms may mask these clinical symptoms and make them difficult to identify and evaluate in the earliest stages of the illness. This review summarizes our current knowledge of motor signs that are thought to occur in the prodromal phase of Parkinson's disease and suggests how motor assessment batteries could be designed to detect these subclinical motor deficits with a high degree of accuracy and sensitivity. © 2012 Movement Disorder Society