Contents

#### **Preface XI**



Preface

world renowned Parkinson's disease expert.

Parkinson's disease is a neurodegenerative condition for which no cure is available at this time. It is characterized by both motor and non-motor symptoms. Non-motor symptoms of Parkinson's disease are responsible for increasing disability and long term care placement of patients. Therefore, recently non-motor symptoms have been a focus of attention. This book presents in-depth information about some of the important non-motor symptoms of Parkin‐ son's disease. Furthermore, this book also provides a detailed update on the surgical treat‐ ment of Parkinson's disease. In addition, motor fluctuations which are considered long term complications of pharmacological treatments of Parkinson's disease have been discussed as well. This book can be used by physicians, researchers and neuroscientists as a reference as well as to learn new information about these topics related to Parkinson's disease. Authors of the individual chapters are well known in their fields and the book has been edited by a

**A. Q. Rana, MD, FRCPC, FRCP - U.K. (HON)**

Canada

Director, Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre

## Preface

Chapter 7 **The Potential of Targeting LRRK2 in Parkinson's Disease 161**

Naoki Tani, Ryoma Morigaki, Ryuji Kaji and Satoshi Goto

Chapter 9 **Deep Brain Stimulation for Camptocormia Associated with**

F.Y. Ho, K.E. Rosenbusch and A. Kortholt

Naoki Tani, Ryuji Kaji and Satoshi Goto

**Parkinson's Disease 193**

**VI** Contents

**Parkinson's Disease 211**

Chapter 8 **Current Use of Thalamic Vim Stimulation in Treating**

Parkinson's disease is a neurodegenerative condition for which no cure is available at this time. It is characterized by both motor and non-motor symptoms. Non-motor symptoms of Parkinson's disease are responsible for increasing disability and long term care placement of patients. Therefore, recently non-motor symptoms have been a focus of attention. This book presents in-depth information about some of the important non-motor symptoms of Parkin‐ son's disease. Furthermore, this book also provides a detailed update on the surgical treat‐ ment of Parkinson's disease. In addition, motor fluctuations which are considered long term complications of pharmacological treatments of Parkinson's disease have been discussed as well. This book can be used by physicians, researchers and neuroscientists as a reference as well as to learn new information about these topics related to Parkinson's disease. Authors of the individual chapters are well known in their fields and the book has been edited by a world renowned Parkinson's disease expert.

**A. Q. Rana, MD, FRCPC, FRCP - U.K. (HON)**

Director, Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre Canada

**Chapter 1**

**Mutations of PARK Genes and**

**Concentrations in Parkinson's Disease**

py with L-3,4-dihydroxy-phenylalanine (L-dopa) [Olanow, 2008].

Parkinson's disease (PD) is a chronic and progressive neurological disorder characterized by resting tremor, rigidity, and bradykinesia, affecting at least 2% of individuals above the age of 65 years. Parkinson's disease is a result of degeneration of the dopamine-producing neurons of the *substantia nigra*. Available therapies in PD will only improve the symptoms but not halt progression of disease. The most effective treatment for PD patients is thera‐

It is now believed that the cause of PD, are both environmental and genetic factors. During the last two decades, there has been breakthrough progress in genetics of PD. It is known that genetic background of PD is in mutations a number of pathogenic genes PARK, e.g. *SNCA*, *PRKN*, *UCHL1, DJ-1, PINK1, ATP13A2*, and *LRRK2* (Polrolniczak et a., 2011, 2012). In 2001, Shimura et al. first described the presence in the human brain complex contain‐ ing Parkin with the glycosylated form of the alpha-synuclein (ASN, alpha-SP22). More‐ over, the study by Dorszewska et al. (2012) has been shown, that in the PD patients increased plasma level of ASN was associated by the decreased of Parkin plasma level. It has also shown that configuration: increased plasma level of ASN and decreased of Parkin concentra‐ tion was associated with earlier onset of PD. It seems that in PD genotypic testing of PARK mutations and analysis of their phenotypes (e.g. ASN, Parkin) may be diagnostic agents for

> © 2014 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**Alpha-Synuclein and Parkin**

Anna Oczkowska, Margarita Lianeri,

http://dx.doi.org/10.5772/57107

**1. Introduction**

these patients.

Wojciech Kozubski and Jolanta Dorszewska

Additional information is available at the end of the chapter
