Neuroendocrine abnormalities are common in Parkinson's disease (PD) and include disruption of melatonin secretion, disturbances of glucose, insulin resistance and bone metabolism, and body weight changes. They have been associated with multiple non-motor symptoms in PD and have important clinical consequences, including therapeutics. Some of the underlying mechanisms have been implicated in the pathogenesis of PD and represent promising targets for the development of disease biomarkers and neuroprotective therapies. In this systems-based review, we describe clinically relevant neuroendocrine abnormalities in Parkinson's disease to highlight their role in overall phenotype. We discuss pathophysiological mechanisms, clinical implications, and pharmacological and non-pharmacological interventions based on the current evidence. We also review recent advances in the field, focusing on the potential targets for development of neuroprotective drugs in Parkinson's disease and suggest future areas for research.
- PARKINSON'S DISEASE
- DIABETES MELLITUS
- METABOLIC DISEASE
- SLEEP DISORDERS
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Contributors EDP-F wrote the first draft, contributed to project conception and organisation. DPB, PMB, TF and RAB revised and critically reviewed the manuscript for intellectual content. TTW contributed to project conception and organisation, and critically reviewed the manuscript for intellectual content.
Funding RAB is partly supported by an NIHR award of a Biomedical research Centre to Addenbrooke's Hospital/University of Cambridge. TTW receives funding from the Reta Lila Weston Trust for Medical Research.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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