Basic science in Parkinson's disease: its impact on clinical practice.

Failures in clinical studies that were aimed to prove disease-modifying effects of treatments in Parkinson's disease (PD) raise the question as to whether basic sciences have had an impact in clinical practice. This question implies that despite well-publicized results obtained by intensive genetic and pathogenetic research, e.g. the identification of mutations and cellular biochemical pathways that underlie Parkinson-specific neurodegeneration, no relevant disease-modifying treatment options have been developed. This view neglects the fact that today there are plenty of dopaminergic and non-dopaminergic and surgical treatment options, and that PD was not treatable 50 years ago. This progress was made possible only by basic science. In this review, we underline the success of previous basic science for daily practice in PD and its impact for the understanding and development of an early diagnosis. Early, even pre-symptomatic diagnosis might be key to successfully establish disease-modifying treatments.