Lateralisation in Parkinson disease

  • P. Riederer
  • K. A. Jellinger
  • P. Kolber
  • G. Hipp
  • J. Sian-Hülsmann
  • R. Krüger


Asymmetry of dopaminergic neurodegeneration and subsequent lateralisation of motor symptoms are distinctive features of Parkinson’s disease compared to other forms of neurodegenerative or symptomatic parkinsonism. Even 200 years after the first description of the disease, the underlying causes for this striking clinicopathological feature are not yet fully understood. There is increasing evidence that lateralisation of disease is due to a complex interplay of hereditary and environmental factors that are reflected not only in the concept of dominant hemispheres and handedness but also in specific susceptibilities of neuronal subpopulations within the substantia nigra. As a consequence, not only the obvious lateralisation of motor symptoms occurs but also patterns of associated non-motor signs are defined, which include cognitive functions, sleep behaviour or olfaction. Better understanding of the mechanisms contributing to lateralisation of neurodegeneration and the resulting patterns of clinical phenotypes based on bilateral post-mortem brain analyses and clinical studies focusing on right/left hemispheric symptom origin will help to develop more targeted therapeutic approaches, taking into account subtypes of PD as a heterogeneous disorder.


Parkinson’s disease Parkinsonism Asymmetry Lateralisation Dopamine Handedness Genetics 




atypical Parkinsonian Syndrome






depression anxiety stress scales


definite suicidal behaviour




dopamine transporter


fluorine-18-labelled fluorodopa


Diffusion Tensor Imaging






Help Advance Luxembourg’s Parkinson Research Study


Lewy body


locus coeruleus


left-dominant Parkinson’s disease


Lewy body dementia


late-onset Parkinson’s disease


leucine-rich repeat kinase 2


International Parkinson and Movement Disorder Society


magnetic resonance imaging


multiple system atrophy


multiple system atrophy-type parkinson


Montreal Cognitive Assessment






olfactory bulb




Parkinson’s disease


Parkinson’s disease with dementia


progressive supranuclear palsy


positron emission tomography


preformed fibrils


rapid eye movement


right-dominant Parkinson’s disease


raphe nucleus


substantia nigra


substantia nigra pars compacta


single-photon-emission computed tomography


tyrosine hydroxylase


United Parkinson’s Disease Rating Scale


young-onset Parkinson’s disease



The work of RK, GH and PK was supported by grants from the Luxembourg National Research Fund (FNR) within the National Centre of Excellence in Research on Parkinson’s disease (NCER-PD), the PEARL programme (FNR; FNR/P13/6682797 to RK) and by the European Union’s Horizon2020 research and innovation program under grant agreement No. 692320 (CENTRE-PD to RK).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • P. Riederer
    • 1
    • 2
  • K. A. Jellinger
    • 3
  • P. Kolber
    • 4
  • G. Hipp
    • 4
  • J. Sian-Hülsmann
    • 5
  • R. Krüger
    • 4
  1. 1.Center of Mental Health, Clinic and Policlinic for Psychiatry, Psychosomatics and PsychotherapyUniversity Hospital WürzburgWürzburgGermany
  2. 2.Psychiatry Department of Clinical ResearchUniversity of Southern Denmark, Odense University HospitalOdense CDenmark
  3. 3.Institute of Clinical NeurobiologyViennaAustria
  4. 4.Parkinson Research ClinicCentre Hospitalier de LuxembourgLuxembourgLuxembourg
  5. 5.Department of Medical PhysiologyUniversity of NairobiNairobiKenya

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