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Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/mds.26424.

MDS clinical diagnostic criteria for Parkinson's disease.

Author information

1
Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada.
2
Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases, Tuebingen, Germany.
3
Penn Neurological Institute, Philadelphia, Pennsylvania, USA.
4
Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
5
Department of Neurology, The Mount Sinai Hospital, New York, New York, USA.
6
Department of Neurology, Philipps University of Marburg, Marburg, Germany.
7
University of Navarra-FIMA, Pamplona, Spain.
8
Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.
9
Department of Neurosciences, UC San Diego, La Jolla, California, USA.
10
Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.
11
Neuroscience Research Australia & University of NSW, Randwick, Australia.
12
Rush University Medical Center, Chicago, Illinois, USA.
13
Hopital De La Salpetriere, Paris, France.
14
Xuanwu Hospital of Capitol of Medical University, Beijing, Peoples Republic of China.
15
Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.
16
The Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA.
17
Department of Neurology, Christian-Albrechts University, Kiel, Germany.

Abstract

This document presents the Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (PD). The Movement Disorder Society PD Criteria are intended for use in clinical research but also may be used to guide clinical diagnosis. The benchmark for these criteria is expert clinical diagnosis; the criteria aim to systematize the diagnostic process, to make it reproducible across centers and applicable by clinicians with less expertise in PD diagnosis. Although motor abnormalities remain central, increasing recognition has been given to nonmotor manifestations; these are incorporated into both the current criteria and particularly into separate criteria for prodromal PD. Similar to previous criteria, the Movement Disorder Society PD Criteria retain motor parkinsonism as the core feature of the disease, defined as bradykinesia plus rest tremor or rigidity. Explicit instructions for defining these cardinal features are included. After documentation of parkinsonism, determination of PD as the cause of parkinsonism relies on three categories of diagnostic features: absolute exclusion criteria (which rule out PD), red flags (which must be counterbalanced by additional supportive criteria to allow diagnosis of PD), and supportive criteria (positive features that increase confidence of the PD diagnosis). Two levels of certainty are delineated: clinically established PD (maximizing specificity at the expense of reduced sensitivity) and probable PD (which balances sensitivity and specificity). The Movement Disorder Society criteria retain elements proven valuable in previous criteria and omit aspects that are no longer justified, thereby encapsulating diagnosis according to current knowledge. As understanding of PD expands, the Movement Disorder Society criteria will need continuous revision to accommodate these advances.

KEYWORDS:

Parkinson's disease; absolute exclusion criteria; clinical diagnostic criteria; motor parkinsonism; non-motor manifestations; red flags; supportive criteria

PMID:
26474316
DOI:
10.1002/mds.26424
[Indexed for MEDLINE]

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