Diagnostic Criteria for Parkinson Disease

Abstract

The clinical diagnosis of Parkinson disease (PD) is based on the identification of some combination of the cardinal motor signs of bradykinesia, rigidity, tremor, and postural instability, but few attempts have been made to develop explicit diagnostic criteria. We propose a clinical diagnostic classification based on a comprehensive review of the literature regarding the sensitivity and specificity of the characteristic clinical features of PD. Three levels of diagnostic confidence are differentiated: Definite, Probable, and Possible. The diagnoses of Possible and Probable PD are based on clinical criteria alone. Neuropathologic confirmation is required for the diagnosis of Definite PD in patients with the clinical diagnosis of Possible or Probable PD. Criteria for histopathologic confirmation of PD are also presented.

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

“…Based on a literature review, Gelb et al [8] developed a set of diagnostic criteria that, similarly to the set proposed by Calne et al [7], used three levels of confidence: possible, probable and definite PD (the latter requiring histopathological confirmation). These authors emphasized asymmetric onset of symptoms and response to l-dopa or dopamine agonist treatment, whereas postural reflex impairment was not listed as a cardinal symptom.…”

“…Two studies used Danish national hospital discharge data but took different approaches [627,628]. One of them [628] followed a national cohort of individuals above 20 years in 1981, identified head trauma that caused hospitalization between 1981 and 1993, and hospital discharge PD diagnoses after 1995 (8,769 cases). No association was observed between head trauma and PD [628].…”

Depression in Parkinson's disease is related to a genetic polymorphism of the cannabinoid receptor gene (CNR1)

“…PD was diagnosed at least by two neurologists, according to the criteria of Parkinson's Disease Society of United Kingdom Brain Bank. 56 Also, we used a general group with 92 subjects, representative of the Spanish population, to compare genotypes.…”

Effects of various factors on sleep disorders and quality of life in Parkinson’s disease

“…The study included 220 participants, 110 of whom fulfilled the diagnostic criteria for PD (i.e., United Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria) [1] and presented with different stages and different duration of the disease. This group was agematched with 110 healthy controls.…”

“…Today, it is considered that multifactorial genesis, probably an interaction of genetic and environmental factors, is the most likely progenitor of the disease [3]. This chronic progressive neurodegenerative disease is mainly caused by the degeneration of nigrostriatal dopaminergic neurons [1] PD occurs in all age groups, but more often in patients over the age of 60, and in this population its frequency is approximately 1% [3]. PD is characterized by progressive motor symptoms (MS) and non-motor symptoms (NMS), such as disorders of the gastrointestinal, urinary, circulatory, autonomic system etc.…”