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. 2013 May;12(5):514-24.
doi: 10.1016/S1474-4422(13)70047-4. Epub 2013 Apr 11.

Changing the research criteria for the diagnosis of Parkinson's disease: obstacles and opportunities

Daniela Berg  1 , Anthony E Lang, Ronald B Postuma, Walter Maetzler, Guenther Deuschl, Thomas Gasser, Andrew Siderowf, Anthony H Schapira, Wolfgang Oertel, José A Obeso, C Warren Olanow, Werner Poewe, Matthew Stern
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Changing the research criteria for the diagnosis of Parkinson's disease: obstacles and opportunities

Daniela Berg et al. Lancet Neurol. 2013 May.

Abstract

Recent findings question our present understanding of Parkinson's disease and suggest that new research criteria for the diagnosis of Parkinson's disease are needed, similar to those recently defined in Alzheimer's disease. However, our ability to redefine Parkinson's disease is hampered by its complexity and heterogeneity in genetics, phenotypes, and underlying molecular mechanisms; the absence of biochemical markers or ability to image Parkinson's disease-specific histopathological changes; the long prodromal period during which non-motor manifestations might precede classic motor manifestations; and uncertainty about the status of disorders diagnosed clinically as Parkinson's disease but without Lewy pathology. Although it is too early to confidently redefine Parkinson's disease, the time has come to establish a research framework that could lead to new diagnostic criteria. We propose the establishment of three tiers encompassing clinical features, pathological findings, and genetics or molecular mechanisms. Specific advances in each tier, bridged by neuroimaging and biochemical data, will eventually lead to a redefinition of Parkinson's disease.

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Comment in

  • Parkinson's disease redefined.
    Deutch AY. Deutch AY. Lancet Neurol. 2013 May;12(5):422-3. doi: 10.1016/S1474-4422(13)70052-8. Epub 2013 Apr 11. Lancet Neurol. 2013. PMID: 23582176 No abstract available.

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