MDS clinical diagnostic criteria for Parkinson's disease

Abstract

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. © 2015 International Parkinson and Movement Disorder Society

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Affiliated Institutions

• Toronto Western Hospital CA
• Rush University Medical Center US
• Institute for Neurodegenerative Disorders US
• Christian-Albrechts-Universität zu Kiel DE
• Sorbonne Université FR
• Universidad de Navarra ES
• University of California, San Diego US
• Innsbruck Medical University AT
• Pitié-Salpêtrière Hospital FR
• Mount Sinai Hospital US
• Hertie Institute for Clinical Brain Research DE
• Philipps University of Marburg DE
• Radboud University Medical Center NL
• Mayo Clinic in Arizona US
• German Center for Neurodegenerative Diseases DE
• Neuroscience Research Australia AU
• Penn Center for AIDS Research US
• Radboud University Nijmegen NL
• Montreal General Hospital CA

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