Time to Redefine PD? Introductory Statement of the MDS Task Force on the Definition of Parkinson's Disease
Identifieur interne : 000374 ( Main/Exploration ); précédent : 000373; suivant : 000375Time to Redefine PD? Introductory Statement of the MDS Task Force on the Definition of Parkinson's Disease
Auteurs : Daniela Berg [Allemagne] ; Ronald B. Postuma [Canada] ; Bastiaan Bloem [Pays-Bas] ; Piu Chan [République populaire de Chine] ; Bruno Dubois [France] ; Thomas Gasser [Allemagne] ; Christopher G. Goetz [États-Unis] ; Glenda M. Halliday [Australie] ; John Hardy [Royaume-Uni] ; Anthony E. Lang [Canada] ; Irene Litvan [États-Unis] ; Kenneth Marek [États-Unis] ; José Obeso [Espagne] ; Wolfgang Oertel [Allemagne] ; C Warren Olanow [États-Unis] ; Werner Poewe [Autriche] ; Matthew Stern [États-Unis] ; Günther Deuschl [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Parkinson Disease.
- pathology : Parkinson Disease.
- Advisory Committees, Diagnostic and Statistical Manual of Mental Disorders, Humans, Neuropsychological Tests.
Abstract
With advances in knowledge disease, boundaries may change. Occasionally, these changes are of such a magnitude that they require redefinition of the disease. In recognition of the profound changes in our understanding of Parkinson's disease (PD), the International Parkinson and Movement Disorders Society (MDS) commissioned a task force to consider a redefinition of PD. This review is a discussion article, intended as the introductory statement of the task force. Several critical issues were identified that challenge current PD definitions. First, new findings challenge the central role of the classical pathologic criteria as the arbiter of diagnosis, notably genetic cases without synuclein deposition, the high prevalence of incidental Lewy body (LB) deposition, and the nonmotor prodrome of PD. It remains unclear, however, whether these challenges merit a change in the pathologic gold standard, especially considering the limitations of alternate gold standards. Second, the increasing recognition of dementia in PD challenges the distinction between diffuse LB disease and PD. Consideration might be given to removing dementia as an exclusion criterion for PD diagnosis. Third, there is increasing recognition of disease heterogeneity, suggesting that PD subtypes should be formally identified; however, current subtype classifications may not be sufficiently robust to warrant formal delineation. Fourth, the recognition of a nonmotor prodrome of PD requires that new diagnostic criteria for early-stage and prodromal PD should be created; here, essential features of these criteria are proposed. Finally, there is a need to create new MDS diagnostic criteria that take these changes in disease definition into consideration. © 2014 The Authors.
Url:
DOI: 10.1002/mds.25844
PubMed: 24619848
PubMed Central: 4204150
Affiliations:
- Allemagne, Australie, Autriche, Canada, Espagne, France, Pays-Bas, Royaume-Uni, République populaire de Chine, États-Unis
- Californie, Connecticut, Illinois, Pennsylvanie, Tyrol (Land), État de New York
- Innsbruck, Paris
- Université de médecine d'Innsbruck
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Le document en format XML
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<keywords scheme="MESH" xml:lang="en"><term>Advisory Committees</term>
<term>Diagnostic and Statistical Manual of Mental Disorders</term>
<term>Humans</term>
<term>Neuropsychological Tests</term>
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<front><div type="abstract" xml:lang="en"><p>With advances in knowledge disease, boundaries may change. Occasionally, these changes are of such a magnitude that they require redefinition of the disease. In recognition of the profound changes in our understanding of Parkinson's disease (PD), the International Parkinson and Movement Disorders Society (MDS) commissioned a task force to consider a redefinition of PD. This review is a discussion article, intended as the introductory statement of the task force. Several critical issues were identified that challenge current PD definitions. First, new findings challenge the central role of the classical pathologic criteria as the arbiter of diagnosis, notably genetic cases without synuclein deposition, the high prevalence of incidental Lewy body (LB) deposition, and the nonmotor prodrome of PD. It remains unclear, however, whether these challenges merit a change in the pathologic gold standard, especially considering the limitations of alternate gold standards. Second, the increasing recognition of dementia in PD challenges the distinction between diffuse LB disease and PD. Consideration might be given to removing dementia as an exclusion criterion for PD diagnosis. Third, there is increasing recognition of disease heterogeneity, suggesting that PD subtypes should be formally identified; however, current subtype classifications may not be sufficiently robust to warrant formal delineation. Fourth, the recognition of a nonmotor prodrome of PD requires that new diagnostic criteria for early-stage and prodromal PD should be created; here, essential features of these criteria are proposed. Finally, there is a need to create new MDS diagnostic criteria that take these changes in disease definition into consideration. © 2014 The Authors. <italic>Movement</italic>
Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.</p>
</div>
</front>
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