Parkinson’s disease: clinical features and diagnosis
Identifieur interne : 000543 ( Main/Corpus ); précédent : 000542; suivant : 000544Parkinson’s disease: clinical features and diagnosis
Auteurs : J. JankovicSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2008-04.
Abstract
Objective: Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. Methods: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”. Results: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. Conclusions: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.
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DOI: 10.1136/jnnp.2007.131045
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Jankovic</name></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2008-04">2008-04</date><biblScope unit="volume">79</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="368">368</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">55AD69CFECBB95F9086D16234062561A2C8D3DAC</idno><idno type="DOI">10.1136/jnnp.2007.131045</idno><idno type="href">jnnp-79-368.pdf</idno><idno type="ArticleID">jn131045</idno><idno type="PMID">18344392</idno><idno type="local">jnnp;79/4/368</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective: Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. Methods: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”. Results: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. Conclusions: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>J Jankovic</name></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Review</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Editor's choice</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Genetics</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Memory disorders (neurology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Drugs: CNS (not psychiatric)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Pain (neurology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sleep disorders (neurology)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Memory disorders (psychiatry)</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sleep disorders</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective: Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. Methods: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”. Results: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. Conclusions: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.</abstract><qualityIndicators><score>8</score><pdfVersion>1.2</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>10</keywordCount><abstractCharCount>1863</abstractCharCount><pdfWordCount>7606</pdfWordCount><pdfCharCount>52616</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>251</abstractWordCount></qualityIndicators><title>Parkinson’s disease: clinical features and diagnosis</title><pmid><json:string>18344392</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>79</volume><pages><first>368</first></pages><issn><json:string>0022-3050</json:string></issn><issue>4</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2008</publicationDate><copyrightDate>2008</copyrightDate><doi><json:string>10.1136/jnnp.2007.131045</json:string></doi><id>55AD69CFECBB95F9086D16234062561A2C8D3DAC</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/55AD69CFECBB95F9086D16234062561A2C8D3DAC/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/55AD69CFECBB95F9086D16234062561A2C8D3DAC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/55AD69CFECBB95F9086D16234062561A2C8D3DAC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Parkinson’s disease: clinical features and diagnosis</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2008-03-14</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Parkinson’s disease: clinical features and diagnosis</title><author><persName><forename type="first">J</forename><surname>Jankovic</surname></persName></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2008-04"></date><biblScope unit="volume">79</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="368">368</biblScope></imprint></monogr><idno type="istex">55AD69CFECBB95F9086D16234062561A2C8D3DAC</idno><idno type="DOI">10.1136/jnnp.2007.131045</idno><idno type="href">jnnp-79-368.pdf</idno><idno type="ArticleID">jn131045</idno><idno type="PMID">18344392</idno><idno type="local">jnnp;79/4/368</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008-03-14</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective: Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. Methods: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”. Results: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. Conclusions: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Editor's choice</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Genetics</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Memory disorders (neurology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Drugs: CNS (not psychiatric)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Pain (neurology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Sleep disorders (neurology)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Memory disorders (psychiatry)</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>Sleep disorders</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-03-14">Created</change><change when="2008-04">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/55AD69CFECBB95F9086D16234062561A2C8D3DAC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jn131045</article-id><article-id pub-id-type="doi">10.1136/jnnp.2007.131045</article-id><article-id pub-id-type="other">jnnp;79/4/368</article-id><article-id pub-id-type="pmid">18344392</article-id><article-id pub-id-type="other">368</article-id><article-id pub-id-type="other">jnnp.2007.131045</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Review</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Editor's choice</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Genetics</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Memory disorders (neurology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Drugs: CNS (not psychiatric)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Pain (neurology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Parkinson's disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Sleep disorders (neurology)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Memory disorders (psychiatry)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Sleep disorders</subject></subj-group></article-categories><title-group><article-title>Parkinson’s disease: clinical features and diagnosis</article-title><alt-title alt-title-type="running-head">Review</alt-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Jankovic</surname><given-names>J</given-names></name></contrib></contrib-group><author-notes><corresp>Professor J Jankovic, Department of Neurology, Parkinson’s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, Texas 77030-3498, USA; <email xlink:type="simple">josephj@bcm.tmc.edu</email></corresp></author-notes><pub-date pub-type="ppub"><month>4</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>14</day><month>3</month><year>2008</year></pub-date><volume>79</volume><volume-id pub-id-type="other">79</volume-id><volume-id pub-id-type="other">79</volume-id><issue>4</issue><issue-id pub-id-type="other">jnnp;79/4</issue-id><issue-id pub-id-type="other">4</issue-id><issue-id pub-id-type="other">79/4</issue-id><fpage>368</fpage><history><date date-type="received"><day>26</day><month>7</month><year>2007</year></date><date date-type="rev-recd"><day>3</day><month>9</month><year>2007</year></date><date date-type="accepted"><day>4</day><month>9</month><year>2007</year></date></history><permissions><copyright-statement>2008 BMJ Publishing Group</copyright-statement><copyright-year>2008</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-79-368.pdf"></self-uri><abstract><sec><title>Objective:</title><p>Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders.</p></sec><sec><title>Methods:</title><p>A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”.</p></sec><sec><title>Results:</title><p>Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD.</p></sec><sec><title>Conclusions:</title><p>A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Parkinson’s disease: clinical features and diagnosis</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Parkinson’s disease: clinical features and diagnosis</title></titleInfo><name type="personal"><namePart type="given">J</namePart><namePart type="family">Jankovic</namePart></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>Editor's choice</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Genetics</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Memory disorders (neurology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Drugs: CNS (not psychiatric)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Pain (neurology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Parkinson's disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Sleep disorders (neurology)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Memory disorders (psychiatry)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Sleep disorders</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2008-04</dateIssued><dateCreated encoding="w3cdtf">2008-03-14</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective: Parkinson’s disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. Methods: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included “Parkinson’s disease”, “diagnosis” and “signs and symptoms”. Results: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. Conclusions: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2008</date><detail type="volume"><caption>vol.</caption><number>79</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>368</start></extent></part></relatedItem><identifier type="istex">55AD69CFECBB95F9086D16234062561A2C8D3DAC</identifier><identifier type="DOI">10.1136/jnnp.2007.131045</identifier><identifier type="href">jnnp-79-368.pdf</identifier><identifier type="ArticleID">jn131045</identifier><identifier type="PMID">18344392</identifier><identifier type="local">jnnp;79/4/368</identifier><accessCondition type="use and reproduction" contentType="copyright">2008 BMJ Publishing Group</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/55AD69CFECBB95F9086D16234062561A2C8D3DAC/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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