Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.

TLDR

Few detailed clinico‑pathological correlations of Parkinson’s disease have been published. The study reports pathological findings in 100 prospectively diagnosed idiopathic Parkinson’s disease patients. Among 100 cases, 76 had nigral and cortical Lewy bodies, while the 24 without them were diagnosed with other disorders; applying recommended criteria retrospectively raised diagnostic accuracy to 82%, suggesting Parkinson’s disease may not be a single distinct entity.

Abstract

Few detailed clinico-pathological correlations of Parkinson9s disease have been published. The pathological findings in 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic Parkinson9s disease are reported. Seventy six had nigral Lewy bodies, and in all of these Lewy bodies were also found in the cerebral cortex. In 24 cases without Lewy bodies, diagnoses included progressive supranuclear palsy, multiple system atrophy, Alzheimer9s disease, Alzheimer-type pathology, and basal ganglia vascular disease. The retrospective application of recommended diagnostic criteria improved the diagnostic accuracy to 82%. These observations call into question current concepts of Parkinson9s disease as a single distinct morbid entity.