SIC Task Force appraisal of clinical diagnostic criteria for parkinsonian disorders

TLDR

Diagnosis of degenerative parkinsonian disorders relies on clinical features and ancillary studies, as no biological markers exist for antemortem identification. The review aims to establish widely accepted, reproducible diagnostic criteria for parkinsonian disorders. The authors reviewed SIC Task Force findings on diagnostic criteria across Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration. Clinicopathologic studies reveal high false-positive and false-negative rates, especially early in disease, leading to frequent misdiagnosis.

Abstract

As there are no biological markers for the antemortem diagnosis of degenerative parkinsonian disorders, diagnosis currently relies upon the presence and progression of clinical features and confirmation depends on neuropathology. Clinicopathologic studies have shown significant false-positive and false-negative rates for diagnosing these disorders, and misdiagnosis is especially common during the early stages of these diseases. It is important to establish a set of widely accepted diagnostic criteria for these disorders that may be applied and reproduced in a blinded fashion. This review summarizes the findings of the SIC Task Force for the study of diagnostic criteria for parkinsonian disorders in the areas of Parkinson's disease, dementia with Lewy bodies, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration. In each of these areas, diagnosis continues to rest on clinical findings and the judicious use of ancillary studies.