MDS clinical diagnostic criteria for Parkinson's disease

Ronald B. Postuma, Daniela Berg, Matthew Stern, Werner Poewe, C. Warren Olanow, Wolfgang Oertel, José Obeso, Kenneth Marek, Irene Litvan, Anthony E. Lang, Glenda Halliday, Christopher G. Goetz, Thomas Gasser, Bruno Dubois, Piu Chan, Bastiaan R. Bloem, Charles H. Adler, Günther Deuschl

Research output: Contribution to journalReview articlepeer-review

1392 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1591-1601
Number of pages11
JournalMovement Disorders
Volume30
Issue number12
DOIs
StatePublished - Oct 2015

Keywords

  • Absolute exclusion criteria
  • Clinical diagnostic criteria
  • Motor parkinsonism
  • Non-motor manifestations
  • Parkinson's disease
  • Red flags
  • Supportive criteria

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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