TY  - JOUR
IS  - 4
N1  - © 2014 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
SP  - 454
VL  - 29
A1  - Berg, D
A1  - Postuma, RB
A1  - Bloem, B
A1  - Chan, P
A1  - Dubois, B
A1  - Gasser, T
A1  - Goetz, CG
A1  - Halliday, GM
A1  - Hardy, J
A1  - Lang, AE
A1  - Litvan, I
A1  - Marek, K
A1  - Obeso, J
A1  - Oertel, W
A1  - Olanow, CW
A1  - Poewe, W
A1  - Stern, M
A1  - Deuschl, G
JF  - Mov Disord
UR  - http:://dx.doi.org/10.1002/mds.25844
SN  - 1531-8257
AV  - public
Y1  - 2014/04//
EP  - 462
TI  - Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease.
KW  - MDS diagnostic criteria
KW  -  disease heterogeneity
KW  -  gold standard
KW  -  nonmotor prodrome
KW  -  redefinition of PD
KW  -  subtypes
KW  -  Advisory Committees
KW  -  Diagnostic and Statistical Manual of Mental Disorders
KW  -  Humans
KW  -  Neuropsychological Tests
KW  -  Parkinson Disease
N2  - 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.
ID  - discovery1425474
ER  -