Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease.
Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease.
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DOI：
10.1002/mds.25844
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发表时间：
2014-04
影响因子：
8.6
通讯作者：
Deuschl, Guenther
中科院分区：
文献类型：
--
作者：
Berg, Daniela;Postuma, Ronald B.;Bloem, Bastiaan;Chan, Piu;Dubois, Bruno;Gasser, Thomas;Goetz, Christopher G.;Halliday, Glenda M.;Hardy, John;Lang, Anthony E.;Litvan, Irene;Marek, Kenneth;Obeso, Jose;Oertel, Wolfgang;Olanow, C. Warren;Poewe, Werner;Stern, Matthew;Deuschl, Guenther
关键词：
随着疾病知识的进步，界限可能会改变。有时，这些变化如此之大，以至于需要重新定义这种疾病。为了认识到我们对帕金森氏病(PD)的认识发生了深刻的变化，国际帕金森和运动障碍协会(MDS)委托了一个特别工作组来考虑重新定义PD。本审查是一篇讨论性文章，旨在作为工作队的介绍性发言。确定了挑战当前PD定义的几个关键问题。首先，新的发现挑战了经典病理标准作为诊断仲裁器的中心角色，特别是没有突触核蛋白沉积的遗传性病例，偶发性路易小体(LB)沉积的高发生率，以及PD的非运动性前驱症状。然而，目前尚不清楚这些挑战是否值得改变病理黄金标准，特别是考虑到替代黄金标准的局限性。其次，帕金森病患者对痴呆的认识日益增加，这对弥漫性LB病和帕金森病之间的区别提出了挑战。可以考虑排除痴呆作为帕金森病诊断的排除标准。第三，人们对疾病异质性的认识越来越多，这表明应该正式确定PD亚型；然而，当前的亚型分类可能不够强大，不足以保证正式划分。第四，识别帕金森病的非运动性先兆需要建立新的早期和前驱帕金森病的诊断标准；在这里，这些标准的基本特征被提出。最后，有必要创建新的MDS诊断标准，将疾病定义中的这些变化考虑在内。©2014作者。《运动障碍》由威利期刊公司代表国际帕金森和运动障碍协会出版。
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. © 2014 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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DOI：
10.1093/brain/awq079
发表时间：
2010-06
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Bohnen NI;Müller ML;Kotagal V;Koeppe RA;Kilbourn MA;Albin RL;Frey KA
通讯作者：
Frey KA
影响因子：
11
作者：
HUGHES, AJ;DANIEL, SE;LEES, AJ
通讯作者：
LEES, AJ
影响因子：
9.9
作者：
Klein, J. C.;Eggers, C.;Hilker, R.
通讯作者：
Hilker, R.
影响因子：
11.2
作者：
CALNE, DB;SNOW, BJ;LEE, C
通讯作者：
LEE, C
影响因子：
8.6
作者：
Buchman, Aron S.;Nag, Sukriti;Shulman, Joshua M.;Lim, Andrew S. P.;VanderHorst, Veronique G. J. M.;Leurgans, Sue E.;Schneider, Julie A.;Bennett, David A.
通讯作者：
Bennett, David A.