机构：[1]Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and German Center of Neurodegenerative Diseases, Tuebingen, Germany[2]Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada[3]Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands[4]Xuanwu Hospital of Capital Medical University, Beijing, People’s Republic of China首都医科大学宣武医院[5]Department of neurology, Salp^etrie` re Hospital, APHP, University Paris 6, UPMC, Paris, France[6]Rush University Medical Center, Chicago, Illinois, USA[7]Neuroscience Research, Randwick, Australia and the University of New South Wales, Sydney, Australia[8]Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK[9]Edmond J Safra Program in Parkinson’s Disease, Division of Neurology, Toronto Western Hospital and the University of Toronto, Toronto, Canada[10]Department of Neurosciences, University of California San Diego, La Jolla, California, USA[11]Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA[12]University of Navarra-FIMA, Pamplona, Spain[13]Department of Neurology, Philipps University of Marburg, Marburg, Germany[14]Department of Neurology, The Mount Sinai Hospital, New York, New York, USA[15]Department of Neurology, Innsbruck Medical University, Innsbruck, Austria[16]Penn Neurological Institute, Philadelphia, Pennsylvania, USA[17]Department of Neurology, Christian-Albrechts University, Kiel, Germany
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. (c) 2014 International Parkinson and Movement Disorder Society
基金：
Wellcome Trust [089698]; Medical Research Council [MC_G1000735, G0701075]
第一作者机构：[1]Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and German Center of Neurodegenerative Diseases, Tuebingen, Germany[*1]Hertie Institute of Clinical Brain Research, HoppeSeyler-Stra?e 3, 72076 Tubingen, Germany
共同第一作者：
通讯作者：
通讯机构：[*1]Hertie Institute of Clinical Brain Research, HoppeSeyler-Stra?e 3, 72076 Tubingen, Germany
推荐引用方式(GB/T 7714)：
Daniela Berg,Ronald B. Postuma,Bastiaan Bloem,et al.Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease[J].MOVEMENT DISORDERS.2014,29(4):454-462.doi:10.1002/mds.25844.
APA：
Daniela Berg,Ronald B. Postuma,Bastiaan Bloem,Piu Chan,Bruno Dubois...&G€unther Deuschl.(2014).Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease.MOVEMENT DISORDERS,29,(4)
MLA：
Daniela Berg,et al."Time to redefine PD? Introductory statement of the MDS Task Force on the definition of Parkinson's disease".MOVEMENT DISORDERS 29..4(2014):454-462
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