Importance of low diagnostic Accuracy for early Parkinson's disease

Beach, Thomas G.; Adler, Charles H.

doi:10.1002/mds.27485

Cited by 83 publications

(77 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accuracy of clinical diagnosis of early‐stage PD, reported in de novo patients, varies between 38% and 65% . Sixteen of our 21 ET patients had a second clinical diagnosis of PD, which was confirmed at autopsy in 10 (63%; Table ).…”

Section: Discussionsupporting

confidence: 91%

“…The most common error was a clinical diagnosis of PD in 5 patients who had PSP pathology. Similar errors have been reported by several other studies . The main reason for that is the absence of ophthalmoplegia and early gait difficulty .…”

Section: Discussionsupporting

confidence: 91%

“…The main reason for that is the absence of ophthalmoplegia and early gait difficulty . Recent literature indicates that PSP is more common than has been recognized so far . Such errors would likely continue until there are biomarkers that distinguish PD from PSP.…”

Section: Discussionmentioning

confidence: 99%

“…Essential tremor (ET) and Parkinson's disease (PD) are the two most common movement disorders . Parkinson's disease (PD) is characterized by marked SN neuronal loss and Lewy body inclusions and is the most common variant of Parkinson's syndrome (PS). The term parkinsonism is used interchangeably with PS.…”

mentioning

confidence: 99%

“…Because there are no biological markers for ET or PS, the diagnosis of each is based on the clinical history and findings . There is no diagnostic brain pathology in most ET cases, but most PS variants have distinct brain pathology . Functional imaging, such as PET and dopamine transporter (DaT), studies can distinguish ET from PS cases, but cannot differentiate between PS variants .…”

mentioning

confidence: 99%

See 4 more Smart Citations

Parkinsonism in essential tremor cases: A clinicopathological study

Rajput

Bocking

et al. 2019

Movement Disorders

View full text Add to dashboard Cite

Background Essential tremor and Parkinson's syndrome are two common movement disorders that may co‐occur in some individuals. There is no diagnostic neuropathology for essential tremor, but in PD and other Parkinson's syndrome variants, the neuropathology is well known. The spectrum of Parkinson's syndrome variants associated with essential tremor, their clinical features, and course have not been determined in autopsy‐confirmed cases. Objectives To identify: diagnostic features of essential tremor/Parkinson's syndrome, different Parkinson's syndrome variants, and long‐term clinical profile in such cases. Methods Patients that had an essential tremor diagnosis and a subsequent clinical or pathological diagnosis of Parkinson's syndrome seen in our clinic during 50 years were included. The diagnosis of parkinsonism was made when bradykinesia, rigidity, and resting tremor were all clinically evident. Results Twenty‐one cases were included. All the common variants of parkinsonism co‐occurred with essential tremor. The most common was PD (67%) followed by PSP. The pathological findings were not predicted clinically in 2 cases that had essential tremor/PD and in all 5 essential tremor/PSP cases. Conclusion In most essential tremor/Parkinson's syndrome patients, the main motor features of parkinsonism—bradykinesia, rigidity, and resting tremor—were identifiable. All known degenerative Parkinson's syndrome variants co‐occurred in essential tremor patients. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Parkinsonism in essential tremor cases: A clinicopathological study

Rajput

Bocking

et al. 2019

Movement Disorders

View full text Add to dashboard Cite

show abstract

Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies

Gibbons,

Levine,

Adler

et al. 2024

JAMA

View full text Add to dashboard Cite

ImportanceFinding a reliable diagnostic biomarker for the disorders collectively known as synucleinopathies (Parkinson disease [PD], dementia with Lewy bodies [DLB], multiple system atrophy [MSA], and pure autonomic failure [PAF]) is an urgent unmet need. Immunohistochemical detection of cutaneous phosphorylated α-synuclein may be a sensitive and specific clinical test for the diagnosis of synucleinopathies.ObjectiveTo evaluate the positivity rate of cutaneous α-synuclein deposition in patients with PD, DLB, MSA, and PAF.Design, Setting, and ParticipantsThis blinded, 30-site, cross-sectional study of academic and community-based neurology practices conducted from February 2021 through March 2023 included patients aged 40 to 99 years with a clinical diagnosis of PD, DLB, MSA, or PAF based on clinical consensus criteria and confirmed by an expert review panel and control participants aged 40 to 99 years with no history of examination findings or symptoms suggestive of a synucleinopathy or neurodegenerative disease. All participants completed detailed neurologic examinations and disease-specific questionnaires and underwent skin biopsy for detection of phosphorylated α-synuclein. An expert review panel blinded to pathologic data determined the final participant diagnosis.ExposureSkin biopsy for detection of phosphorylated α-synuclein.Main OutcomesRates of detection of cutaneous α-synuclein in patients with PD, MSA, DLB, and PAF and controls without synucleinopathy.ResultsOf 428 enrolled participants, 343 were included in the primary analysis (mean [SD] age, 69.5 [9.1] years; 175 [51.0%] male); 223 met the consensus criteria for a synucleinopathy and 120 met criteria as controls after expert panel review. The proportions of individuals with cutaneous phosphorylated α-synuclein detected by skin biopsy were 92.7% (89 of 96) with PD, 98.2% (54 of 55) with MSA, 96.0% (48 of 50) with DLB, and 100% (22 of 22) with PAF; 3.3% (4 of 120) of controls had cutaneous phosphorylated α-synuclein detected.Conclusions and RelevanceIn this cross-sectional study, a high proportion of individuals meeting clinical consensus criteria for PD, DLB, MSA, and PAF had phosphorylated α-synuclein detected by skin biopsy. Further research is needed in unselected clinical populations to externally validate the findings and fully characterize the potential role of skin biopsy detection of phosphorylated α-synuclein in clinical care.

show abstract

Status of Current Biofluid Biomarkers in Parkinson's Disease

Mollenhauer

2023

Movement Disord Clin Pract

View full text Add to dashboard Cite

Importance of low diagnostic Accuracy for early Parkinson's disease

Cited by 83 publications

References 49 publications

Parkinsonism in essential tremor cases: A clinicopathological study

Parkinsonism in essential tremor cases: A clinicopathological study

Skin Biopsy Detection of Phosphorylated α-Synuclein in Patients With Synucleinopathies

Status of Current Biofluid Biomarkers in Parkinson's Disease

Contact Info

Product

Resources

About