title: MDS clinical diagnostic criteria for Parkinson's disease.
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.
authors.affiliation: Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada.
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Postuma
authors.affiliation: Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases, Tuebingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Berg
authors.affiliation: Penn Neurological Institute, Philadelphia, Pennsylvania, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Stern
authors.affiliation: Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.affiliation: Department of Neurology, The Mount Sinai Hospital, New York, New York, USA.
authors.forename: C Warren
authors.initials: CW
authors.lastname: Olanow
authors.affiliation: Department of Neurology, Philipps University of Marburg, Marburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Oertel
authors.affiliation: University of Navarra-FIMA, Pamplona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Obeso
authors.affiliation: Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Marek
authors.affiliation: Department of Neurosciences, UC San Diego, La Jolla, California, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
authors.affiliation: Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Lang
authors.affiliation: Neuroscience Research Australia & University of NSW, Randwick, Australia.
authors.forename: Glenda
authors.initials: G
authors.lastname: Halliday
authors.affiliation: Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Goetz
authors.affiliation: Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases, Tuebingen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
authors.affiliation: Hopital De La Salpetriere, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubois
authors.affiliation: Xuanwu Hospital of Capitol of Medical University, Beijing, Peoples Republic of China.
authors.forename: Piu
authors.initials: P
authors.lastname: Chan
authors.affiliation: Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.affiliation: The Parkinson's Disease and Movement Disorders Center, Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Adler
authors.affiliation: Department of Neurology, Christian-Albrechts University, Kiel, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Deuschl
mesh_terms: D006801:Humans; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology; D012015:Reference Standards; D012720:Severity of Illness Index; D012958:Societies, Scientific / Q000592:standards
keywords: Parkinson's disease; absolute exclusion criteria; clinical diagnostic criteria; motor parkinsonism; non-motor manifestations; red flags; supportive criteria