Session Information
Date: Wednesday, June 7, 2017
Session Title: Phenomenology and Clinical Assessment Of Movement Disorders
Session Time: 1:15pm-2:45pm
Location: Exhibit Hall C
Objective: To assess the new Movement Disorder Society (MDS) diagnostic criteria for PD.
Background: Evolving knowledge regarding PD led to the development of new clinical diagnostic criteria (Postuma et al 2015), but these have not yet been assessed in large cohorts.
Methods: Recently diagnosed (<3.5 years) PD cases fulfilling step 1 of the United Kingdom (UK) brain bank criteria in Tracking Parkinson’s, a UK multicenter prospective natural history study, were categorized by the MDS diagnostic criteria for PD.
Results: In 2000 cases, 1835 (91.7%) met the MDS criteria for PD, categorized as either clinically established (n=1261, 63.1%) or clinically probable (n=574, 28.7%); 165 (8.3%) did not fulfil the criteria. Clinically established cases were significantly more likely to have limb rest tremor (89.3%), a good L-dopa response (79.5%), and olfactory loss (71.1%), compared to clinically probable cases (60.6%, 44.4%, and 34.5%, respectively), but differences between probable PD and cases not fulfilling criteria were less evident. In cases not fulfilling criteria, the mean MDS UPDRS motor score (25.1, SD 13.2) was significantly higher than in probable PD (22.0, SD 12.0, p=0.016) but not established PD (22.9, SD 12.0, p=0.066). The L-dopa equivalent daily dose of 341mg (SD 261) in non-PD cases was significantly higher than in probable PD (250mg, SD 214, p<0.001), and those with established PD (308mg, SD 199, p=0.025). 86.0% of cases categorized as PD at baseline remained in this category after 30 months of follow-up; 97.0% of cases categorized as non-PD at baseline remained in this category after 30 months of follow-up.
Conclusions: Over 90% of cases of parkinsonism with a clinical diagnosis of early PD entering a prospective cohort study fulfilled the MDS criteria for PD. Cases not fulfilling the MDS criteria had significant phenotypic differences from those categorized as PD. We will re-evaluate these observations after longitudinal follow-up of our cohort, which includes invitation to participate in a brain donation programme.
References: Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, Obeso J, Marek K, Litvan I, Lang AE, Halliday G, Goetz CG, Gasser T, Dubois B, Chan P, Bloem BR, Adler CH, Deuschl G. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/mds.26424. Review. PubMed PMID: 26474316.
To cite this abstract in AMA style:
N. Malek, M. Lawton, K. Grosset, N. Bajaj, R. Barker, Y. Ben-Shlomo, D. Burn, T. Foltynie, J. Hardy, H. Morris, N. Williams, N. Wood, D. Grosset. Fulfilment of Movement Disorder Society clinical diagnostic criteria for Parkinson’s disease in a large cohort study of recent onset cases. [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/fulfilment-of-movement-disorder-society-clinical-diagnostic-criteria-for-parkinsons-disease-in-a-large-cohort-study-of-recent-onset-cases/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/fulfilment-of-movement-disorder-society-clinical-diagnostic-criteria-for-parkinsons-disease-in-a-large-cohort-study-of-recent-onset-cases/