Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
J Neural Transm (Vienna). 2013 Apr;120(4):619-25. doi: 10.1007/s00702-013-1007-z. Epub 2013 Mar 15.
As there are no definite diagnostic tests or reliable biomarkers for Parkinson disease (PD), its diagnosis still relies on the presence of a combination of cardinal motor features, along with the exclusion of other causes of Parkinsonism and the presence of some of supportive features. To date, several diagnostic criteria have been developed for different purposes through expert opinions or comprehensive review of the literature. However, none of them are without limitations. In this article, we review different diagnostic criteria for PD which have been published in the English medical literature, highlighting specific limitations and pitfalls. With considerable progress in the understanding of PD, particularly in a view of diverse clinical symptomatology and its evolution, it will be difficult to establish a single criterion that is capable of capturing all cases at different disease stages. Rather, we should aim to develop a set of criteria which include a consensus on clinical gold standard or reliable biomarkers at different levels of diagnostic certainty for different purposes. Despite a more refined set of criteria that may aid in the recognition of PD, the accuracy of its diagnosis still largely depends on the observational skills and clinical sensitivity of the treating physician.
由于目前尚无针对帕金森病 (PD) 的明确诊断测试或可靠的生物标志物，其诊断仍然依赖于存在一系列主要的运动特征，同时排除其他帕金森综合征的原因，并存在一些支持性特征。迄今为止，已经通过专家意见或对文献的综合回顾，为不同目的制定了几种诊断标准。然而，它们都存在局限性。在本文中，我们回顾了在英文医学文献中发表的用于 PD 的不同诊断标准，重点介绍了其特定的局限性和陷阱。随着对 PD 的认识的不断深入，尤其是从不同的临床症状及其演变来看，要建立一个能够在不同疾病阶段捕捉所有病例的单一标准将非常困难。相反，我们应该致力于制定一套标准，这些标准应包括对不同诊断确定性水平的临床金标准或可靠生物标志物的共识，以达到不同的目的。尽管更精细的一套标准可能有助于识别 PD，但对其诊断的准确性仍在很大程度上取决于治疗医生的观察技能和临床敏感性。
