Department of Neurology and Clinical Neuroscience, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
Department of Neurology, Faculty of Medicine, University of Cologne, Cologne, Germany.
J Neural Transm (Vienna). 2023 Jun;130(6):839-846. doi: 10.1007/s00702-023-02634-5. Epub 2023 Apr 12.
The clinical presentation of Parkinson's disease and atypical Parkinsonian syndromes is often heterogeneous. Additional diagnostic procedures including brain imaging and biomarker analyses can help to appreciate the various syndromes, but a precise clinical evaluation and differentiation is always necessary. To better assess the relevance of distinct clinical symptoms that arose within 1 year of disease manifestation and evaluate their indicative potential for an atypical Parkinsonian syndrome, we conducted a modified Delphi panel with seven movement disorder specialists. Five different topics with several clinical symptom items were discussed and consensus criteria were tested. This resulted in distinct symptom patterns for each atypical Parkinsonian syndrome showing the multitude of clinical involvement in each neurodegenerative disease. Strongly discriminating clinical signs were few and levels of indication were variable. A prospective validation of the assessments made is needed. This demonstrates that both clinical evaluation and elaborate additional diagnostic procedures are needed to achieve a high diagnostic standard.
帕金森病和非典型帕金森综合征的临床表现通常具有异质性。包括脑成像和生物标志物分析在内的其他诊断程序有助于了解各种综合征，但精确的临床评估和鉴别始终是必要的。为了更好地评估疾病表现后 1 年内出现的不同临床症状的相关性，并评估其对非典型帕金森综合征的指示潜力，我们与 7 名运动障碍专家进行了一项改良 Delphi 小组研究。讨论了五个不同主题和几个临床症状项目，并测试了共识标准。这为每种非典型帕金森综合征产生了不同的症状模式，显示了每种神经退行性疾病的多种临床受累。具有强区分力的临床体征很少，指示水平也各不相同。需要对所做的评估进行前瞻性验证。这表明，为了达到高标准的诊断，临床评估和详细的其他诊断程序都是必要的。
