Department of Neurology with Friedrich Baur Institute, LMU University Hospital, Ludwig-Maximilians-University (LMU) Munich, Marchioninistr. 15, 81377, Munich, Germany.
German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
J Neurol. 2024 Nov;271(11):7102-7119. doi: 10.1007/s00415-024-12687-5. Epub 2024 Sep 19.
Accurate definition and operational criteria for diagnosing Parkinson's disease (PD) are crucial for evidence-based, patient-centered care.
To offer evidence-based recommendations for defining and diagnosing PD, incorporating contemporary clinical, imaging, biomarker, and genetic insights.
The guideline development began with the steering committee establishing key PICO (patient, intervention, comparison, outcome) questions, which were refined by the coauthors. Systematic literature searches identified relevant studies, reviews, and meta-analyses. Recommendations were drafted, evaluated, optimized, and voted upon by the German Parkinson's Guideline Group.
Parkinson's disease (PD) is now understood to encompass a broader spectrum of etiologies than previously recognized. Advances in molecular pathogenesis, neuroimaging, and early clinical phenotypes suggest that PD is not a uniform disease entity and is often not idiopathic. This necessitates an updated framework for PD definition and diagnosis. The German Society for Neurology now endorses a broader concept of PD, incorporating both idiopathic and hereditary forms, as opposed to the previously narrower concept of "idiopathic Parkinson syndrome." The revised guidelines recommend using the 2015 Movement Disorders Society diagnostic criteria, emphasize the importance of long-term clinical follow-up for improved diagnostic accuracy, and highlight the significance of non-motor symptoms in clinical diagnosis. Specific recommendations are provided for the use of imaging and fluid biomarkers and genetic testing to support the clinical diagnosis.
The updated guidelines from the German Society for Neurology enhance diagnostic accuracy for PD, promoting optimized clinical care.
准确定义和操作标准对于基于证据、以患者为中心的护理至关重要。
提供基于证据的帕金森病（PD）定义和诊断建议，纳入当代临床、影像学、生物标志物和遗传学的见解。
指南制定始于指导委员会确定关键的 PICO（患者、干预、比较、结局）问题，然后由共同作者进行细化。系统的文献检索确定了相关的研究、综述和荟萃分析。建议由德国帕金森病指南小组起草、评估、优化和投票。
现在人们认识到，帕金森病（PD）的病因范围比以前认识的更广泛。分子发病机制、神经影像学和早期临床表型方面的进展表明，PD 不是一种单一的疾病实体，而且往往不是特发性的。这需要更新 PD 的定义和诊断框架。德国神经病学会现在支持更广泛的 PD 概念，包括特发性和遗传性形式，而不是以前更窄的“特发性帕金森综合征”概念。修订后的指南建议使用 2015 年运动障碍学会的诊断标准，强调长期临床随访对提高诊断准确性的重要性，并强调非运动症状在临床诊断中的重要性。还提供了关于使用影像学和液体生物标志物和遗传测试来支持临床诊断的具体建议。
德国神经病学会的更新指南提高了 PD 的诊断准确性，促进了优化的临床护理。
