The DOI matches its Crossref record; 156 of the 157 references it cites were found in a registry or an index.
Parkinson's disease: clinical features and diagnosis
Open accessAbstract
OBJECTIVE: Parkinson's disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. This review describes the clinical characteristics of PD with emphasis on those features that differentiate the disease from other parkinsonian disorders. METHODS: A MedLine search was performed to identify studies that assess the clinical characteristics of PD. Search terms included "Parkinson's disease", "diagnosis" and "signs and symptoms". RESULTS: Because there is no definitive test for the diagnosis of PD, the disease must be diagnosed based on clinical criteria. Rest tremor, bradykinesia, rigidity and loss of postural reflexes are generally considered the cardinal signs of PD. The presence and specific presentation of these features are used to differentiate PD from related parkinsonian disorders. Other clinical features include secondary motor symptoms (eg, hypomimia, dysarthria, dysphagia, sialorrhoea, micrographia, shuffling gait, festination, freezing, dystonia, glabellar reflexes), non-motor symptoms (eg, autonomic dysfunction, cognitive/neurobehavioral abnormalities, sleep disorders and sensory abnormalities such as anosmia, paresthesias and pain). Absence of rest tremor, early occurrence of gait difficulty, postural instability, dementia, hallucinations, and the presence of dysautonomia, ophthalmoparesis, ataxia and other atypical features, coupled with poor or no response to levodopa, suggest diagnoses other than PD. CONCLUSIONS: A thorough understanding of the broad spectrum of clinical manifestations of PD is essential to the proper diagnosis of the disease. Genetic mutations or variants, neuroimaging abnormalities and other tests are potential biomarkers that may improve diagnosis and allow the identification of persons at risk.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Most medical diagnoses rely on standardized guidelines [23, 26, 60].”
From Understanding the Effect of Counterfactual Explanations on Trust and Reliance on AI for Human-AI Collaborative Clinical Decision Making (2023) · cites this paper as [26]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Resting tremor that occurs in a fully supported arm serves as an important symptom in differentiating PD from ET in clinical diagnosis (Jankovic, 2008).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Jankovic, 2008
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Around 80% have limb tremor, most commonly a resting pill-rolling type of tremor of the hands.”
From The clinical symptoms of Parkinson's disease. (2016) · cites this paper as Jankovic 2008
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease.
Gibb, W. R., & Lees, A. J. (1988) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.51.6.745 · Cited by 3,481
Parkinson, J. (2002) · Journal of Neuropsychiatry · doi:10.1176/jnp.14.2.223 · Cited by 2,856
Diagnostic Criteria for Parkinson Disease
Gelb, D. J., Oliver, E., & Gilman, S. (1999) · Archives of Neurology · doi:10.1001/archneur.56.1.33 · Cited by 2,822
Dopamine neuron systems in the brain: An update
Björklund, A., & Dunnett, S. B. (2007) · Trends in Neurosciences · doi:10.1016/j.tins.2007.03.006 · Cited by 1,777
Goetz, C. G., Fahn, S., Martínez‐Martín, P., Poewe, W. H., Sampaio, C., Stebbins, G. T., Stern, M. B., Tilley, B. C., Dodel, R. C., Dubois, B., et al. (2006) · Movement Disorders · doi:10.1002/mds.21198 · Cited by 1,443
Self-citationHughes, A. J., Ben-Shlomo, Y., Daniel, S. E., & Lees, A. J. (1992) · Neurology · doi:10.1212/wnl.42.6.1142 · Cited by 1,313
Bloem, B. R., Hausdorff, J. M., Visser, J. E., & Giladi, N. (2004) · Movement Disorders · doi:10.1002/mds.20115 · Cited by 1,298
Modification of Parkinsonism — Chronic Treatment with L-Dopa
Cotzias, G. C., Papavasiliou, P. S., & Gellene, R. A. (1969) · New England Journal of Medicine · doi:10.1056/nejm196902132800701 · Cited by 1,287
Schenck, C. H., Bundlie, S. R., & Mahowald, M. W. (1996) · Neurology · doi:10.1212/wnl.46.2.388 · Cited by 1,083
Sydney multicenter study of Parkinson's disease: Non‐L‐dopa–responsive problems dominate at 15 years
Hely, M. A., Morris, J. G. L., Reid, W. G. J., & Trafficante, R. (2005) · Movement Disorders · doi:10.1002/mds.20324 · Cited by 1,050
Research works printed but not linked: 6
- [41]41. Stamey WP, Jankovic J. Shoulder pain in Parkinson's disease. Mov Disord 2007;22:S247-8.
- [50]50. Djaldetti R, Mosberg-Galili R, Sroka H, et al. Camptocormia (bent spine) in patients with Parkinson's disease-characterization and possible pathogenesis of an unusual phenomenon. Mov Disord 1999;14:443-7.
- [53]53. Wenning GK, Ebersbach G, Verny M, et al. Progression of falls in postmortem- confirmed parkinsonian disorders. Mov Disord 1999;14:947-50.
- [57]57. Koller WC, Glatt S, Vetere-Overfield B, et al. Falls and Parkinson's disease. Clin Neuropharmacol 1989;12:98-105.
- [68]68. Marchese R, Diverio M, Zucchi F, et al. The role of sensory cues in the rehabilitation of parkinsonian patients: a comparison of two physical therapy protocols. Mov Disord 2000;15:879-83.
- [75]75. Wu J, Sitburana O, Jankovic J. The specificity and sensitivity of ''applause sign'' in differentiating PSP and other parkinsonian syndromes. Mov Disord 2007;22:S254-5.
Cited by
Sorted by citations
Items 1,001–1,030 of 1,030
Bortolozzi, A., Manashirov, S., Chen, A., & Artigas, F. (2021) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2021.107873 · Cited by 37
Oh, S. J., Ahn, H., Jung, K.-H., Han, S. J., Nam, K. R., Kang, K. J., Park, J.-A., Lee, K. C., Lee, Y. J., & Choi, J. Y. (2020) · Molecular Imaging and Biology · doi:10.1007/s11307-020-01485-w · Cited by 50
Alternative platelet activation pathways and their role in neurodegenerative diseases
Ferrer-Raventós, P., & Beyer, K. (2021) · Neurobiology of Disease · doi:10.1016/j.nbd.2021.105512 · Cited by 39
“It develops after the loss of dopaminergic neurons in the substantia nigra, the ventral part of the pars compacta (SNpc), leading to motor symptoms including bradykinesia, tremor and rigidity (Jankovic, 2008).”
Xing, X., Luo, N., Li, S., Zhou, L., Song, C., & Liu, J. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.701632 · Cited by 39
Hu, Z., Hao, M., Xu, S., Xiao, Q., & Lan, N. (2019) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-019-0505-0 · Cited by 38
Laboratoire de recherche en génie électrique, E. N. S. D. L. T. (., Benba, A., Jilbab, A., Laboratoire de recherche en génie électrique, E. N. S. D. L. T. (., Hammouch, A., & Laboratoire de recherche en génie électrique, E. N. S. D. L. T. (. (2015) · International Journal on Electrical Engineering and Informatics · doi:10.15676/ijeei.2015.7.2.10 · Cited by 33
Costa, J., González, H. A., Valldeoriola, F., Gaig, C., Tolosa, E., & Valls‐Solé, J. (2010) · Movement Disorders · doi:10.1002/mds.23334 · Cited by 33
Chang, B., Geng, Z., Mei, J., Wang, Z., Chen, P., Jiang, Y., & Niu, C. (2024) · Neurotherapeutics · doi:10.1016/j.neurot.2024.e00471 · Cited by 30
Hao, M.-Z., Xu, S.-Q., Hu, Z.-X., Xu, F.-L., Niu, C.-X. M., Xiao, Q., & Lan, N. (2017) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-017-0286-2 · Cited by 29
“Tremor dominant patients do not respond to medication, such as Levodopa, as well as other patients with PD [1, 2, 4].”
BackgroundADORA2A rs5760423 and CYP1A2 rs762551 Polymorphisms as Risk Factors for Parkinson’s Disease
Siokas, V., Aloizou, A.-M., Tsouris, Z., Liampas, I., Liakos, P., Calina, D., Docea, A. O., Tsatsakis, A., Bogdanos, D. P., Hadjigeorgiou, G. M., et al. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10030381 · Cited by 29
Baudouin, R., Lechien, J. R., Carpentier, L., Gurruchaga, J., Lisan, Q., & Hans, S. (2023) · Otolaryngology–Head and Neck Surgery · doi:10.1177/01945998221120189 · Cited by 27
Inflammatory Pathways in Parkinson’s Disease; A BNE Microarray Study
Durrenberger, P. F., Grünblatt, E., Fernando, F. S., Monoranu, C. M., Evans, J., Riederer, P., Reynolds, R., & Dexter, D. T. (2012) · Parkinson's Disease · doi:10.1155/2012/214714 · Cited by 63
“It is estimated that 70% to 80% of striatal DA neurones are lost at the time of first diagnosis of the motor symptoms [7].”
Post-COVID-19 Parkinsonism and Parkinson’s Disease Pathogenesis: The Exosomal Cargo Hypothesis
Mysiris, D. S., Vavougios, G. D., Karamichali, E., Papoutsopoulou, S., Stavrou, V. T., Papayianni, E., Boutlas, S., Mavridis, T., Foka, P., Zarogiannis, S. G., et al. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23179739 · Cited by 25
A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor
Zhang, B., Huang, F., Liu, J., & Zhang, D. (2018) · Frontiers in Neuroscience · doi:10.3389/fnins.2018.00317 · Cited by 24
“Resting tremor that occurs in a fully supported arm serves as an important symptom in differentiating PD from ET in clinical diagnosis (Jankovic, 2008).”
BackgroundKodali, M., Kadiri, S. R., & Alku, P. (2024) · Computer Speech & Language · doi:10.1016/j.csl.2023.101548 · Cited by 24
Measuring activities of daily living in Parkinson’s disease: On a road to nowhere and back again?
Hagell, P. (2019) · Measurement · doi:10.1016/j.measurement.2018.09.050 · Cited by 23
“, depression, anxiety, sleep disorders, fatigue, cognitive impairment, dysautonomia and pain) are also common and make significant contributions to the overall impact of PD [3, 4].”
He, X., Hao, M.-Z., Wei, M., Xiao, Q., & Lan, N. (2015) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/s12984-015-0101-x · Cited by 18
“The tremor dominant patients suffer milder rigidity and bradykinesia [6–9] with less impairment of motor functions [10, 11].”
BackgroundDevelopment of a closed-loop system for tremor suppression in patients with Parkinson's disease
Xu, F. L., Hao, M. Z., Xu, S. Q., Hu, Z. X., Xiao, Q., & Lan, N. (2016) · 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2016.7591063 · Cited by 18
“There are four cardinal symptoms of PD: tremor at rest, rigidity, akinesia, postural instability [1].”
BackgroundBounsall, K., Milne-Ives, M., Hall, A., Carroll, C., & Meinert, E. (2023) · JMIR Research Protocols · doi:10.2196/46581 · Cited by 16
“PD is a neurological disorder associated with motor and nonmotor features [4] affecting multiple aspects of movement, including planning, initiation, and execution [5].”
Yuan, H., Liu, S., Liu, J., Lin, H., Yang, C., Cai, X., Zeng, L., & Li, S. (2021) · Mathematical Problems in Engineering · doi:10.1155/2021/5669932 · Cited by 10
The factor structure of the UPDRS motor scores changes during early Parkinson's disease
Brakedal, B., Tysnes, O.-B., Skeie, G. O., Larsen, J. P., & Müller, B. (2014) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2014.03.008 · Cited by 8
Xie, M., Wang, T., Feng, J., Ma, D., Feng, L., & Hao, Y. (2025) · Current Neuropharmacology · doi:10.2174/1570159x23666250225091729 · Cited by 7
“PD is a neurodegenerative disorder characterized by motor deficiencies such as rigidity, bradykinesia, and resting tremor [218].”
Driving with Parkinson's Disease: Exploring Lived Experience
Holmes, J. D., Alvarez, L., Johnson, A. M., Robinson, A. E., Gilhuly, K., Horst, E., Kowalchuk, A., Rathwell, K., Reklitis, Y., & Wheildon, N. (2019) · Parkinson's Disease · doi:10.1155/2019/3169679 · Cited by 6
“Julian described freezing in his hands, a common symptom associated with PD [15], when stating, “I was driving .”
BackgroundReal-time classification of movement patterns of tremor patients
Piepjohn, P., Bald, C., Kuhlenbäumer, G., Becktepe, J. S., Deuschl, G., & Schmidt, G. (2022) · Biomedical Engineering / Biomedizinische Technik · doi:10.1515/bmt-2021-0140 · Cited by 5
Kim, M. Y., Jethani, P., Kang, E., Lipsey, K. L., & Foster, E. R. (2024) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2023.10.009 · Cited by 5
Amplitude and velocity dependence of patellar pendulum triggered by T reflex in Parkinson’s rigidity
Uslu, S., Gürbüz, M., Kızılay, F., Özkaynak, S., Nüzket, T., & Uysal, H. (2021) · Neurological Sciences · doi:10.1007/s10072-020-04936-y · Cited by 5
Daneault, J.-F., Carignan, B., Rahimi, F., Sadikot, A. F., & Duval, C. (2013) · Contemporary Clinical Neuroscience · doi:10.1007/978-1-4614-4027-7_8 · Cited by 3
New trends in advanced Parkinson disease stage therapy
Kolesárová, M., Franko, O., Kolesár, D., Gažová, A., & Kyselovič, J. (2023) · Česká a slovenská farmacie · doi:10.5817/csf2023-1-37 · Cited by 2
Pereira, C. R., Machado, J., Criado, B., Santos, R., Reis, A. M., Ramos, B., Santos, M. J., & Greten, H. J. (2025) · Clinical Parkinsonism & Related Disorders · doi:10.1016/j.prdoa.2025.100324 · Cited by 1
Parkinson’s Disease: Bridging Gaps, Building Biomarkers, and Reimagining Clinical Translation
Tanaka, M. (2025) · doi:10.20944/preprints202506.2099.v2 · Cited by 57
Metadata
- Authors
- Jankovic, J.
- Affiliations
- Baylor College of Medicine (US)
- Corresponding author
- Jankovic, J
- ORCID
- Jankovic, J
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2008-04-01
- Volume
- 79
- Issue
- 4
- Pages
- 368-376
- ISSN
- 0022-3050 (ISSN-L)
- OpenAlex
- W2145954079
- Cited by
- 5,720
- References
- 157
- Citations by year
- 2026: 307 · 2025: 455 · 2024: 503 · 2023: 422 · 2022: 424 · 2021: 444 · 2020: 455 · 2019: 405 · 2018: 349 · 2017: 323 · 2016: 324 · 2015: 298 · 2014: 257 · 2013: 232 · 2012: 184
- FWCI
- 15.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Parkinson Foundation
- Parkinsonfonden
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- Parkinson's disease, clinical features, diagnosis, parkinsonism, resting tremor, bradykinesia, rigidity, postural instability, non-motor symptoms, autonomic dysfunction, levodopa response, differential diagnosis, biomarkers, genetic mutations, neuroimaging
- MeSH terms
- Diagnosis, Differential, Humans, Neurologic Examination, Parkinson Disease, Parkinsonian Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
