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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.
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“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]
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“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
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“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
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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
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