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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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“Parkinson’s disease (PD) is a chronic neurodegenerative disease generally conceptualised as affecting motor function [1].”
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“The increase in tone should be independent of velocity and is described as “lead-pipe” resistance, often with the “cogwheel” phenomenon, where a superimposed tremor is also felt (5).”
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“Beyond the cardinal motor symptoms, tremor, rigidity, bradykinesia/akinesia, and postural instability, the life quality of PD patients is also compromised by non-motor features including cognitive impairment, hyposmia, sleep disorders, depression, constipation, and autonomic dysfunction [2,3].”
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Learning Hand Kinematics for Parkinson's Disease Assessment Using a Multimodal Sensor Glove
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Prolonged Swallowing Time in Dysphagic Parkinsonism Patients With Aspiration Pneumonia
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“1 Parkinson’s disease PD is a neurodegenerative age-related disorder characterized by several motor impairments, such as tremor, rigidity, bradikinesia, postural instability, and other non-motor symptoms, as psychiatric manifestations, sleep disturbance and hyposmia [54].”
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“Parkinson’s disease (PD) is a neurodegenerative disorder most commonly characterized by tremor, rigidity, akinesia or bradykinesia, and postural instability [Jankovic, 2008].”
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“Patients become refractory to these interventions over time, however, owing to a continued loss of dopaminergic neurons, resulting in dose escalations and debilitating drug-induced dyskinesia (Jankovic, 2008; Panneton et al., 2010; Kalia and Lang, 2015).”
BackgroundRepurposing metformin to treat age-related neurodegenerative disorders and ischemic stroke
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BackgroundMethodInfluentialA Stage-Based Approach to Therapy in Parkinson’s Disease
Carrarini, C., Russo, M., Dono, F., Pietro, M. D., Rispoli, M. G., Stefano, V. D., Ferri, L., Barbone, F., Vitale, M., Thomas, A., et al. (2019) · Biomolecules · doi:10.3390/biom9080388 · Cited by 58
“The quantitative assessment of clinical symptoms and progression of the course is an essential component of any therapeutic trial in PD (Table 2) [1].”
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“Exome sequencing of another series of 1243 PD and 472 controls of western European ancestry identified A32T, P34L, and I80V rare variants of CHCHD2 in four earlyonset PD patients and none in controls (Jansen et al., 2015).”
Interaction between autophagy and the NLRP3 inflammasome in Alzheimer’s and Parkinson’s disease
Lu, R., Zhang, L., & Yang, X. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.1018848 · Cited by 58
Translational molecular imaging and drug development in Parkinson’s disease
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Dysphagia in Parkinson's disease is responsive to levodopa
Sutton, J. P. (2013) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2012.11.007 · Cited by 58
Parkinson's Disease Motor Symptoms in Machine Learning: A Review
Ahlrichs, C., & Lawo, M. (2013) · Health Informatics - An International Journal · doi:10.5121/hiij.2013.2401 · Cited by 63
Abnormal regional homogeneity in Parkinson's disease: a resting state fMRI study
Li, Y., Liang, P., Jia, X., & Li, K. (2015) · Clinical Radiology · doi:10.1016/j.crad.2015.10.006 · Cited by 58
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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