Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.

  title={Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.},
  author={Andrew J. Hughes and Susan E. Daniel and Linda Kilford and Andrew John Lees},
  journal={Journal of Neurology, Neurosurgery \& Psychiatry},
  pages={181 - 184}
  • A. HughesS. Daniel A. Lees
  • Published 1 March 1992
  • Medicine, Psychology
  • Journal of Neurology, Neurosurgery & Psychiatry
Few detailed clinico-pathological correlations of Parkinson's disease have been published. The pathological findings in 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic Parkinson's disease are reported. Seventy six had nigral Lewy bodies, and in all of these Lewy bodies were also found in the cerebral cortex. In 24 cases without Lewy bodies, diagnoses included progressive supranuclear palsy, multiple system atrophy, Alzheimer's disease, Alzheimer… 

Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease

Assessment of the clinical features suggests that an accuracy of 90% may be the highest that can be expected using current diagnostic criteria for idiopathic PD.

A clinicopathologic study of 100 cases of Parkinson's disease.

The clinical details of 100 cases of histologically confirmed Parkinson's disease were examined and correlated with pathologic findings, finding the general pattern of disease conformed to traditional descriptions, and the findings broaden the present clinical and pathologic spectrum of Parkinson's Disease.

Diagnosis and Differential Diagnosis of Parkinson’s Disease

Diagnostic criteria mainly focussing on the diagnosis of idiopathic Parkinson’s disease (iPD) are summarized and specific factors to differentiate this disorder from other disease entities are delineated.

1 Diagnosis and Differential Diagnosis of Parkinson ’ s Disease

Diagnostic criteria mainly focussing on the diagnosis of idiopathic Parkinson’s disease (iPD) are summarized and specific factors to differentiate this disorder from other disease entities are delineated.

The differential diagnosis of Parkinson's disease.

The diagnosis of Parkinson's disease continues to be challenging with misdiagnosis rates as high as 20-30% in early stages, largely due to failure to recognize atypical parkinsonian disorders including multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration and dementia with Lewy bodies.

Clinical diagnosis of Parkinson's disease. Proposal of diagnostic subgroups classified at different levels of confidence

The objective of this paper is to evaluate the accuracy of conventional diagnostic criteria for Parkinson's disease and give an overview of alternative causes to parkinsonian syndromes, and propose criteria for diagnostic subgroups of the disease classified at different levels of confidence.

The role of functional neuroimaging in the differential diagnosis of idiopathic Parkinson’s disease and multiple system atrophy

A review of different PET imaging methods for the differential diagnosis of PD and MSA patients using positron emission tomography as the established method.

'Atypical' Parkinson's disease - sporadic.

Morphological substrates of parkinsonism with and without dementia: a retrospective clinico-pathological study.

  • K. Jellinger
  • Psychology, Medicine
    Journal of neural transmission. Supplementum
  • 2007
Clinico-pathological studies in DBL, demented and nondemented PD, and AD cases showed a negative relation between cognitive impairment and Alzheimer changes, suggesting that these either alone or in combination with cortical Lewy body pathologies are major causes of cognitive dysfunction.

The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service.

The clinical and pathological diagnoses of 143 cases of parkinsonism seen by neurologists associated with the movement disorders service at The National Hospital for Neurology and Neurosurgery in London suggest that neurologists with particular expertise in the field of movement disorders may be using a method of pattern recognition for diagnosis which goes beyond that inherent in any formal set of diagnostic criteria.



Clinical and pathological aspects of parkinsonism in Alzheimer's disease. A role for extranigral factors?

To examine the natural history and pathogenesis of parkinsonism in Alzheimer's disease, 44 subjects with clearly established senile dementia of the Alzheimer type were studied during a 66-month period; the chief clinical features of both types were bradykinesia and rigidity, but not resting tremor.

Clinically atypical expression of pathologically typical Lewy-body parkinsonism.

It is concluded that the clinical spectrum of Lewy-body PD is wider than is generally assumed and that the diagnosis of pathologically typical Parkinson's disease cannot be excluded on clinical grounds alone.

Neuropathological features of Alzheimer's disease in non-demented parkinsonian patients.

  • S. DanielA. Lees
  • Psychology, Medicine
    Journal of neurology, neurosurgery, and psychiatry
  • 1991
Two patients with levodopa-responsive Parkinson's syndrome had numerous cortical and striatal senile plaques and some neurofibrillary tangles at necropsy. In addition neurons in the pars compacta of

The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease.

  • W. GibbA. Lees
  • Medicine, Psychology
    Journal of neurology, neurosurgery, and psychiatry
  • 1988
Associated pathological findings suggest that cases of incidental Lewy body disease are presymptomatic cases of Parkinson's disease, and confirm the importance of age (time) in the evolution of the disease.

Clinically diagnosed Alzheimer's disease: Autopsy results in 150 cases

It is concluded that degenerative changes in the substantia nigra were more common in patients with AD than has been reported for the general aged population and the histological criteria established by the National Institutes of Health/American Association of Retired Persons Research Workshop on the Diagnosis of Alzheimer's Disease worked well.

Striatonigral degeneration. A clinicopathological study.

The clinical and pathological features of 10 cases of striatonigral degeneration are described: 5 were misdiagnosed in life as Parkinson's disease, and correlation was found between the neuronal counts in caudate:putamen, striatum:nigra compacta, globus pallidus: nigra Compacta, nigra compactA:locus coeruleus.

Diagnosis of Alzheimer's disease.

The purpose of the meeting was to identify the most important scientific research opportunities and the crucial clinical and technical issues that influence the progress of research on the diagnosis of AD.


The degree of dementia of the patients had a negative correlation with the number of medial neurons, suggesting that degeneration of the nigrostriatal neurons may contribute as a subcortical component to dementia in PD patients.

New developments in the pathology of Parkinson's disease.

Quantitative morphological studies in PD indicate that in addition to nigrostriatal dopaminergic pathways, other dopamineergic, noradrenergic, serotonergic, and cholinergic systems are involved, causing multiple neuromediator dysfunctions.