Redefinition of Parkinson’s Disease

AbstractIn 2015, a working group of the International Parkinsonʼs and Movement Disorders Society (MDS) presented new clinical diagnostic criteria for Parkinsonʼs disease (PD). This review outlines the key insights with regard to pathophysiology, various clinical manifestations and clinical progression which form the basis for a redefinition and the new, summarized clinical diagnostic criteria of Parkinson’s disease. Essential findings, which led to the new diagnostic criteria, include (i) the recognition of the importance of non-motor symptoms, which may have a tremendous influence on the quality of life of patients and have an increasing relevance with regard to early and differential diagnosis of PD is stated. (ii) The categorization of dementia in the course of Parkinson’s disease. While there has been a clear separation between Parkinson’s disease and dementia with Lewy bodies so far, now a continuum is postulated which summarizes Parkinson’s disease without, with late and with early (within the first year after the occurrence of motor symptoms) dementia under the umbrella term of Lewy Body Diseases (LBD). (iii) The realization of a slowly spreading process of neurodegeneration