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UK%20Parkinson's%20Disease%20Society%20Brain%20Bank%20Criteria%20for%20the%20Diagnosis%20of%20Parkinson's%20Disease
Availability
Please visit this website for more information about the instrument: UK Parkinson's Disease Society Brain Bank Criteria for the Diagnosis of Parkinson's Disease
Classification
Supplemental: Parkinson's Disease (PD)
Short Description of Instrument
This instrument includes inclusion and exclusion criteria for diagnosing Parkinson's disease, as well as supportive diagnostic criteria. These criteria require verification of the occurrence of exclusion criteria and consideration of a parkinsonian syndrome other than PD before affirming a diagnosis of probable PD.
Scoring and Psychometric Properties
This instrument breaks the diagnosis of Parkinsonian syndrome into 3 steps. Step 1 is presence of bradykinesia and at least one of three other characteristic symptoms. Step 2 includes the exclusion criteria and Step 3 includes supportive prospective positive criteria, of which three or more are required for a diagnosis of definite Parkinson's disease.
Rationale/Justification
Strengths:
  • Fairly simple to use

  • Has been in longstanding use (since 1992)

  • Widespread use

  • Validated against pathology

 
Weaknesses:
  • Limited accuracy in early disease (see Adler et al., 2014)

  • Postural instability included as Step 1 criteria (could inadvertently include Progressive Supranuclear Palsy)

  • Step 2 criteria would exclude people with head injury, encephalitis or more than one affected relative. One could argue that those with negative MRI, even with head injury history could still be called PD. The same is true for encephalitis. It is possible to have PD with a genetic etiology.

  • Step 3 supportive criteria mostly require over 5-10 years of follow-up which limits utility in earlier disease

  • Potentially allows Dementia with Lewy Bodies (DLB) to be called PD

  • No definition of bradykinesia
References
Key Reference:
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4.
 
Additional Reference:
Adler CH, Beach TG, Hentz JG, Shill HA, Caviness JN, Driver-Dunckley E, Sabbagh MN, Sue LI, Jacobson SA, Belden CM, Dugger BN. Low clinical diagnostic accuracy of early vs advanced Parkinson disease: clinicopathologic study. Neurology. 2014 Jul 29;83(5):406-12.
 
Document last updated August 2022