Progress and Prospects in Parkinson's Research/Atypical Parkinsonism

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"A range of overlapping neurological conditions with similar symptoms gives rise to frequent diagnostic problems."

Background
The following table identifies some common neurological disorders, their 'trademark' pathological characteristics, and the parts of the CNS affected

Research
1992

Hughes et al re-evaluated 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic Parkinson's disease.

"In 24 cases without Lewy bodies, diagnoses included progressive supranuclear palsy, multiple system atrophy, Alzheimer's disease, Alzheimer-type pathology, and basal ganglia vascular disease. The retrospective application of recommended diagnostic criteria improved the diagnostic accuracy to 82%. These observations call into question current concepts of Parkinson's disease as a single distinct morbid entity."

2003

Yekhief et al evaluated the use of MRI scans in the diagnosis of PD and PD+ syndromes.

"The “cortical” score distinguished CBD and PSP from MSA with a fair PPV (>90%). The PPV of the “putaminal” score was high (70%) for the differential diagnosis of MSA with PSP and CBD. The “midbrain” score was significantly higher in PSP and CBD compared to MSA. These results are in accordance with the underlying pathology found in these disorders and demonstrate that a simple MRI scoring procedure may help the neurologist to differentiate primary causes of parkinsonism in everyday practice."