TY - JOUR
T1 - A biological classification of Parkinson's disease
T2 - the SynNeurGe research diagnostic criteria
AU - Höglinger, Günter U.
AU - Adler, Charles H.
AU - Berg, Daniela
AU - Klein, Christine
AU - Outeiro, Tiago F.
AU - Poewe, Werner
AU - Postuma, Ronald
AU - Stoessl, A. Jon
AU - Lang, Anthony E.
N1 - Publisher Copyright:
© 2024 Elsevier Ltd
PY - 2024/2
Y1 - 2024/2
N2 - With the hope that disease-modifying treatments could target the molecular basis of Parkinson's disease, even before the onset of symptoms, we propose a biologically based classification. Our classification acknowledges the complexity and heterogeneity of the disease by use of a three-component system (SynNeurGe): presence or absence of pathological α-synuclein (S) in tissues or CSF; evidence of underlying neurodegeneration (N) defined by neuroimaging procedures; and documentation of pathogenic gene variants (G) that cause or strongly predispose to Parkinson's disease. These three components are linked to a clinical component (C), defined either by a single high-specificity clinical feature or by multiple lower-specificity clinical features. The use of a biological classification will enable advances in both basic and clinical research, and move the field closer to the precision medicine required to develop disease-modifying therapies. We emphasise the initial application of these criteria exclusively for research. We acknowledge its ethical implications, its limitations, and the need for prospective validation in future studies.
AB - With the hope that disease-modifying treatments could target the molecular basis of Parkinson's disease, even before the onset of symptoms, we propose a biologically based classification. Our classification acknowledges the complexity and heterogeneity of the disease by use of a three-component system (SynNeurGe): presence or absence of pathological α-synuclein (S) in tissues or CSF; evidence of underlying neurodegeneration (N) defined by neuroimaging procedures; and documentation of pathogenic gene variants (G) that cause or strongly predispose to Parkinson's disease. These three components are linked to a clinical component (C), defined either by a single high-specificity clinical feature or by multiple lower-specificity clinical features. The use of a biological classification will enable advances in both basic and clinical research, and move the field closer to the precision medicine required to develop disease-modifying therapies. We emphasise the initial application of these criteria exclusively for research. We acknowledge its ethical implications, its limitations, and the need for prospective validation in future studies.
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U2 - 10.1016/S1474-4422(23)00404-0
DO - 10.1016/S1474-4422(23)00404-0
M3 - Review article
C2 - 38267191
AN - SCOPUS:85183012500
SN - 1474-4422
VL - 23
SP - 191
EP - 204
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 2
ER -