Neuropathological assessment of Parkinson's disease: refining the diagnostic criteria

Dennis W. Dickson, Heiko Braak, John E. Duda, Charles Duyckaerts, Thomas Gasser, Glenda M. Halliday, John Hardy, James B. Leverenz, Kelly Del Tredici, Zbigniew K. Wszolek, Irene Litvan

Research output: Contribution to journalReview articlepeer-review

494 Scopus citations


To date, there have been few systematic attempts to provide a standard operating procedure for the neuropathological diagnosis of Parkinson's disease (PD). Pathological examination cannot classify the clinical syndrome with certainty; therefore, the neuropathological diagnosis is, at best, a probability statement. The neuropathological diagnosis of parkinsonism has become increasingly based on fundamental molecular underpinnings, with recognition that the genetics of parkinsonism is heterogeneous and includes disorders that are associated with and without Lewy bodies. The advent of α-synuclein immunohistochemistry has substantially improved the ability to identify Lewy pathology, particularly cortical Lewy bodies and smaller aggregates within processes and the neuropil. In this Review we discuss the diagnostic criteria for the neuropathological assessment of PD. These criteria are provisional and need to be validated through an iterative process that could help with their refinement. Additionally, we suggest future directions for neuropathology research on PD.

Original languageEnglish (US)
Pages (from-to)1150-1157
Number of pages8
JournalThe Lancet Neurology
Issue number12
StatePublished - Dec 2009

ASJC Scopus subject areas

  • Clinical Neurology


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