MNCD : A New Tool for Classifying Parkinson's Disease in Daily Clinical Practice

Jaime Kulisevsky, Diego Santos García, María Álvarez Sauco, Matilde Calopa, Fátima Carrillo, Francisco Escamilla Sevilla, Eric Freire, Rocío García Ramos, Juan Carlos Gómez Esteban, Inés Legarda, Maria-Rosario Luquin, Juan Carlos Martínez-Castrillo, Pablo Martínez-Martin, Irene Martínez-Torres, Pablo Mir, Ángel Sesar Ignacio

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Background and objective : Parkinson's disease (PD) is a clinically heterogeneous disorder in which the symptoms and prognosis can be very different among patients. We propose a new simple classification to identify key symptoms and staging in PD. Patients and Methods : Sixteen movement disorders specialists from Spain participated in this project. The classification was consensually approved after a discussion and review process from June to October 2021. The TNM classification and the National Institutes of Health Stroke Scale (NIHSS) were considered as models in the design. Results : The classification was named MNCD and included 4 major axes: (1) motor symptoms; (2) non-motor symptoms; (3) cognition; (4) dependency for activities of daily living (ADL). Motor axis included 4 sub-axes: (1) motor fluctuations; (2) dyskinesia; (3) axial symptoms; (4) tremor. Four other sub-axes were included in the non-motor axis: (1) neuropsychiatric symptoms; (2) autonomic dysfunction; (3) sleep disturbances and fatigue; (4) pain and sensory disorders. According to the MNCD, 5 stages were considered, from stage 1 (no disabling motor or non-motor symptoms with normal cognition and independency for ADL) to 5 (dementia and dependency for basic ADL). Conclusions : A new simple classification of PD is proposed. The MNCD classification includes 4 major axes and 5 stages to identify key symptoms and monitor the evolution of the disease in patients with PD. It is necessary to apply this proof of concept in a properly designed study.
Idioma originalEnglish
Estat de la publicacióPublicada - 2021


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