Scientific publications

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

Dec 28, 2021 | Magazine: Diagnostics

Diego Santos García  1   2 , María Álvarez Sauco  3 , Matilde Calopa  4 , Fátima Carrillo  5   6 , Francisco Escamilla Sevilla  7 , Eric Freire  3   8 , Rocío García Ramos  9 , Jaime Kulisevsky  6   10 , Juan Carlos Gómez Esteban  11 , Inés Legarda  12 , María Rosario Isabel Luquín  13 , Juan Carlos Martínez Castrillo  14 , Pablo Martínez-Martin  6 , Irene Martínez-Torres  15 , Pablo Mir  5   6 , Ángel Sesar Ignacio  16

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.

CITATION  Diagnostics (Basel). 2021 Dec 28;12(1):55.  doi: 10.3390/diagnostics12010055

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