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      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Brain Health

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      Executive Page

      Executive Page: Join or renew your membership now and celebrate 10 years of the EAN

      November 6, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN News One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      EAN News

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN News

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      EAN Congress news

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN Congress news

      Burden of Sleep/Wake Disorders Project at EAN Congress 2023

      October 19, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Research
    • All Paper of the Month Research Highlights
      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research

      EAN Guideline Production Group at the Guidelines International Network Conference 2023

      October 31, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Transdermal Nicotine Treatment and Progression of Early Parkinson’s Disease

      October 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma

      July 24, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – October 2023

      October 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – September 2023

      September 1, 2023

  • Education
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports
      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      Kick off the new season with highlights on the eanCampus

      October 13, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      Advocacy

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EAN News

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EBC

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EBC

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      Surveys

      COVID-19 and neurology: a survey of previous and continued restrictions on clinical practice, professional education and neuroeconomics

      March 3, 2023

      Surveys

      Help EAN contribute towards the development of a European Pain Research strategy

      December 5, 2022

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eanpages

  • EAN News
    • All Executive Page EAN News EAN Congress news Interviews
      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Brain Health

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      Executive Page

      Executive Page: Join or renew your membership now and celebrate 10 years of the EAN

      November 6, 2023

      Executive Page

      Executive Page: Advocacy for brain health gaining momentum across the neurological landscape

      October 1, 2023

      Executive Page Dear EAN members, dear friends, It is my pleasure to give you an update on behalf of the EAN Scientific Committee following a busy year since my appointment as chair. It has been a privilege to be so deeply involved in the scientific activities of the EAN and to work closely with an amazing community of people who are so dedicated to the advancement of neurology. One of the strongest threads within that community is the EAN’s group of Scientific Panels, which are often referred to as the organisation’s ‘scientific backbone’. The panels have a hand in everything the EAN does from a scientific point of view, including coordinating clinical research, disseminating good practice, assisting in planning the EAN annual congress, supporting the EAN’s educational efforts, and producing guidelines that assist neurologists in daily practice. All of this work requires a considerable amount of oversight, and this is why each panel is run by its own Management Group, elected by the panel members. Being a part of one of these Management Groups (PDF) is an opportunity to play a direct part in determining the direction of scientific progress within Europe, and I am excited to say that the call for applications to stand for election will be announced in September. All panel members and EAN individual members are eligible to apply to be candidates, with the vote being held among the existing panel members in autumn. I would like to urge every neurologist with a passion for the scientific future of their special area of interest to consider standing for election to the relevant Management Group and to look out for the call for applications later this month. I can tell you from personal experience that fulfilling a role such as this within the structure of the EAN is a fascinating and extremely rewarding experience. The chance to take on such a unique leadership position should not be missed! The most satisfying aspect of being involved in the EAN’s organisational structure is surely seeing all the hard work and planning come to fruition when a small idea evolves into a newly launched project. One such example is the 1st EAN Science School, taking place in Salzburg next March. The idea of the Science School is to offer early career neurologists with an interest in translational research a new avenue for learning about basic pathomechanisms of neurological disorders. Application for this very first edition, on ‘Pathophysiology of disorders of the nervous system’, closed last week and we have been delighted with the level of interest. It was a pleasure to be part of the task force in charge of planning this new project and I look forward to seeing it officially transferred to the hands of the Scientific Committee after a successful event and evaluation in spring. Of our ongoing activities, one of the most significant is the EAN Neuro-covid Registry, which aims to collate epidemiological data on neurological manifestations in patients with COVID-19 infection reported by neurologists in outpatient services, emergency rooms, and hospital departments. We currently have 1,542 patients entered in the database, from 35 centres across 23 countries. So far, 29 patients have been followed for 12 months and 387 have completed the 6-months follow up. This is a decent start, but I would like to strongly encourage EAN members and their institutions to get involved and contribute cases to what will become an invaluable resource for neurologists and clinicians to improve care for Covid-19 patients. Finally, I would like share a word on a forthcoming collaboration between EAN and the Human Brain Project in December, that I think will interest a lot of EAN members. The EAN-EBRAINS joint workshop on ‘The future of medical data sharing in clinical neurosciences’ will be a three-day virtual event that aims to discuss issues and challenges associated with data sharing in Europe, from ethics to data safety and privacy, including those specific to data federation, such as the development and validation of federated algorithms. The whole workshop is completely free of charge and registration is open until 25 November, so please check out the details and sign up! I wish you all a healthy and pleasant autumn and I look forward to updating you again. Best wishes Thomas Berger Chair of the EAN Scientific Committee

      Executive Page: Management Group elections are coming – run for office and help shape our future!

      September 1, 2023

      Executive Page

      Executive Page: Thank you for making the EAN Congress 2023 a great success!

      July 24, 2023

      EAN News One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      EAN News

      Swiss Brain Health Plan launches in Zurich

      November 24, 2023

      EAN News

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN News

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      EAN Congress news

      EAN 2024 – Abstract submission and registration OPEN!

      November 22, 2023

      EAN Congress news

      Burden of Sleep/Wake Disorders Project at EAN Congress 2023

      October 19, 2023

      EAN Congress news

      African Academy of Neurology features in Special Studio Session at EAN 2023

      July 25, 2023

      EAN Congress news

      Find photos, facts, figures and reports in our EAN Congress Review

      July 24, 2023

      Interviews

      Video Interview: Prof. Mary Reilly, Moritz Romberg lecturer at EAN 2023

      July 4, 2023

      Interviews

      Video Interview: Mark Hallett, C. Brown-Séquard lecturer at EAN 2023

      July 3, 2023

      Interviews

      Video Interview: Josep Dalmau, Camillo Golgi Lecturer at EAN 2023

      July 2, 2023

      Interviews

      Video Interview: Dementia & Cognitive Disorders Panel Co-Chairs

      September 8, 2022

  • Research
    • All Paper of the Month Research Highlights
      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research

      EAN Guideline Production Group at the Guidelines International Network Conference 2023

      October 31, 2023

      Paper of the Month

      Research Paper of the Month: Effects of oral anticoagulation in people with atrial fibrillation after spontaneous intracranial haemorrhage (COCROACH)

      November 6, 2023

      Paper of the Month

      Research Paper of the Month: Transdermal Nicotine Treatment and Progression of Early Parkinson’s Disease

      October 1, 2023

      Paper of the Month

      Research Paper of the Month: Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA

      September 1, 2023

      Paper of the Month

      Research Paper of the Month: Vorasidenib in IDH1- or IDH2-Mutant Low-Grade Glioma

      July 24, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – December 2023

      December 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – November 2023

      November 6, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – October 2023

      October 1, 2023

      Research Highlights One glowing light bulb that stands out from unlit or dim lamps on a blue background

      Research Highlights of the Month – September 2023

      September 1, 2023

  • Education
    • All eLearning Student Corner Resident and Research Fellows Fellowship reports
      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      End 2023 with highlighted content on the eanCampus!

      December 2, 2023

      eLearning

      Call for Applications: e-Learning Platform Associate Editors

      November 7, 2023

      eLearning

      Kick off the new season with highlights on the eanCampus

      October 13, 2023

      eLearning

      World Brain Day with the European Academy of Neurology

      July 21, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

      Student Corner Illustration of a vertical pencil point on a blue background, with a yellow light bulb above it

      Student Corner: My EAN Congress experience

      September 5, 2023

      Student Corner

      Student Teaser Fellowship reports 2022 – Rotterdam, London, & Paris

      August 22, 2023

      Student Corner

      Student Teaser Fellowship winners 2023

      June 28, 2023

      Resident and Research Fellows

      EAN Spring School 2024 – Apply NOW until 31 January 2024

      December 1, 2023

      Resident and Research Fellows

      EAN Autumn School 2023: Report

      November 30, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Resident and Research Fellows

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Oxford Autoimmune Neurology Group

      September 16, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Centre Hospitalier Universitaire Vaudois, Lausanne

      September 15, 2023

      Fellowship reports

      Research Fellowship Report 2022 – Department of Neuromuscular Diseases Institute, University College London

      September 14, 2023

      Fellowship reports

      Student Teaser Fellowship reports 2022 – Pisa, London, & Lausanne

      September 13, 2023

  • Other News
    • All EAN Staff EBC News in general Surveys
      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      Advocacy

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EAN News

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EAN Staff

      EAN Head Office Profiles: Ulla & Piyapat

      December 1, 2023

      EAN Staff

      EAN Head Office Profiles: Maria & Immanuel

      November 7, 2023

      EAN Staff

      EAN Head Office Profiles: Kathrin & Sasha

      August 28, 2023

      EAN Staff Anja Sander receiving flowers at the end of EAN Congress 2023

      Celebrating 20 Years of Excellence: Anja Sander, EAN’s Executive Director!

      August 3, 2023

      EBC

      Brain community launches Call to Action during Brain Health & Research Day at UNGA78

      October 19, 2023

      EBC

      Brain Innovation Days 2023: Meet the speakers!

      October 2, 2023

      EBC

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      EBC

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      News in general

      WHO’s Intersectoral Global Action Plan on epilepsy and other neurological disorders (IGAP) published in all six UN languages

      August 3, 2023

      News in general

      WHO recognises the public health need for effective and affordable treatments for multiple sclerosis

      August 3, 2023

      News in general

      Brain Innovation Days: Discover the early programme and register today!

      July 21, 2023

      News in general

      Join the community’s calls for a European Brain Research and Innovation Plan

      July 21, 2023

      Surveys

      Neurorehabilitation Across Europe after Ischemic and Traumatic Brain Injuries: a survey to increase knowledge on brain-injury-specific neurorehabilitation

      July 14, 2023

      Surveys

      ILAE survey on genetic testing in the epilepsies

      July 14, 2023

      Surveys

      COVID-19 and neurology: a survey of previous and continued restrictions on clinical practice, professional education and neuroeconomics

      March 3, 2023

      Surveys

      Help EAN contribute towards the development of a European Pain Research strategy

      December 5, 2022

Forum

Forum: EFNS/MDS-ES/ENS recommendations for the diagnosis of Parkinson’s disease & Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson’s disease

January 1, 2013

The Editors have – together with the Scientific Committee – decided that new guideline papers will be presented in the Forum of NEUROPENEWS. In the January issue of the European Journal of Neurology the EFNS/MDS-ES/ENS Recommendations for the Diagnosis of Parkinson’s disease and the Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson’s disease on behalf of the EFNS/MDS-ES Scientist Panel on Movement disorders are published, and we highlight these important articles by offering you the abstracts. We also asked the corresponding author, Alfredo Berardelli, for a short statement. The article EFNS/MDS-ES/ENS Recommendations for the Diagnosis of Parkinson’s disease is also available for CME on the EFNS website for registered users.

Prof. Alfredo Berardelli
Prof. Alfredo Berardelli

EFNS/MDS-ES/ENS recommendations for the diagnosis of Parkinson’s Disease:


Abstract:
A Task Force was convened by the EFNS/MDS-ES/ENS Scientist Panel on Parkinson’s disease and other Movement Disorders to systemically review relevant publications on the diagnosis of Parkinson`s disease (PD). Following the EFNS instruction for the preparation of neurological diagnostic guidelines, recommendation levels have been generated for diagnostic criteria and investigations. For the clinical diagnosis, we recommend the use of the Queen Square Brain Bank criteria (level B). Genetic testing for specific mutations is recommended on an individual basis (level B), taking into account specific features (i.e. family history and age of onset). We recommend olfactory testing to differentiate PD from other parkinsonian disorders including recessive forms (Level A). Screening for pre-motor PD with olfactory testing requires additional tests due to limited specificity. Drug challenge tests are not recommended for the diagnosis in de novo parkinsonian patients. There is an insufficient evidence to support their role in the differential diagnosis between PD and other parkinsonian syndromes. We recommend an assessment of cognition and a screening for RBD, psychotic manifestations and severe depression in the initial evaluation of suspected PD cases (Level A). Transcranial sonography (TCS) is recommended for the differentiation of PD from atypical and secondary parkinsonian disorders (Level A), for the early diagnosis of PD, and in the detection of subjects at risk for PD (Level A), although the technique is so far not universally used and requires some expertise. Because specificity of TCS for the development of PD is limited, TCS should be used in conjunction with other screening tests. Conventional MRT and DWI at 1.5T are recommended as neuroimaging tools that can support a diagnosis of MSA or PSP versus PD on the basis of regional atrophy and signal change as well as diffusivity patterns (Level A). DAT Scan SPECT is registered in Europe and US for the differential diagnosis between degenerative parkinsonisms and essential tremor (Level A). More specifically DATSCAN is indicated in presence of significant diagnostic uncertainty such as parkinsonism associated with neuroleptic exposure and atypical tremor manifestations such as isolated unilateral postural tremor. Studies of [123I]MIBG/SPECT cardiac uptake may be used to identify PD patients vs. controls and MSA patients (Level A). All other SPECT imaging studies do not fulfill registration standards and cannot be recommended for routine clinical use. At present, no conclusion can be drawn as to diagnostic efficacy of autonomic function tests (AFTs), neurophysiological tests and PET imaging in PD.

A. Berardelli, G. Wenning, A. Antonini, D. Berg, B. R. Bloem, V. Bonifati, D. Brooks, D. Burn, C. Colosimo, A. Fanciulli, J. Ferreira, T. Gasser, F. Grandas, P. Kanovsky, V. Kostic, J. Kulisevsky, W. Oertel, W. Poewe, J.-P. Reese, M. Relja, E. Ruzicka, A. Schapira, A. Schrag, K. Seppi, P. Taba and M. Vidailhet; European Journal of Neurology, Vol. 20, Issue 1, pages 16-34, January 2013

Introduction by Alfredo Berardelli and Carlo Colosimo:
The idea of having new European recommendations on Parkinson’s disease (PD) came mainly from the observation that the diagnosis of PD is still based on the UK Brain Bank diagnostic criteria, which were a milestone in this field but are dating back to 1988 and did not include most of the recent technological advances in the field.

A Task Force was convened by the EFNS/Movement Disorder Society-European Section Scientist Panel on PD and other movement disorders to systemically review relevant publications on the diagnosis of PD. The main conclusion coming from the panel of 26 experts is  that , while the core clinical criteria for identifying a subject with a parkinsonian disorder should still remain those proposed by Gibb and Lees 25 years ago, there is a need to add complementary investigations in order to increase the sensitivity and specificity of the clinical judgment. When and which tests are needed in a single case depends on the clinical answer we are looking for (is this a case of true parkinsonism or something else? If yes, are we dealing with the common PD or with a secondary case? Or could it be an atypical case?).

Interestingly, some of these laboratory tests (e.g smell  tests, SPECT with dopamine transporter tracers [DaTscan], transcranial sonography of the midbrain) can be effectively used in the attempt to identify people in the preclinical phase of the disease. As a matter of fact some of these investigations have already been used in ongoing population studies in Europe and North America, showing preliminary satisfactory results as possible screening tools.

Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson’s disease:


Abstract:

Objective: To summarise the 2010 EFNS/MDS-ES evidence-based treatment recommendations for the management of Parkinson’s disease (PD). This summary includes the treatment recommendations for early and late PD.

Methods: For the 2010 publication, a literature search was undertaken for articles published up to September 2009. For this summary an additional literature search was taken on upto December 2010. Classification of scientific evidence and the rating of recommendations were made according to the EFNS guidance. In cases where there was insufficient scientific evidence, a consensus statement (‘good practice point’) was made.

Results: For each clinical indication, a list of therapeutic interventions is provided, including classification of evidence.

J. Ferreira, R. Katzenschlager, B. R. Bloem, U. Bonuccelli, D. Burn, G. Deuschl, E. Dietrichs, G. Fabbrini, A. Friedman, P. Kanovsky, V. Kostic, A. Nieuwboer, P. Odin, W. Poewe, O. Rascol, C. Sampaio, M. Schüpbach, E. Tolosa, C. Trenkwalder, A. Schapira, A. Berardelli and W. Oertel; European Journal of Neurology, Vol. 20, Issue 1, pages 5-15, January 2013

Introduction by Alfredo Berardelli and Giovanni Fabbrini:
A neurologist needs to take several important decisions when treating patients with Parkinson’s disease. Common problems include: a) which is the best time to start pharmacological treatment; b) how to start pharmacological treatment; c) the availability of drugs capable in delaying disease progression; d) how to deal with motor complications and dyskinesias; e) which is the role of therapies in the advanced phases of the disease; f) how to advise patients regarding physiotherapy and other forms of allied health disciplines; g) therapeutic approaches for non-motor symptoms. The authors of this review tried to answer these and other questions summarizing the key points of the modern management of Parkinson’s disease. The recommendations come from a careful revision of papers dealing with the treatment of both early and advanced phases of Parkinson’s disease. Papers were only selected for review when there was an established rating scale or objective outcome measurement of endpoints; included a minimum of 20 subjects treated for a minimum duration of 4 weeks, and were reported in full-paper format in English.  Classifications of evidence and ratings of efficacy were made according to EFNS guidance. A consensus “good practice point” suggestion was reached when evidence from the literature was insufficient to answer the specific question. In summary this review paper is a useful instrument for the correct approach to the treatment of Parkinson’s disease.

Alfredo Berardelli is Professor of Neurology at the University of Rome “La Sapienza”, Department of Neurological Sciences and corresponding author of the Task Forces, which developed the above guideline papers. Carlo Colosimo and Giovanni Fabbrini are Professors of Neurology at the University of Rome “La Sapienza”, Department of Neurology and co-authors of the guidelines on which they have commented.

Forum: EFNS/MDS-ES/ENS recommendations for the diagnosis of Parkinson’s disease & Summary of the recommendations of the EFNS/MDS-ES review on therapeutic management of Parkinson’s disease was last modified: January 2nd, 2013 by Editor
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