Table 1:

Diagnostic criteria for specific types of overt alpha-synucleinopathies

Parkinsonism: a syndrome with any two out of four cardinal signs

• Resting tremor

• Bradykinesia

• Rigidity

• Impaired postural reflexes

Overt alpha-synucleinopathies

Parkinson’s disease: parkinsonism with all of the following

• No other neurological explanation (e.g., repeated head injury; history of encephalitis, brain tumor; hydrocephalus; neuroleptic treatment within 6 months before onset; repeated stroke with step-wise progression)

• No documentation of unresponsiveness to levodopa at doses of at least 1 gm/day in combination with carbidopa (Only applicable to patients who received treatment)

• No prominent or early signs (within 1 year of onset) of more extensive nervous system involvement not explained otherwise (e.g., dysautonomia)

Dementia with Lewy bodies:

• Essential

○ Dementia present before or within 1 year of the onset of parkinsonism

• Core clinical features

○ One or more spontaneous cardinal feature of parkinsonism defined above

○ Fluctuating cognition in attention and alertness

○ Recurrent visual hallucinations

○ REM sleep behavior disorder

Parkinsons disease with dementia:

• Core Features

○ Diagnosis of idiopathic Parkinsons disease

○ A dementia syndrome with insidious onset and slow progression presenting at least 1 year after the onset of parkinsonism