Open AccessEtiologies of P arkinsonism in a Century‐Long Autopsy‐Based Cohort
Author(s) -
Horvath Judit,
Burkhard Pierre R.,
Bouras Constantin,
Kövari Enikö
Publication year - 2013
Publication title -
brain pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.986
H-Index - 132
eISSN - 1750-3639
pISSN - 1015-6305
DOI - 10.1111/j.1750-3639.2012.00611.x
Subject(s) - progressive supranuclear palsy , parkinsonism , autopsy , etiology , medicine , corticobasal degeneration , atrophy , pathology , cohort , substantia nigra , parkinson's disease , disease
We investigated the distribution of different etiologies underlying P arkinsonism in a hospital‐based autopsy collection, studied the demographic data and evaluated diagnostic accuracy using histopathological examination as the gold standard. Out of a total of 9359 consecutive autopsy cases collected between 1914 and 2010, we identified 261 individuals who carried a clinical diagnosis of a P arkinsonian syndrome at death. A detailed neuropathological examination revealed idiopathic P arkinson's disease ( PD ) in 62.2%, progressive supranuclear palsy ( PSP ) in 4.2%, multiple system atrophy ( MSA ) in 2.3%, corticobasal degeneration ( CBD ) in 1.2%, postencephalitic P arkinsonism ( PEP ) in 2.7%, vascular P arkinsonism ( VaP ) in 8.8% and A lzheimer‐type pathology ( ATP ) of the substantia nigra in 8%. The diagnostic accuracy of PD in our cohort was lower (71.2%) than those reported in previous studies, although it tended to increase during the last decades up to 85.7%. Of particular interest, we found that PD , while being the most frequent cause of Parkinsonism, was greatly overdiagnosed, with VaP and ATP being the most frequent confounding conditions.