Neurophysiology of Atypical Parkinsonian Syndromes: A Study Group Position Paper
Bibliographic record
Abstract
Atypical parkinsonian syndromes (APs) are characterized by parkinsonian features combined with additional motor and non-motor signs and symptoms. Neurophysiological studies have contributed to clarifying differences and similarities between APs and idiopathic Parkinson's disease (PD) and to unravel specific pathophysiological features of APs. A comprehensive and updated evaluation of the potential clinical utility of the available neurophysiological tools in APs is, however, currently needed. The Neurophysiology Study Group of the International Parkinson and Movement Disorder Society reviewed previously published neurophysiological studies including those based on electromyography, electroencephalography, and evoked potentials, transcranial magnetic stimulation and kinematics, in most relevant APs, including progressive supranuclear palsy, multiple system atrophy, corticobasal syndrome, Lewy body dementia, fronto-temporal dementia, vascular parkinsonism, normal pressure hydrocephalus, and drug-induced parkinsonism. Following a critical narrative review of all the available information for each AP, the study group examined the most relevant pathophysiological advances achieved in the field owing to the application of specific neurophysiological tools. Furthermore, the review includes statements regarding the potential role in a research context (ie, pathophysiological investigation) as well as in the clinical setting (ie, clinical utility) of each neurophysiological technique, through an estimation of the corresponding levels of evidence, based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Finally, an example of a possible stepwise approach based on the sequential application of specific neurophysiological techniques for better supporting the clinical differential diagnosis of PD and APs is proposed. © 2025 International Parkinson and Movement Disorder Society.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".