Diagnostic Feature Associations in Atypical Parkinsonian Disorders: A Survey of Movement Disorders Specialists

Movement disorders specialists show strong consensus on how 32 clinical features are attributed in atypical parkinsonian disorders, with raw agreement 81.9% and Gwet’s AC1 0.67.

• Why it matters: Antemortem diagnosis of APDs is difficult due to overlapping symptoms, phenotypic heterogeneity, and limited definitive biomarkers, while consensus criteria may not match real-world reasoning.
• What they did: A survey of movement disorders specialists compared feature-implication ratings against the 2024 “General Neurologist’s Practical Diagnostic Algorithm for APDs,” assessing inter-rater agreement and framework coverage.
• The result: Specialist endorsement rose with framework association strength (12.9% to 36.2% to 82.6%), diagnosis-level coverage varied by disorder, and exact-set agreement depended on whether modest associations were included.

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