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Additional diagnostic procedures including brain imaging and biomarker analyses can help to appreciate the various syndromes, but a precise clinical evaluation and differentiation is always necessary. To better assess the relevance of distinct clinical symptoms that arose within 1\u00a0year of disease manifestation and evaluate their indicative potential for an atypical Parkinsonian syndrome, we conducted a modified Delphi panel with seven movement disorder specialists. Five different topics with several clinical symptom items were discussed and consensus criteria were tested. This resulted in distinct symptom patterns for each atypical Parkinsonian syndrome showing the multitude of clinical involvement in each neurodegenerative disease. Strongly discriminating clinical signs were few and levels of indication were variable. A prospective validation of the assessments made is needed. This demonstrates that both clinical evaluation and elaborate additional diagnostic procedures are needed to achieve a high diagnostic standard.<\/jats:p>","DOI":"10.1007\/s00702-023-02634-5","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T17:02:54Z","timestamp":1681318974000},"page":"839-846","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Significance of clinical symptoms and red flags in early differential diagnosis of Parkinson\u2019s disease and atypical Parkinsonian syndromes"],"prefix":"10.1007","volume":"130","author":[{"ORCID":"http:\/\/orcid.org\/0000-0002-3833-9822","authenticated-orcid":false,"given":"Nils","family":"Schr\u00f6ter","sequence":"first","affiliation":[]},{"given":"Thilo","family":"van Eimeren","sequence":"additional","affiliation":[]},{"given":"Joseph","family":"Classen","sequence":"additional","affiliation":[]},{"given":"Johannes","family":"Levin","sequence":"additional","affiliation":[]},{"given":"Christoph","family":"Redecker","sequence":"additional","affiliation":[]},{"given":"Martin","family":"Wolz","sequence":"additional","affiliation":[]},{"given":"Lars","family":"T\u00f6nges","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"2634_CR1","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1001\/archneur.60.3.387","volume":"60","author":"D Aarsland","year":"2003","unstructured":"Aarsland D, Andersen K, Larsen JP et al (2003) Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. 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