...we find the SynNeurGe criteria more appropriate than NSD-ISS, because SynNeurGe includes Parkinson's disease without synucleinopathy. ...the NSD-ISS proposes a system based on six stages, five of ...which are based on when motor or non-motor symptoms appear, whereas the SynNeurGe criteria only assess the presence of symptoms, but without considering their functional impact.1,2 We have proposed a simple classification of Parkinson's' disease based on four axes (motor, non-motor, cognition, and dependency MNCD) and five stages.3 Analogous to the TNM staging system used in oncology and with the virtues of the Hoehn and Yahr scale in terms of simplicity,4 we have shown that the MNCD staging system also correlates with disease severity and patients' quality of life.5 The MNCD is intended to be a simple tool to identify key symptoms and presentations in Parkinson's disease and monitor disease progression that could be correlated with biological classification data. DS-G has received grants from the Spanish Ministry of Economy and Competitiveness (reference number PI16/01575) co-founded by Instituto de Salud Carlos III for the project titled “Non-motor progression and impact on quality of life in Parkinson's disease”; and has received payments or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Abbvie, UCB Pharma, Lundbeck, KRKA, Zambon, Bial, Italfarmaco, Teva, Archímedes, Esteve, Stada, and Merz.
Parkinson's disease (PD) management requires the involvement of movement disorders experts, other medical specialists, and allied health professionals. Traditionally, multispecialty care has been ...implemented in the form of a multidisciplinary center, with an inconsistent clinical benefit and health economic impact. With the current capabilities of digital technologies, multispecialty care can be reshaped to reach a broader community of people with PD in their home and community. Digital technologies have the potential to connect patients with the care team beyond the traditional sparse clinical visit, fostering care continuity and accessibility. For example, video conferencing systems can enable the remote delivery of multispecialty care. With big data analyses, wearable and non-wearable technologies using artificial intelligence can enable the remote assessment of patients' conditions in their natural home environment, promoting a more comprehensive clinical evaluation and empowering patients to monitor their disease. These advances have been defined as technology-enabled care (TEC). We present examples of TEC under development and describe the potential challenges to achieve a full integration of technology to address complex care needs in PD.
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