A new scale for prognostication in Parkinson disease: Of animals and men

Prognosis has always represented one the main goals of medicine. For example, stroke prognosis was discussed by Ibn Sina (Avicenna) in his Canon of Medicine published in 1025. 1 Not too far off from our current concepts, Ibn Sina stated that stroke prognostic factors were respiratory status and impairment of the swallowing reflex. In modern medicine, oncology is the area in which the determination of prognostic factors has reached the highest reliability, with development of the first version of TNM staging by Pierre Denoix during the 1940s. 2 The awareness of the necessity to develop prognostic rating scales in the area of neurodegenerative disorders is more recent, probably driven by the increasing range of available therapies and therapeutic trials. However, it is largely recognized that attaining a reliable outcome prediction in neurodegenerative disorders is complex, due to their clinical and pathogenic heterogeneity.