## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) ## Breadcrumb - [Home](/) - [Understanding Parkinson's](/understanding-parkinsons) # Getting Diagnosed Finding out you have Parkinson's can be a lengthy process. Explore how a Parkinson's diagnosis is made and what type of diagnostic tools are used. ![Getting Diagnosed](/sites/default/files/styles/1902x600/public/images/gettingdiagnosed.jpg?h=83615a45&itok=wkmPjJFp) IN THIS SECTIONIN THIS SECTION - [Understanding Parkinson’s](/understanding-parkinsons) View Menu - [Understanding Parkinson’s](/understanding-parkinsons) - [What is Parkinson's?](/understanding-parkinsons/what-is-parkinsons) - [10 Early Signs](/understanding-parkinsons/10-early-signs) - [Causes](/understanding-parkinsons/causes) - [Movement Symptoms](/understanding-parkinsons/movement-symptoms) - [Non-Movement Symptoms](/understanding-parkinsons/non-movement-symptoms) - [Getting Diagnosed](/understanding-parkinsons/getting-diagnosed) - [Statistics](/understanding-parkinsons/statistics) - [Living with Parkinson’s](/living-with-parkinsons) View Menu - [Living With Parkinson’s](/living-with-parkinsons) - [New to Parkinson's](/living-with-parkinsons/new-to-parkinsons) - [Our Care Programs](/living-with-parkinsons/care-programs) - [Finding Care](/living-with-parkinsons/finding-care) - [Treatment](/living-with-parkinsons/treatment) - [Management & Lifestyle](/living-with-parkinsons/management) - [Emotional & Mental Health](/living-with-parkinsons/emotional-mental-health) - [Legal, Financial & Insurance](/living-with-parkinsons/legal-financial) - [My PD Story](/living-with-parkinsons/stories) - [Resources & Support](/resources-support) View Menu - [Resources & Support](/resources-support) - [Helpline](/resources-support/helpline) - [In Your Area](/your-area) - [PD Library](/resources-support/pd-library) - [Hospital Safety Guide](/resources-support/hospital-safety-guide) - [Online Education](/resources-support/online-education) - [Events](/resources-support/events) - [Community Grants](/resources-support/community-grants) - [For Care Partners](/resources-support/carepartners) - [For Professionals](/resources-support/professionals) - [Find Your Chapter](/resources-support/find-your-chapter) - [Blog](/resources-support/blog) - [Advancing Research](/advancing-research) View Menu - [Advancing Research](/advancing-research) - [Finding A Cure](/advancing-research/finding-cure) - [Our Research](/advancing-research/our-research) - [Understanding Research](/advancing-research/understanding-research) - [Join A Study](/advancing-research/join-study) - [Advocate for Research](/advancing-research/advocate-research) - [For Researchers](/advancing-research/for-researchers) - [Drug Discovery and Development](/advancing-research/parkinsons-drug-discovery) - [How You Can Help](/how-to-help) View Menu - [How You Can Help](/how-to-help) - [Donate Now](/how-to-help/donate) - [Why Support Us](/how-to-help/why-support-us) - [Make a Tribute Gift](/how-to-help/tribute) - [Fundraise](/how-to-help/fundraise) - [Volunteer](/how-to-help/volunteer) - [Corporate Sponsors](/how-to-help/corporate-sponsors) - [Planned Giving](/how-to-help/more-ways-to-give/planned-giving) - [More Ways to Give](/how-to-help/more-ways-to-give) - [Policy & Advocacy](/how-to-help/policy-advocacy-priorities) ## 💡 Quick Summary - Parkinson’s disease is diagnosed clinically, based on medical history, current symptoms and a physical exam. - No single lab or test confirms a diagnosis, though tests like an MRI, DaTscan or blood work can help rule out other conditions. - Key diagnostic criteria include [bradykinesia](/understanding-parkinsons/movement-symptoms/bradykinesia "Bradykinesia (Slowness of Movement)") (slowness of movement) plus at least one of the following: resting tremor, stiffness/rigidity, or balance issues. - Advanced tools like DaTscan (images dopamine function) or the Syn-One Test (skin biopsy for PD-related proteins) can support [diagnosis](/understanding-parkinsons/getting-diagnosed "Getting Diagnosed") but are not always needed. ## How is Parkinson's disease diagnosed? Parkinson’s disease (PD) is a “clinical” diagnosis. This means that an individual’s history, symptoms, and physical exam are used to make the diagnosis. There is not a specific lab or imaging test that can diagnose PD. However, certain tests such as magnetic resonance imaging of the brain (MRI brain), a dopamine transporter scan (DaT scan), or blood work can be used to support the diagnosis of PD or to rule out other medical conditions that can mimic PD. Making an accurate diagnosis of Parkinson’s, particularly in its early [stages](/understanding-parkinsons/what-is-parkinsons/stages "Stages of Parkinson's"), can be difficult. Often, an internist or family physician is the first to make a diagnosis. Many people may seek an additional opinion from a [movement disorder specialist](/your-area "In Your Area"). A movement disorder specialist is a neurologist with experience and specific training in the assessment and treatment of PD and related disorders. The newest criteria for diagnosing Parkinson’s was developed by the International Parkinson and Movement Disorder Society (MDS), and reflect the most current understanding of PD. To consider a diagnosis of Parkinson’s disease, a person must have bradykinesia (slowness of movement). In addition to bradykinesia, a person must also have one or more of the following: - Shaking or tremor in a limb that occurs while it is at rest - Stiffness or rigidity of the arms, legs, or trunk - Trouble with balance and falls ## Neurology Appointment The first and most important diagnostic tool for Parkinson’s is a medical history and physical examination conducted by a neurologist. A neurologist will make a diagnosis based on: - A detailed history of symptoms, existing medical conditions, current and past medications, family history, and lifestyle factors. Certain medical conditions, as well as some medications, can cause symptoms similar to Parkinson’s. - A detailed neurological examination during which a neurologist will ask you to perform tasks to assess the agility of arms and legs, muscle tone, gait and balance, to see if: - Expression and speech are animated - Tremor can be observed in your extremities at rest or in action - There is stiffness in your extremities or neck - There are changes to your walking, step size, and ability to turn - You can maintain your balance and examine your posture You may notice that a neurologist records your exam according to the Unified Parkinson’s Disease Rating Scale (UPDRS). This is a universal scale used by neurologists and movement disorder specialists to comprehensively assess and document the exam of a person with PD. This scale can be used as a baseline, to judge the effect of medication, and to track the progression of the disease during future visits. In Parkinson’s disease, there is a loss of neurons that make the neurotransmitter dopamine. Your doctor may start a medication to help replace dopamine or increase its effect in the brain. These medications are known as dopaminergic medications. Most commonly, people with PD will see improvement in the speed of their movement, stiffness, or tremor when they start dopaminergic medications. Lack of response to medications may prompt the doctor to seek an alternative diagnosis and order further testing such as an MRI of the brain or lab work. When unsure of a PD diagnosis, a DaTscan can also be considered but is not needed in all cases. ### What is a DaTscan and what role does it play in a Parkinson’s diagnosis? ![DaTscan imagery comparing the DaTscan of a normal patient with that of a patient with Parkinson's disease. ](/sites/default/files/styles/no_sizing/public/images/DatScan1.jpg?itok=Jzc_jK5n) In 2011, the FDA approved the use of a scan called a dopamine transporter scan (DaTscan). A DaTscan is an imaging technology that allows visualization of the dopamine system in the brain. It is similar to an MRI, but instead of looking at the structure of the brain it looks at the function. A DaTscan can show if there is reduced function of the dopamine system in an area of the brain involved in controlling movement. A DaTscan involves injection of a small amount of a radioactive drug that is then measured by a single-photon emission computed tomography scanner (SPECT scanner). The SPECT scanner measures the levels and location of the drug in the brain. A negative DaTscan suggests that a person does not have Parkinson’s. It is important to know that a negative DaTscan does not rule out PD, especially early in the disease, but a positive DaTscan can help confirm it. A positive DaTscan can differentiate PD from essential tremor (ET) as there is no dopamine deficiency in the latter. However, DaTscan abnormalities can be seen in PD as well as other forms of atypical parkinsonism that cause a loss of dopamine (Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal Syndrome). This means that a positive result does not differentiate Parkinson’s disease from other forms of atypical parkinsonism. ### I have PD and several symptoms. Should I get a DaTscan? In many cases, a DaTscan is not needed to diagnose Parkinson’s disease. There is no need for DaTscan when your history and exam are typical for Parkinson’s disease, and you meet the diagnostic criteria. Occasionally, if signs and symptoms are mild or you don’t meet the diagnostic criteria, your doctor will refer you for a DaT scan. Another reason physicians may order a DaTscan may be to help inform their diagnosis of Parkinson’s disease if you have an unsatisfying response to therapy. Keep in mind that ultimately the diagnosis is based on your history and physical exam. The DaT scan is most commonly used to complete the picture and is not a test for a diagnosis. ![Four images of a brain via DaTscan. Figure 1 shows a scan image of a healthy brain. By comparison, Figures 2 through 4 are examples of abnormal scans that could show brain degeneration, which is consistent with a diagnosis of Parkinsonian syndrome.](/sites/default/files/styles/no_sizing/public/images/DaTscan2.png?itok=bPJnLhe9) Figure 1 shows a scan image of a healthy brain. By comparison, Figures 2 through 4 are examples of abnormal scans that could show brain degeneration, which is consistent with a diagnosis of Parkinsonian syndrome. - ### Are there risks associated with a DaTscan? Possible adverse reactions such as headache, nausea, vertigo, dry mouth and mild to moderate dizziness were reported, hypersensitivity reaction and injection site pain have also been reported. To minimize radiation exposure, patients are encouraged to hydrate prior to and following a DaTscan to permit frequent urination. Patients should urinate frequently for the first 48 hours following DaTscan administration. - ### How can I get a DaTscan? Speak with your doctor to see if a DaTscan is right for you. - ### Is the DaTscan test covered by insurance, Medicare and Medicaid? A DaTscan is covered by Medicare and Medicaid. Insurers are likely to cover a DaTscan, but coverage varies, so contact your insurer for confirmation before the procedure. - ### Want to learn more about the latest in DaTscan technology? Read [*What's Hot in PD? An Update on DaTscanning for Parkinson's Disease Diagnosis*](/blog/research/diagnosis "What's Hot in PD? An Update on DAT Scanning for Parkinson's Disease Diagnosis"). ## The Syn-One (Skin Biopsy) Test The Syn-One Test is a lab test that uses a skin sample to look for abnormal alpha-synuclein, a protein linked to Parkinson’s. Results can give doctors more information when it’s not clear if symptoms are due to Parkinson’s. This test involves three small skin biopsies on the upper back, lower thigh and lower leg. The areas are numbed with a local anesthetic before small skin samples (biopsies) are taken. The samples are collected in a clinic and analyzed by CND Life Sciences. Results are usually available within two to three weeks and sent to your doctor. Medicare often covers the cost of the test when it is ordered to help clarify a diagnosis. - ### How does the test work? Alpha-synuclein is a protein in the nervous system. In Parkinson’s and related conditions, this protein can misfold and build up in nerve cells, especially in the brain, but also in other parts of the body, including the skin. One form of this protein, called phosphorylated alpha-synuclein, is found in these buildups. The Syn-One Test looks for this form in small nerve fibers in the skin. Certain patterns of this protein are linked to Parkinson’s and related conditions. However, the test does not detect this abnormal form of the protein in everyone with Parkinson’s. - ### Does everyone need a Syn-One Test? No. Most of the time, Parkinson’s is diagnosed based on a neurological exam, response to medication and how symptoms develop over time. **What the Test Can Do** It may be used when it is not clear what is causing symptoms. It can show signs that suggest a synuclein-related condition, such as Parkinson’s, dementia with Lewy bodies or multiple system atrophy. **What the Test Cannot Do** The Syn-One Test cannot diagnose Parkinson’s on its own or tell which condition it is. Results may not change treatment. **Other Tests Your Doctor May Use** A doctor may order a DaTscan instead of a Syn-One Test. A DaTscan also cannot tell the difference between types of parkinsonism. Usually, one test is chosen, not both. - ### When should I ask about this test? You may want to ask about this test if: - A diagnosis is not clear after an exam - Symptoms do not clearly fit Parkinson’s - Symptoms are not responding to medication as expected - There is a question about whether symptoms are due to Parkinson’s or another condition **You can ask:** - Could this test help clarify what is going on? - Would a Syn-One Test or DaTscan be useful? - Would results change treatment? A movement disorders specialist has training in Parkinson’s and related conditions and may help when a diagnosis is not clear or more input is needed. If this is not an option, a neurologist can help guide next steps. Contact our Helpline at 1-800-4PD-INFO (1-800-473-4636) or to help find a movement disorders specialist near you. [Learn more about Parkinson’s Biomarkers](/understanding-parkinsons/getting-diagnosed/biomarkers "Parkinson’s Biomarkers") ### Parkinson's Foundation Helpline Contact our Helpline at 1-800-4PD-INFO (1-800-473-4636) or Helpline@Parkinson.org for answers to your Parkinson’s questions. Helpline specialists can assist you in English or Spanish, Monday through Friday, 9 a.m. to 7 p.m. ET. [LEARN MORE](/resources-support/helpline) *Page reviewed by Dr. Michael S. Okun, Chair of Neurology and Executive Director at the Norman Fixel Institute for Neurological Diseases at the University of Florida Health and Dr. Lauren Fanty, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.* - ### References 1. Postuma RB, et al. MDS clinical diagnostic criteria for Parkinson’s disease. *J Mov Disord*. 2015;30(12):1591-1599. 2. Morbelli S, et al. EANM practice guideline/SNMMI procedure standard for dopaminergic imaging in Parkinsonian syndromes. *Eur. J. Nucl. Med. Mol. Imaging*. 2020;47:1885-1912. 3. de la Fuente-Fernandez R. Role of DaTSCAN and clinical diagnosis in Parkinson disease. *Neurology*. 2012;78:696-701. ## Related Materials Fact Sheets ### [ My Parent Has Parkinson's. What Does It Mean? ](/library/fact-sheets/parent-has-parkinsons) [Read Now](/library/fact-sheets/parent-has-parkinsons) Fact Sheets ### [ Managing "Off" Time in Parkinson's ](/library/fact-sheets/managing-off-time) [Read Now](/library/fact-sheets/managing-off-time) Fact Sheets ### [ Medications for Non-motor Symptoms ](/library/fact-sheets/medications-nonmotor-symptoms) [Read Now](/library/fact-sheets/medications-nonmotor-symptoms) - Share on Facebook - Share on X - Share on LinkedIn