Slowness of movement AND decrement in amplitude or speed

4- to 6-Hz tremor in the fully resting limb, which is suppressed during movement initiation

Velocity-independent resistance to passive movement not solely reflecting failure to relax (ie, distinct from spasticity or paratonia)

In the absence of clear documentation of initial response a dramatic response can be classified as: a) Marked improvement with dose increases or marked worsening with dose decreases. Mild changes do not qualify. Document this either objectively (>30% in UPDRS III with change in treatment), or subjectively (clearly-documented history of marked changes from a reliable patient or caregiver). b) Unequivocal and marked on/off fluctuations, which must have at some point included predictable end-of-dose wearing off.

(in past, or on current examination)

(eg, sustained gaze evoked nystagmus, macro square wave jerks, hypermetric saccades)

(a): Orthostatic decrease of blood pressure within 3 min of standing by at least 30 mm Hg systolic or 15 mm Hg diastolic, in the absence of dehydration, medication, or other diseases that could plausibly explain autonomic dysfunction. (b): long-standing or small amount stress incontinence in women is excluded. In men, urinary retention must not be attributable to prostate disease, and must be associated with erectile dysfunction

These include sleep dysfunction (sleep-maintenance insomnia, excessive daytime somnolence, symptoms of REM sleep behavior disorder), autonomic dysfunction (constipation, daytime urinary urgency, symptomatic orthostasis), hyposmia, or psychiatric dysfunction (depression, anxiety, or hallucinations)

defined as pyramidal weakness or clear pathologic hyperreflexia (excluding mild reflex asymmetry and isolated extensor plantar response)

The patient or caregiver reports bilateral symptom onset with no side predominance, and no side predominance is observed on objective examination