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Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis*

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Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis*

Auteurs : Ping Liu [République populaire de Chine] ; Tao Feng [République populaire de Chine] ; Yong Wang [République populaire de Chine] ; Xuan Zhang [République populaire de Chine] ; Biao Chen [République populaire de Chine]

Source :

Journal of Zhejiang University. Science. B [ 1673-1581 ] ; 2011.

RBID : PMC:3167902

Abstract

The aim of this study was to investigate the clinical heterogeneity of Parkinson’s disease (PD) among a cohort of Chinese patients in early stages. Clinical data on demographics, motor variables, motor phenotypes, disease progression, global cognitive function, depression, apathy, sleep quality, constipation, fatigue, and L-dopa complications were collected from 138 Chinese PD subjects in early stages (Hoehn and Yahr stages 1–3). The PD subject subtypes were classified using k-means cluster analysis according to the clinical data from five to three-cluster consecutively. Kappa statistical analysis was performed to evaluate the consistency among different subtype solutions. The cluster analysis indicated four main subtypes: the non-tremor dominant subtype (NTD, n=28, 20.3%), rapid disease progression subtype (RDP, n=7, 5.1%), young-onset subtype (YO, n=50, 36.2%), and tremor dominant subtype (TD, n=53, 38.4%). Overall, 78.3% (108/138) of subjects were always classified between the same three groups (52 always in TD, 7 in RDP, and 49 in NTD), and 98.6% (136/138) between five- and four-cluster solutions. However, subjects classified as NTD in the four-cluster analysis were dispersed into different subtypes in the three-cluster analysis, with low concordance between four- and three-cluster solutions (kappa value=−0.139, P=0.001). This study defines clinical heterogeneity of PD patients in early stages using a data-driven approach. The subtypes generated by the four-cluster solution appear to exhibit ideal internal cohesion and external isolation.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167902

DOI: 10.1631/jzus.B1100069
PubMed: 21887844
PubMed Central: 3167902

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<author><name sortKey="Wang, Yong Jun" sort="Wang, Yong Jun" uniqKey="Wang Y" first="Yong" last="Wang">Yong Wang</name>
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<author><name sortKey="Wang, Yong Jun" sort="Wang, Yong Jun" uniqKey="Wang Y" first="Yong" last="Wang">Yong Wang</name>
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<author><name sortKey="Zhang, Xuan" sort="Zhang, Xuan" uniqKey="Zhang X" first="Xuan" last="Zhang">Xuan Zhang</name>
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<country xml:lang="fr">République populaire de Chine</country>
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<author><name sortKey="Chen, Biao" sort="Chen, Biao" uniqKey="Chen B" first="Biao" last="Chen">Biao Chen</name>
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<front><div type="abstract" xml:lang="en"><p>The aim of this study was to investigate the clinical heterogeneity of Parkinson’s disease (PD) among a cohort of Chinese patients in early stages. Clinical data on demographics, motor variables, motor phenotypes, disease progression, global cognitive function, depression, apathy, sleep quality, constipation, fatigue, and L-dopa complications were collected from 138 Chinese PD subjects in early stages (Hoehn and Yahr stages 1–3). The PD subject subtypes were classified using <italic>k</italic>
-means cluster analysis according to the clinical data from five to three-cluster consecutively. Kappa statistical analysis was performed to evaluate the consistency among different subtype solutions. The cluster analysis indicated four main subtypes: the non-tremor dominant subtype (NTD, <italic>n</italic>
=28, 20.3%), rapid disease progression subtype (RDP, <italic>n</italic>
=7, 5.1%), young-onset subtype (YO, <italic>n</italic>
=50, 36.2%), and tremor dominant subtype (TD, <italic>n</italic>
=53, 38.4%). Overall, 78.3% (108/138) of subjects were always classified between the same three groups (52 always in TD, 7 in RDP, and 49 in NTD), and 98.6% (136/138) between five- and four-cluster solutions. However, subjects classified as NTD in the four-cluster analysis were dispersed into different subtypes in the three-cluster analysis, with low concordance between four- and three-cluster solutions (kappa value=−0.139, <italic>P</italic>
=0.001). This study defines clinical heterogeneity of PD patients in early stages using a data-driven approach. The subtypes generated by the four-cluster solution appear to exhibit ideal internal cohesion and external isolation.</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <front><journal-meta><journal-id journal-id-type="nlm-ta">J Zhejiang Univ Sci B</journal-id>
<journal-id journal-id-type="publisher-id">JZUS</journal-id>
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<issn pub-type="epub">1862-1783</issn>
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<publisher-loc>Hangzhou</publisher-loc>
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<article-meta><article-id pub-id-type="pmid">21887844</article-id>
<article-id pub-id-type="pmc">3167902</article-id>
<article-id pub-id-type="doi">10.1631/jzus.B1100069</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Articles</subject>
<subj-group><subject>Biomedicine</subject>
</subj-group>
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<title-group><article-title>Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis<xref ref-type="fn" rid="FN01">*</xref>
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<contrib-group><contrib contrib-type="author"><name><surname>Liu</surname>
<given-names>Ping</given-names>
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<xref ref-type="author-notes" rid="CorAuth">‡</xref>
<xref ref-type="aff" rid="aff1">1</xref>
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<contrib contrib-type="author"><name><surname>Wang</surname>
<given-names>Yong-jun</given-names>
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<xref ref-type="aff" rid="aff1">1</xref>
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<contrib contrib-type="author"><name><surname>Zhang</surname>
<given-names>Xuan</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chen</surname>
<given-names>Biao</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China</aff>
<aff id="aff2"><label>2</label>
Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing 100053, China</aff>
<author-notes><fn id="CorAuth"><label>‡</label>
<p>Corresponding Author</p>
</fn>
<corresp id="cor01">†E-mail:<email>happyft@sina.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>9</month>
<year>2011</year>
</pub-date>
<volume>12</volume>
<issue>9</issue>
<fpage>694</fpage>
<lpage>703</lpage>
<history><date date-type="received"><day>7</day>
<month>3</month>
<year>2011</year>
</date>
<date date-type="accepted"><day>26</day>
<month>5</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2011</copyright-statement>
<copyright-year>2011</copyright-year>
</permissions>
<abstract><p>The aim of this study was to investigate the clinical heterogeneity of Parkinson’s disease (PD) among a cohort of Chinese patients in early stages. Clinical data on demographics, motor variables, motor phenotypes, disease progression, global cognitive function, depression, apathy, sleep quality, constipation, fatigue, and L-dopa complications were collected from 138 Chinese PD subjects in early stages (Hoehn and Yahr stages 1–3). The PD subject subtypes were classified using <italic>k</italic>
-means cluster analysis according to the clinical data from five to three-cluster consecutively. Kappa statistical analysis was performed to evaluate the consistency among different subtype solutions. The cluster analysis indicated four main subtypes: the non-tremor dominant subtype (NTD, <italic>n</italic>
=28, 20.3%), rapid disease progression subtype (RDP, <italic>n</italic>
=7, 5.1%), young-onset subtype (YO, <italic>n</italic>
=50, 36.2%), and tremor dominant subtype (TD, <italic>n</italic>
=53, 38.4%). Overall, 78.3% (108/138) of subjects were always classified between the same three groups (52 always in TD, 7 in RDP, and 49 in NTD), and 98.6% (136/138) between five- and four-cluster solutions. However, subjects classified as NTD in the four-cluster analysis were dispersed into different subtypes in the three-cluster analysis, with low concordance between four- and three-cluster solutions (kappa value=−0.139, <italic>P</italic>
=0.001). This study defines clinical heterogeneity of PD patients in early stages using a data-driven approach. The subtypes generated by the four-cluster solution appear to exhibit ideal internal cohesion and external isolation.</p>
</abstract>
<kwd-group><kwd>Parkinson’s disease</kwd>
<kwd>Heterogeneity</kwd>
<kwd>Subtype</kwd>
<kwd>Cluster analysis</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>Crosschecked</meta-name>
<meta-value>Aug. 4, 2011</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>

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Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis*

Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis*

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Abstract

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