Clinical subtypes of Parkinson's disease
Identifieur interne : 000559 ( Main/Corpus ); précédent : 000558; suivant : 000560Clinical subtypes of Parkinson's disease
Auteurs : Stephanie M. Van Rooden ; Fabrice Colas ; Pablo Martínez-Martín ; Martine Visser ; Dagmar Verbaan ; Johan Marinus ; Ray K. Chaudhuri ; Joost N. Kok ; Jacobus J. Van HiltenSource :
- Movement Disorders [ 0885-3185 ] ; 2011-01.
English descriptors
Abstract
The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.
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DOI: 10.1002/mds.23346
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Van Rooden</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Colas, Fabrice" sort="Colas, Fabrice" uniqKey="Colas F" first="Fabrice" last="Colas">Fabrice Colas</name><affiliation><mods:affiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Martinez Artin, Pablo" sort="Martinez Artin, Pablo" uniqKey="Martinez Artin P" first="Pablo" last="Martínez-Martín">Pablo Martínez-Martín</name><affiliation><mods:affiliation>Alzheimer Disease Research Unit, National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain</mods:affiliation></affiliation></author><author><name sortKey="Visser, Martine" sort="Visser, Martine" uniqKey="Visser M" first="Martine" last="Visser">Martine Visser</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Verbaan, Dagmar" sort="Verbaan, Dagmar" uniqKey="Verbaan D" first="Dagmar" last="Verbaan">Dagmar Verbaan</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Marinus, Johan" sort="Marinus, Johan" uniqKey="Marinus J" first="Johan" last="Marinus">Johan Marinus</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Chaudhuri, Ray K" sort="Chaudhuri, Ray K" uniqKey="Chaudhuri R" first="Ray K." last="Chaudhuri">Ray K. 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Van Hilten</name><affiliation><mods:affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-01">2011-01</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="51">51</biblScope><biblScope unit="page" to="58">58</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">024084E75605ADB978E238301755FD6D08A792C7</idno><idno type="DOI">10.1002/mds.23346</idno><idno type="ArticleID">MDS23346</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>cluster analysis</term><term>motor complications</term><term>nondopaminergic</term><term>subtypes</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Stephanie M. van Rooden MSc</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Fabrice Colas PhD</name><affiliations><json:string>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Pablo Martínez‐Martín MD</name><affiliations><json:string>Alzheimer Disease Research Unit, National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain</json:string></affiliations></json:item><json:item><name>Martine Visser PhD</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Dagmar Verbaan PhD</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Johan Marinus PhD</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Ray K. Chaudhuri MD</name><affiliations><json:string>National Parkinson Foundation Centre of Excellence, King's College Hospital and University, Hospital Lewisham, London, United Kingdom/King's College and Institute of Psychiatry, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Joost N. Kok PhD</name><affiliations><json:string>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</json:string><json:string>Department of Medical Statistics and Bioinformatics/Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands</json:string></affiliations></json:item><json:item><name>Jacobus J. van Hilten MD</name><affiliations><json:string>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>subtypes</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>cluster analysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>nondopaminergic</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>motor complications</value></json:item></subject><articleId><json:string>MDS23346</json:string></articleId><language><json:string>eng</json:string></language><abstract>The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.</abstract><qualityIndicators><score>7.197</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1789</abstractCharCount><pdfWordCount>4197</pdfWordCount><pdfCharCount>27928</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>251</abstractWordCount></qualityIndicators><title>Clinical subtypes of Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>8</total><last>58</last><first>51</first></pages><issn><json:string>0885-3185</json:string></issn><issue>1</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/mds.23346</json:string></doi><id>024084E75605ADB978E238301755FD6D08A792C7</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/024084E75605ADB978E238301755FD6D08A792C7/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/024084E75605ADB978E238301755FD6D08A792C7/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/024084E75605ADB978E238301755FD6D08A792C7/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Clinical subtypes of Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Potential conflicts of interest: None.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Clinical subtypes of Parkinson's disease</title><author><persName><forename type="first">Stephanie M.</forename><surname>van Rooden</surname></persName><roleName type="degree">MSc</roleName><note type="correspondence"><p>Correspondence: Department of Neurology, K5Q‐92 Leiden University Medical Center, P.O. Box 9600, NL 2300 RC Leiden, The Netherlands</p></note><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Fabrice</forename><surname>Colas</surname></persName><roleName type="degree">PhD</roleName><affiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Pablo</forename><surname>Martínez‐Martín</surname></persName><roleName type="degree">MD</roleName><affiliation>Alzheimer Disease Research Unit, National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain</affiliation></author><author><persName><forename type="first">Martine</forename><surname>Visser</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Dagmar</forename><surname>Verbaan</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Johan</forename><surname>Marinus</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Ray K.</forename><surname>Chaudhuri</surname></persName><roleName type="degree">MD</roleName><affiliation>National Parkinson Foundation Centre of Excellence, King's College Hospital and University, Hospital Lewisham, London, United Kingdom/King's College and Institute of Psychiatry, London, United Kingdom</affiliation></author><author><persName><forename type="first">Joost N.</forename><surname>Kok</surname></persName><roleName type="degree">PhD</roleName><affiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</affiliation><affiliation>Department of Medical Statistics and Bioinformatics/Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands</affiliation></author><author><persName><forename type="first">Jacobus J.</forename><surname>van Hilten</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>subtypes</term></item><item><term>cluster analysis</term></item><item><term>nondopaminergic</term></item><item><term>motor complications</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-04-19">Received</change><change when="2010-06-18">Registration</change><change when="2011-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/024084E75605ADB978E238301755FD6D08A792C7/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="10"><doi origin="wiley" registered="yes">10.1002/mds.v26.1</doi><numberingGroup><numbering type="journalVolume" number="26">26</numbering><numbering type="journalIssue">1</numbering></numberingGroup><coverDate startDate="2011-01">January 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="130" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23346</doi><idGroup><id type="unit" value="MDS23346"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2010-04-19"></event><event type="manuscriptRevised" date="2010-06-02"></event><event type="manuscriptAccepted" date="2010-06-18"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:3.1.6 mode:FullText" date="2012-07-17"></event><event type="publishedOnlineEarlyUnpaginated" date="2010-11-16"></event><event type="publishedOnlineFinalForm" date="2011-02-14"></event><event type="firstOnline" date="2010-11-16"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">51</numbering><numbering type="pageLast">58</numbering></numberingGroup><correspondenceTo>Department of Neurology, K5Q‐92 Leiden University Medical Center, P.O. Box 9600, NL 2300 RC Leiden, The Netherlands</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23346.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="32"></count><count type="wordTotal" number="5900"></count></countGroup><titleGroup><title type="main" xml:lang="en">Clinical subtypes of Parkinson's disease<link href="#fn12"></link></title><title type="short" xml:lang="en">Clinical Subtypes of Parkinson's Disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Stephanie M.</givenNames><familyName>van Rooden</familyName><degrees>MSc</degrees></personName><contactDetails><email>s.m.van_rooden@lumc.nl</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Fabrice</givenNames><familyName>Colas</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Pablo</givenNames><familyName>Martínez‐Martín</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Martine</givenNames><familyName>Visser</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Dagmar</givenNames><familyName>Verbaan</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Johan</givenNames><familyName>Marinus</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Ray K.</givenNames><familyName>Chaudhuri</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af2 #af5"><personName><givenNames>Joost N.</givenNames><familyName>Kok</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jacobus J.</givenNames><familyName>van Hilten</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="NL" type="organization"><unparsedAffiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="NL" type="organization"><unparsedAffiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="ES" type="organization"><unparsedAffiliation>Alzheimer Disease Research Unit, National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="GB" type="organization"><unparsedAffiliation>National Parkinson Foundation Centre of Excellence, King's College Hospital and University, Hospital Lewisham, London, United Kingdom/King's College and Institute of Psychiatry, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="NL" type="organization"><unparsedAffiliation>Department of Medical Statistics and Bioinformatics/Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">subtypes</keyword><keyword xml:id="kwd3">cluster analysis</keyword><keyword xml:id="kwd4">nondopaminergic</keyword><keyword xml:id="kwd5">motor complications</keyword></keywordGroup><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23346:MDS_23346_sm_suppinfoApp"></mediaResource><caption>Supporting Information Appendix</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23346:MDS_23346_sm_suppinfoTab"></mediaResource><caption>Table e‐1. BIC table of the model based cluster analysis on data of PROPARK year 1.</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn12"><p>Potential conflicts of interest: None.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Clinical subtypes of Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Clinical Subtypes of Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Clinical subtypes of Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Stephanie M.</namePart><namePart type="family">van Rooden</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><description>Correspondence: Department of Neurology, K5Q‐92 Leiden University Medical Center, P.O. Box 9600, NL 2300 RC Leiden, The Netherlands</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Fabrice</namePart><namePart type="family">Colas</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pablo</namePart><namePart type="family">Martínez‐Martín</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Alzheimer Disease Research Unit, National Centre for Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martine</namePart><namePart type="family">Visser</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dagmar</namePart><namePart type="family">Verbaan</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Johan</namePart><namePart type="family">Marinus</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ray K.</namePart><namePart type="family">Chaudhuri</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>National Parkinson Foundation Centre of Excellence, King's College Hospital and University, Hospital Lewisham, London, United Kingdom/King's College and Institute of Psychiatry, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joost N.</namePart><namePart type="family">Kok</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Leiden Institute for Advanced Computer Science, Leiden University, Leiden, The Netherlands</affiliation><affiliation>Department of Medical Statistics and Bioinformatics/Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jacobus J.</namePart><namePart type="family">van Hilten</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-01</dateIssued><dateCaptured encoding="w3cdtf">2010-04-19</dateCaptured><dateValid encoding="w3cdtf">2010-06-18</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent><extent unit="references">32</extent><extent unit="words">5900</extent></physicalDescription><abstract lang="en">The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data‐driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model‐based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.</abstract><note type="content">*Potential conflicts of interest: None.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>subtypes</topic><topic>cluster analysis</topic><topic>nondopaminergic</topic><topic>motor complications</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Supporting Information Appendix - Table e‐1. BIC table of the model based cluster analysis on data of PROPARK year 1. - </note><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>51</start><end>58</end><total>8</total></extent></part></relatedItem><identifier type="istex">024084E75605ADB978E238301755FD6D08A792C7</identifier><identifier type="DOI">10.1002/mds.23346</identifier><identifier type="ArticleID">MDS23346</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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