Clinical subtypes of Parkinson's disease
Identifieur interne : 000363 ( Main/Exploration ); précédent : 000362; suivant : 000364Clinical subtypes of Parkinson's disease
Auteurs : Stephanie M. Van Rooden [Pays-Bas] ; Fabrice Colas [Pays-Bas] ; Pablo Martínez-Martín [Espagne] ; Martine Visser [Pays-Bas] ; Dagmar Verbaan [Pays-Bas] ; Johan Marinus [Pays-Bas] ; Ray K. Chaudhuri [Royaume-Uni] ; Joost N. Kok [Pays-Bas] ; Jacobus J. Van Hilten [Pays-Bas]Source :
- 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.
Url:
DOI: 10.1002/mds.23346
Affiliations:
- Espagne, Pays-Bas, Royaume-Uni
- Angleterre, Communauté de Madrid, Grand Londres, Hollande-Méridionale
- Leyde, Londres, Madrid
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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.</div></front></TEI><affiliations><list><country><li>Espagne</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Communauté de Madrid</li><li>Grand Londres</li><li>Hollande-Méridionale</li></region><settlement><li>Leyde</li><li>Londres</li><li>Madrid</li></settlement></list><tree><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Van Rooden, Stephanie M" sort="Van Rooden, Stephanie M" uniqKey="Van Rooden S" first="Stephanie M." last="Van Rooden">Stephanie M. Van Rooden</name></region><name sortKey="Colas, Fabrice" sort="Colas, Fabrice" uniqKey="Colas F" first="Fabrice" last="Colas">Fabrice Colas</name><name sortKey="Kok, Joost N" sort="Kok, Joost N" uniqKey="Kok J" first="Joost N." last="Kok">Joost N. Kok</name><name sortKey="Kok, Joost N" sort="Kok, Joost N" uniqKey="Kok J" first="Joost N." last="Kok">Joost N. Kok</name><name sortKey="Marinus, Johan" sort="Marinus, Johan" uniqKey="Marinus J" first="Johan" last="Marinus">Johan Marinus</name><name sortKey="Van Hilten, Jacobus J" sort="Van Hilten, Jacobus J" uniqKey="Van Hilten J" first="Jacobus J." last="Van Hilten">Jacobus J. Van Hilten</name><name sortKey="Verbaan, Dagmar" sort="Verbaan, Dagmar" uniqKey="Verbaan D" first="Dagmar" last="Verbaan">Dagmar Verbaan</name><name sortKey="Visser, Martine" sort="Visser, Martine" uniqKey="Visser M" first="Martine" last="Visser">Martine Visser</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Martinez Artin, Pablo" sort="Martinez Artin, Pablo" uniqKey="Martinez Artin P" first="Pablo" last="Martínez-Martín">Pablo Martínez-Martín</name></region></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Chaudhuri, Ray K" sort="Chaudhuri, Ray K" uniqKey="Chaudhuri R" first="Ray K." last="Chaudhuri">Ray K. Chaudhuri</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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