A clinico-pathological study of subtypes in Parkinson's disease
Identifieur interne : 000906 ( Main/Exploration ); précédent : 000905; suivant : 000907A clinico-pathological study of subtypes in Parkinson's disease
Auteurs : M. Selikhova [Royaume-Uni, Russie] ; D. R. Williams [Royaume-Uni, Australie] ; P. A. Kempster [Royaume-Uni, Australie] ; J. L. Holton [Royaume-Uni] ; T. Revesz [Royaume-Uni] ; Andrew Lees (neurologue) [Royaume-Uni]Source :
- Brain [ 0006-8950 ] ; 2009-11.
Abstract
We have carried out a systematic review of the case files of 242 donors with pathologically verified Parkinson's disease at the Queen Square Brain Bank for Neurological Disorders in an attempt to corroborate the data-driven subtype classification proposed by Lewis and colleagues (Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach. J Neurol Neurosurg Psychiatry 2005; 76: 3438). Cases were segregated into earlier disease onset (25), tremor dominant (31), non-tremor dominant (36) and rapid disease progression without dementia (8) subgroups. We found a strong association between a non-tremor dominant disease pattern and cognitive disability. The earlier disease onset group had the longest duration to death, and greatest delay to the onset of falls and cognitive decline. Patients with a tremor dominant disease pattern did not live significantly longer than non-tremor dominant patients and showed no difference in mean time to onset of falls and hallucinations. Rapid disease progression was associated with older age, early depression and early midline motor symptoms, and in 70 of the cases, tremulous onset. The non-tremor dominant subgroup had a significantly higher mean pathological grading of cortical Lewy bodies than all other groupings (P < 0.05) and more cortical amyloid- plaque load and cerebral amyloid angiopathy than early disease onset and tremor dominant groups (P 0.047). An analysis of cases with pathologically defined neocortical Lewy body disease confirmed the link between bradykinetic onset, cognitive decline and Lewy body deposition in the neocortex. Although neuropathological examination failed to distinguish the other subtypes, the classification scheme was supported by an analysis of clinical data that were independent of the basic subgroup definitions.
Url:
DOI: 10.1093/brain/awp234
Affiliations:
- Australie, Royaume-Uni, Russie
- Angleterre, District fédéral central, Grand Londres
- Londres, Moscou
- National Hospital for Neurology and Neurosurgery
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J. Lees, Reta Lila Weston Institute of Neurological Studies, 1 Wakefield Street, London, WC1N 1PJ</wicri:regionArea><wicri:noRegion>WC1N 1PJ</wicri:noRegion><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName>National Hospital for Neurology and Neurosurgery</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-11">2009-11</date><biblScope unit="volume">132</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="page" from="2947">2947</biblScope><biblScope unit="page" to="2957">2957</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">65F118DB03811DB478F3ABAB30F3452B4D2AE668</idno><idno type="DOI">10.1093/brain/awp234</idno><idno type="ArticleID">awp234</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">We have carried out a systematic review of the case files of 242 donors with pathologically verified Parkinson's disease at the Queen Square Brain Bank for Neurological Disorders in an attempt to corroborate the data-driven subtype classification proposed by Lewis and colleagues (Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach. J Neurol Neurosurg Psychiatry 2005; 76: 3438). Cases were segregated into earlier disease onset (25), tremor dominant (31), non-tremor dominant (36) and rapid disease progression without dementia (8) subgroups. We found a strong association between a non-tremor dominant disease pattern and cognitive disability. The earlier disease onset group had the longest duration to death, and greatest delay to the onset of falls and cognitive decline. Patients with a tremor dominant disease pattern did not live significantly longer than non-tremor dominant patients and showed no difference in mean time to onset of falls and hallucinations. Rapid disease progression was associated with older age, early depression and early midline motor symptoms, and in 70 of the cases, tremulous onset. The non-tremor dominant subgroup had a significantly higher mean pathological grading of cortical Lewy bodies than all other groupings (P < 0.05) and more cortical amyloid- plaque load and cerebral amyloid angiopathy than early disease onset and tremor dominant groups (P 0.047). An analysis of cases with pathologically defined neocortical Lewy body disease confirmed the link between bradykinetic onset, cognitive decline and Lewy body deposition in the neocortex. Although neuropathological examination failed to distinguish the other subtypes, the classification scheme was supported by an analysis of clinical data that were independent of the basic subgroup definitions.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Royaume-Uni</li><li>Russie</li></country><region><li>Angleterre</li><li>District fédéral central</li><li>Grand Londres</li></region><settlement><li>Londres</li><li>Moscou</li></settlement><orgName><li>National Hospital for Neurology and Neurosurgery</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Selikhova, M" sort="Selikhova, M" uniqKey="Selikhova M" first="M." last="Selikhova">M. Selikhova</name></region><name sortKey="Holton, J L" sort="Holton, J L" uniqKey="Holton J" first="J. L." last="Holton">J. L. Holton</name><name sortKey="Holton, J L" sort="Holton, J L" uniqKey="Holton J" first="J. L." last="Holton">J. L. Holton</name><name sortKey="Holton, J L" sort="Holton, J L" uniqKey="Holton J" first="J. L." last="Holton">J. L. Holton</name><name sortKey="Kempster, P A" sort="Kempster, P A" uniqKey="Kempster P" first="P. A." last="Kempster">P. A. Kempster</name><name sortKey="Kempster, P A" sort="Kempster, P A" uniqKey="Kempster P" first="P. A." last="Kempster">P. A. Kempster</name><name sortKey="Kempster, P A" sort="Kempster, P A" uniqKey="Kempster P" first="P. A." last="Kempster">P. A. Kempster</name><name sortKey="Lees, A J" sort="Lees, A J" uniqKey="Lees A" first="A. J." last="Lees">Andrew Lees (neurologue)</name><name sortKey="Lees, A J" sort="Lees, A J" uniqKey="Lees A" first="A. J." last="Lees">Andrew Lees (neurologue)</name><name sortKey="Lees, A J" sort="Lees, A J" uniqKey="Lees A" first="A. J." last="Lees">Andrew Lees (neurologue)</name><name sortKey="Revesz, T" sort="Revesz, T" uniqKey="Revesz T" first="T." last="Revesz">T. Revesz</name><name sortKey="Revesz, T" sort="Revesz, T" uniqKey="Revesz T" first="T." last="Revesz">T. Revesz</name><name sortKey="Selikhova, M" sort="Selikhova, M" uniqKey="Selikhova M" first="M." last="Selikhova">M. Selikhova</name><name sortKey="Williams, D R" sort="Williams, D R" uniqKey="Williams D" first="D. R." last="Williams">D. R. Williams</name><name sortKey="Williams, D R" sort="Williams, D R" uniqKey="Williams D" first="D. R." last="Williams">D. R. Williams</name><name sortKey="Williams, D R" sort="Williams, D R" uniqKey="Williams D" first="D. R." last="Williams">D. R. Williams</name></country><country name="Russie"><region name="District fédéral central"><name sortKey="Selikhova, M" sort="Selikhova, M" uniqKey="Selikhova M" first="M." last="Selikhova">M. Selikhova</name></region></country><country name="Australie"><noRegion><name sortKey="Williams, D R" sort="Williams, D R" uniqKey="Williams D" first="D. R." last="Williams">D. R. Williams</name></noRegion><name sortKey="Kempster, P A" sort="Kempster, P A" uniqKey="Kempster P" first="P. A." last="Kempster">P. A. Kempster</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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