Comparison of clinical features among Parkinson's disease subtypes: A large retrospective study in a single center

Takuya Konno, Angela Deutschländer, Michael G. Heckman, Maryam Ossi, Emily R. Vargas, Audrey J. Strongosky, Jay A. van Gerpen, Ryan J. Uitti, Owen A. Ross, Zbigniew K. Wszolek

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Introduction: Tremor dominant (TD), postural instability/gait difficulty (PIGD), and akinetic-rigid (AR) subtypes are widely used in classifying patients with Parkinson's disease (PD). Methods: We compared clinical characteristics between PD subtypes in a large retrospective cohort. Between 1998 and 2016, we included a total of 1003 patients with PD in this retrospective study. Six hundred ninety-four patients had more than one visit. Data were collected regarding motor/non-motor symptoms at the initial/final visits. Based on the prominent symptom at the initial visit, we classified patients into one of the four subtypes: TD, AR, gait difficulty, and mixed. Rapid progression was defined by emergence of falls, dementia, or dependency within 5 years after onset. Results: TD was the most prevalent subtype (44%), followed by AR (29%), mixed (18%), and gait difficulty (9%). Rapid progression was observed more frequently in gait difficulty compared to AR (OR: 3.59 P < 0.001). Hallucinations at the final visit were more likely to occur in AR (OR: 2.36, P = 0.005) and mixed (OR: 3.28, P < 0.001) compared to TD. Conclusions: Our findings provide support for a distinction of four different PD subtypes: TD, AR, gait difficulty, and mixed. The gait difficulty subtype was distinguishable from the AR subtype.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of the neurological sciences
Volume386
DOIs
StatePublished - Mar 15 2018

Keywords

  • Akinetic-rigid (AR)
  • Parkinson's disease (PD)
  • Postural instability/gait difficulty (PIGD)
  • Subtype
  • Tremor-dominant (TD)

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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