TY - JOUR
T1 - Comparison of clinical features among Parkinson's disease subtypes
T2 - A large retrospective study in a single center
AU - Konno, Takuya
AU - Deutschländer, Angela
AU - Heckman, Michael G.
AU - Ossi, Maryam
AU - Vargas, Emily R.
AU - Strongosky, Audrey J.
AU - van Gerpen, Jay A.
AU - Uitti, Ryan J.
AU - Ross, Owen A.
AU - Wszolek, Zbigniew K.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/3/15
Y1 - 2018/3/15
N2 - 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.
AB - 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.
KW - Akinetic-rigid (AR)
KW - Parkinson's disease (PD)
KW - Postural instability/gait difficulty (PIGD)
KW - Subtype
KW - Tremor-dominant (TD)
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U2 - 10.1016/j.jns.2018.01.013
DO - 10.1016/j.jns.2018.01.013
M3 - Article
C2 - 29406964
AN - SCOPUS:85041640874
SN - 0022-510X
VL - 386
SP - 39
EP - 45
JO - Journal of the neurological sciences
JF - Journal of the neurological sciences
ER -