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 - Funding Information:
T. Konno received research support from JSPS Overseas Research Fellowships and is partially supported by a gift from Carl Edward Bolch, Jr. and Susan Bass Bolch. A. Deutschländer is supported by the Max Kade Foundation . M. G. Heckman, M. Ossi, and E. R. Vargas are supported by the Mayo Clinic Neuroscience Focused Research Team (Cecilia and Dan Carmichael Family Foundation, and the James C. and Sarah K. Kennedy Fund for Neurodegenerative Disease Research at Mayo Clinic in Florida). A. J. Strongosky, J. A. van Gerpen, R. J. Uitti, O. A. Ross, and Z. K. Wszolek are partially supported by the Mayo Clinic Morris K. Udall Parkinson's Disease Research Center of Excellence (NINDS P50 # NS072187 ). O. A. Ross also receives support from NINDS RO1 NS078086 , Mayo Clinic Center for Regenerative Medicine , Mayo Clinic Center for Individualized Medicine , Mayo Clinic Neuroscience Focused Research Team (Cecilia and Dan Carmichael Family Foundation, and the James C. and Sarah K. Kennedy Fund for Neurodegenerative Disease Research at Mayo Clinic in Florida). Z. K. Wszolek is also supported by the Mayo Clinic Center for Regenerative Medicine , Mayo Clinic Center for Individualized Medicine , Mayo Clinic Neuroscience Focused Research Team (Cecilia and Dan Carmichael Family Foundation, and the James C. and Sarah K. Kennedy Fund for Neurodegenerative Disease Research at Mayo Clinic in Florida), the gift from Carl Edward Bolch, Jr. and Susan Bass Bolch, and Donald G. and Jodi P. Heeringa.
Funding Information:
This work was supported by the Mayo Clinic Neuroscience Focused Research Team ( Cecilia and Dan Carmichael Family Foundation , and the James C. and Sarah K. Kennedy Fund for Neurodegenerative Disease Research at Mayo Clinic in Florida) and the gift from The Sol Goldman Charitable Trust.
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
VL - 386
SP - 39
EP - 45
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
ER -