Clinical clusters and dopaminergic dysfunction in de-novo Parkinson disease
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Accepted version
Supporting information
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The heterogeneity of PD suggests the existence of different subtypes. While some motor clusters have been consistently identified, little is known about non-motor PD subtypes and motor-non-motor interplay. Research in this regard has produced somewhat contradictory results, which might be biased by the inclusion of treated patients. PATIENTS AND METHODS: We performed a non-hierarchical cluster analysis using both motor and non-motor data on 398 newly diagnosed untreated PD patients enrolled in the Parkinson's Progressive Marker Initiative (PPMI) study. We further evaluated whether dopaminergic dysfunction, as measured by (123)[I]-FP-CIT SPECT scan, could explain, at least partially, the observed difference between the clusters. RESULTS: Three clusters were identified. Group 1 was characterized by the lowest motor and non-motor burden, whereas group 2 and 3 had similar motor disability, but different non-motor involvement, especially with regards to apathy and hallucinations. (123)[I]-FP-CIT binding values paralleled motor disability burden among the 3 clusters, but further multivariate analyses also revealed a negative correlation with depression. DISCUSSION: Our results confirm the motor as well as non-motor heterogeneity of PD, suggesting the existence of 3 different subtypes. Dopaminergic dysfunction only marginally explains the non-motor variability of PD. Identification of such clusters can have important implications for generating novel pathophysiological hypotheses and therapeutic strategies.
Date Issued
2016-04-28
Date Acceptance
2016-04-22
Citation
Parkinsonism & Related Disorders, 2016, 28, pp.137-140
ISSN
1353-8020
Publisher
Elsevier
Start Page
137
End Page
140
Journal / Book Title
Parkinsonism & Related Disorders
Volume
28
Copyright Statement
© 2016 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Subjects
Clusters
Heterogeneity
Non-motor
Parkinson
Subtypes
Neurology & Neurosurgery
1103 Clinical Sciences
1702 Cognitive Science
Publication Status
Published