Potential conflicts of interest: None.
Clinical subtypes of Parkinson's disease†
Article first published online: 16 NOV 2010
Copyright © 2010 Movement Disorder Society
Volume 26, Issue 1, pages 51–58, January 2011
How to Cite
van Rooden, S. M., Colas, F., Martínez-Martín, P., Visser, M., Verbaan, D., Marinus, J., Chaudhuri, R. K., Kok, J. N. and van Hilten, J. J. (2011), Clinical subtypes of Parkinson's disease. Mov. Disord., 26: 51–58. doi: 10.1002/mds.23346
- Issue published online: 14 FEB 2011
- Article first published online: 16 NOV 2010
- Manuscript Accepted: 18 JUN 2010
- Manuscript Revised: 2 JUN 2010
- Manuscript Received: 19 APR 2010
- Parkinson's disease;
- cluster analysis;
- motor complications
The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Because subtypes likely reflect distinct underlying etiologies, their identification may facilitate future genetic and pharmacotherapeutic studies. Aim of this study was to identify subtypes by a data-driven approach applied to a broad spectrum of motor and nonmotor features of PD. Data of motor and nonmotor PD symptoms were collected in 802 patients in two different European prevalent cohorts. A model-based cluster analysis was conducted on baseline data of 344 patients of a Dutch cohort (PROPARK). Reproducibility of these results was tested in data of the second annual assessment of the same cohort and validated in an independent Spanish cohort (ELEP) of 357 patients. The subtypes were subsequently characterized on clinical and demographic variables. Four similar PD subtypes were identified in two different populations and are largely characterized by differences in the severity of nondopaminergic features and motor complications: Subtype 1 was mildly affected in all domains, Subtype 2 was predominantly characterized by severe motor complications, Subtype 3 was affected mainly on nondopaminergic domains without prominent motor complications, while Subtype 4 was severely affected on all domains. The subtypes had largely similar mean disease durations (nonsignificant differences between three clusters) but showed considerable differences with respect to their association with demographic and clinical variables. In prevalent disease, PD subtypes are largely characterized by the severity of nondopaminergic features and motor complications and likely reflect complex interactions between disease mechanisms, treatment, aging, and gender. © 2010 Movement Disorder Society.