Parkinson Disease Subtypes

Thenganatt, Mary Ann; Jankovic, Joseph

doi:10.1001/jamaneurol.2013.6233

Cited by 425 publications

(325 citation statements)

References 66 publications

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“…Baseline MDS‐UPDRS and putamen DAT SBR demonstrated a modest correlation, as in other clinical studies. The lack of correlation may reflect the heterogeneity of presentation, course, and response to therapy, a hallmark of PD 53, 54, 55. The PPMI longitudinal data will examine whether baseline biomarkers and/or short‐term change in baseline biomarkers are predictive of longitudinal PD progression outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Marek

Chowdhury

Siderowf

et al. 2018

Ann Clin Transl Neurol

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433

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ObjectiveThe Parkinson's Progression Markers Initiative (PPMI) is an observational, international study designed to establish biomarker‐defined cohorts and identify clinical, imaging, genetic, and biospecimen Parkinson's disease (PD) progression markers to accelerate disease‐modifying therapeutic trials.MethodsA total of 423 untreated PD, 196 Healthy Control (HC) and 64 SWEDD (scans without evidence of dopaminergic deficit) subjects were enrolled at 24 sites. To enroll PD subjects as early as possible following diagnosis, subjects were eligible with only asymmetric bradykinesia or tremor plus a dopamine transporter (DAT) binding deficit on SPECT imaging. Acquisition of data was standardized as detailed at www.ppmi-info.org.ResultsApproximately 9% of enrolled subjects had a single PD sign at baseline. DAT imaging excluded 16% of potential PD subjects with SWEDD. The total MDS‐UPDRS for PD was 32.4 compared to 4.6 for HC and 28.2 for SWEDD. On average, PD subjects demonstrated 45% and 68% reduction in mean striatal and contralateral putamen Specific Binding Ratios (SBR), respectively. Cerebrospinal fluid (CSF) was acquired from >97% of all subjects. CSF (PD/HC/SWEDD pg/mL) α‐synuclein (1845/2204/2141) was reduced in PD vs HC or SWEDD (P < 0.03). Similarly, t‐tau (45/53) and p‐tau (16/18) were reduced in PD versus HC (P < 0.01),Interpretation PPMI has detailed the biomarker signature for an early PD cohort defined by clinical features and imaging biomarkers. This strategy provides the framework to establish biomarker cohorts and to define longitudinal progression biomarkers to support future PD treatment trials.

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Section: Discussionmentioning

confidence: 99%

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Marek

Chowdhury

Siderowf

et al. 2018

Ann Clin Transl Neurol

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433

339

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“…Patients differ substantially on their degree of disability, motor and non-motor symptom profiles, and complications of therapy [3], all of which may have a differential impact on caregiver burden. Neuropsychiatric symptoms (NPS), such as anxiety, depression, apathy, mental fatigue, psychosis, and impulse control disorders (ICDs) are highly prevalent, affecting up to 60-80% of patients with PD [4].…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric symptoms and caregiver's burden in Parkinson's disease

Martinez‐Martín

Rodríguez‐Blázquez

Forjaz

et al. 2015

Parkinsonism & Related Disorders

190

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Introduction: In Parkinson's disease (PD), neuropsychiatric symptoms (NPS) can be particularly burdensome for caregivers. The main goal of this study was to assess the impact of NPS, assessed by means of a new specific scale, on caregiver burden.Methods: A sample of 584 pairs of PD patients and their primary caregivers was studied. Patients' NPS were measured with the Scale for Evaluation of Neuropsychiatric Disorders in PD (SEND-PD), and the Zarit Caregiver Burden Inventory was used to quantify caregiver burden. Three linear regression models were built to check factors associated with caregiver burden, one for the total sample and two for subgroups stratified by the presence of dementia. Results: The most prevalent SEND-PD dimensions were mood/apathy (87.4%), followed by psychotic symptoms (48.5%) and impulse control disorders (26.5%). Patients with dementia (n=94; 16.15% of sample) consistently presented more NPS than patients without dementia (p<0.001). On linear regression models, the main determinants of caregiver burden (for the total sample and the sample of patients without dementia) were SEND-PD dimensions mood/apathy and psychosis, PD-related disability and disease duration. For patients with dementia, the only significant caregiver burden determinants were SEND-PD psychosis and mood/apathy subscale scores.Conclusions: NPS in PD are highly associated with and are determinants of caregiver burden, and are more prevalent and burdensome in patients with dementia. Detailed assessment and specific interventions aimed at NPS could alleviate caregiver burden. Author DeclarationParkinsonism & Related Disorders is committed to proper scientific conduct and the protection of animal and human research subjects. Submission of this manuscript implies compliance with the following ethical requirements. Please affirm that you are representing all of the authors in stating compliance with these policies by checking the box at the end of this section.1. Studies with human subjects must have been conducted in accordance with the Declaration of Helsinki. All persons must have provided informed consent prior to being included in the study.2. Studies with animal subjects must have been conducted in accordance with the Guide for the Care and Use of Laboratory Subjects as adopted by the US National Institutes of Health and/or according to the requirements of all applicable local, national and international standards.3. Protocols with animal or human subjects must have been approved by the relevant local committee(s) charged with ensuring subject protection. Studies that entail pain or distress will be assessed in terms of the balance between the distress inflicted and the likelihood of benefit.4. The authors declare that the manuscript is original, that it is not being considered for publication elsewhere, and that it will not be submitted elsewhere while still under consideration for Parkinsonism & Related Disorders or after it has been accepted by Parkinsonism & Related Disorders.5. All authors have seen and app...

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“…Age of onset of clinical symptoms in PD is one of several criteria employed for disease classification 15 . Age cut-offs for early versus late onset subtypes vary but 40 or 50 years of age is used as a defining threshold 16 .…”

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confidence: 99%

Speech disorders did not correlate with age at onset of Parkinson’s disease

Dias

Barbosa

Limongi

et al. 2016

Arq. Neuro-Psiquiatr.

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Parkinson' s disease (PD) is a neurodegenerative disorder characterized by loss of dopamine-producing cells and affects mainly individuals over 60 years but a young onset subtype is also well recognized 1 . Motor limitations observed in PD are often attributed to basal ganglia dysfunction associated with decreased dopaminergic input to the sensorimotor region of the striatum 2 .The progressive neuronal loss is associated with a variety of motor and non-motor deficits in PD patients. In addition to the predominant symptoms such as muscular rigidity, tremor, bradykinesia and postural instability, many patients develop a distinctive alteration of voice and speech characterized as hypokinetic dysarthria . According to some authors, these changes may be present even before the onset of more overt PD manifestations 13 . Symptoms of PD begin characteristically above the age of 50 years with a mean age of onset around 60 years but some ABSTRACT Speech disorders are common manifestations of Parkinson´s disease. Objective: To compare speech articulation in patients according to age at onset of the disease. Methods: Fifty patients was divided into two groups: Group I consisted of 30 patients with age at onset between 40 and 55 years; Group II consisted of 20 patients with age at onset after 65 years. All patients were evaluated based on the Unified Parkinson's Disease Rating Scale scores, Hoehn and Yahr scale and speech evaluation by perceptual and acoustical analysis. Results: There was no statistically significant difference between the two groups regarding neurological involvement and speech characteristics. Correlation analysis indicated differences in speech articulation in relation to staging and axial scores of rigidity and bradykinesia for middle and late-onset. Conclusions: Impairment of speech articulation did not correlate with age at onset of disease, but was positively related with disease duration and higher scores in both groups.Keywords: Parkinson´s disease, speech articulation, dysarthria. RESUMODistúrbios da fala são comuns da doença de Parkinson. Objetivo: Comparar a articulação da fala de acordo com a idade de início da doença. Métodos: Cinquenta pacientes foram divididos em dois grupos: Grupo I consistiu de 30 pacientes com idade de início entre 40 e 55 anos; Grupo II foi composto por 20 pacientes com idade de início após os 65 anos. Todos foram avaliados pela Unified Parkinson's Disease Rating Scale, Hoehn and Yahr e análise perceptual e acústica da fala. Resultados: Não houve diferença estatística significativa entre os dois grupos quanto às características neurológicas e de fala. Análises de correlação indicaram diferença estatística significativa entre articulação da fala, estágio da doença e escores axiais, de rigidez e bradicinesia. Conclusões: A articulação da fala não se correlacionou com a idade de início da doença, mas foi positivamente relacionada à duração da doença e aos escores mais elevados nos dois grupos.Palavras-chave: doença de Parkinson, articulação da fala, disartria.

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Parkinson Disease Subtypes

Cited by 425 publications

References 66 publications

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Neuropsychiatric symptoms and caregiver's burden in Parkinson's disease

Speech disorders did not correlate with age at onset of Parkinson’s disease

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