The Heterogeneity of Early Parkinson’s Disease: A Cluster Analysis on Newly Diagnosed Untreated Patients

The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD pa...

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Published inPloS one Vol. 8; no. 8; p. e70244
Main Authors Erro, Roberto, Vitale, Carmine, Amboni, Marianna, Picillo, Marina, Moccia, Marcello, Longo, Katia, Santangelo, Gabriella, De Rosa, Anna, Allocca, Roberto, Giordano, Flavio, Orefice, Giuseppe, De Michele, Giuseppe, Santoro, Lucio, Pellecchia, Maria Teresa, Barone, Paolo
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 01.08.2013
Public Library of Science (PLoS)
Subjects
Age
Analysis
Benign
Biology
Brain research
Care and treatment
Cluster Analysis
Clusters
Cohort Studies
Data processing
Demographics
Diagnosis
Dopamine
Female
Genotype & phenotype
Health aspects
Heterogeneity
Humans
Male
Medical diagnosis
Medicine
Middle Aged
Motor Activity
Movement disorders
Neurodegenerative diseases
Parkinson disease
Parkinson Disease - diagnosis
Parkinson Disease - physiopathology
Parkinson's disease
Patients
Phenotype
Science
Signs and symptoms
Statistical analysis
Studies
Subgroups
United Kingdom > UK
Italy
Online AccessGet full text
ISSN1932-6203
1932-6203
DOI10.1371/journal.pone.0070244

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Abstract The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients. We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored. The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant. Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
AbstractList The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients. We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored. The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant. Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients. We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored. The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant. Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
Background The variability in the clinical phenotype of Parkinson’s disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients. Methods We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored. Results The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant. Conclusion Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients.BACKGROUNDThe variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients.We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored.METHODSWe collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored.The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant.RESULTSThe data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant.Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.CONCLUSIONOur results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
BackgroundThe variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients.MethodsWe collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored.ResultsThe data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant.ConclusionOur results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
Background The variability in the clinical phenotype of Parkinson’s disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients. Methods We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored. Results The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant. Conclusion Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.
Audience Academic
Author Vitale, Carmine
Amboni, Marianna
Picillo, Marina
Santangelo, Gabriella
Erro, Roberto
Orefice, Giuseppe
Pellecchia, Maria Teresa
Longo, Katia
Giordano, Flavio
De Rosa, Anna
Moccia, Marcello
De Michele, Giuseppe
Barone, Paolo
Santoro, Lucio
Allocca, Roberto
AuthorAffiliation 4 University Federico II, Department of Neurological Science, Naples, Italy
5 Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Caserta, Italy
3 University Parthenope, Naples, Italy
2 IDC Hermitage - Capodimonte, Naples, Italy
6 University of Salerno, Center for Neurodegenerative Diseases - CEMAND, Salerno, Italy
1 Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL), London, United Kingdom
University of Chicago, United States of America
AuthorAffiliation_xml – name: 6 University of Salerno, Center for Neurodegenerative Diseases - CEMAND, Salerno, Italy
– name: 2 IDC Hermitage - Capodimonte, Naples, Italy
– name: University of Chicago, United States of America
– name: 5 Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Caserta, Italy
– name: 1 Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL), London, United Kingdom
– name: 3 University Parthenope, Naples, Italy
– name: 4 University Federico II, Department of Neurological Science, Naples, Italy
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/23936396$$D View this record in MEDLINE/PubMed
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2013 Erro et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
2013 Erro et al 2013 Erro et al
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– notice: 2013 Erro et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Conceived and designed the experiments: RE CV PB. Performed the experiments: RE CV MA MP KL GS MM RA FG GDM ADR LS GO MTP. Analyzed the data: RE CV. Wrote the paper: RE CV PB.
Competing Interests: Dr. Carmine Vitale has received honoraria for symposia from Boehringer Ingelheim, Lundbeck, Novartis, Schwarz Pharma/UCB, GSK. Dr. Gabriella Santangelo has received honoraria for symposia from Lundbeck. Prof Paolo Barone has received honoraria as a Consultant & Advisory Board Memberships for Novartis, Schwarz Pharma/UCB, Merck-Serono, Eisai, Solvay, General Electric and Lundbeck. He has received research support from Boehringer Ingelheim, Novartis, Schwarz Pharma/UCB, Merck-Serono, Solvay, and Lundbeck. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.
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Snippet The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we...
Background The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this...
Background The variability in the clinical phenotype of Parkinson’s disease seems to suggest the existence of several subtypes of the disease. To test this...
BackgroundThe variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this...
Background The variability in the clinical phenotype of Parkinson’s disease seems to suggest the existence of several subtypes of the disease. To test this...
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SubjectTerms Age
Analysis
Benign
Biology
Brain research
Care and treatment
Cluster Analysis
Clusters
Cohort Studies
Data processing
Demographics
Diagnosis
Dopamine
Female
Genotype & phenotype
Health aspects
Heterogeneity
Humans
Male
Medical diagnosis
Medicine
Middle Aged
Motor Activity
Movement disorders
Neurodegenerative diseases
Parkinson disease
Parkinson Disease - diagnosis
Parkinson Disease - physiopathology
Parkinson's disease
Patients
Phenotype
Science
Signs and symptoms
Statistical analysis
Studies
Subgroups
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Title The Heterogeneity of Early Parkinson’s Disease: A Cluster Analysis on Newly Diagnosed Untreated Patients
URI https://www.ncbi.nlm.nih.gov/pubmed/23936396
https://www.proquest.com/docview/1430168911
https://www.proquest.com/docview/1420165494
https://pubmed.ncbi.nlm.nih.gov/PMC3731357
https://doaj.org/article/928cc79f8c61406d98185276b6025cab
http://dx.doi.org/10.1371/journal.pone.0070244
Volume 8
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