BishtRef
Articles Journals Publishers Authors Subjects Most Cited New Papers Year Stats Open Access
journal article Feb 10, 2016

Nonmotor features of Parkinson's disease subtypes

Connie Marras K. Ray Chaudhuri ORCID
Movement Disorders Vol. 31 No. 8 pp. 1095-1102 · Wiley
View at Publisher Save 10.1002/mds.26510
Abstract
AbstractParkinson's disease is highly heterogeneous in early clinical features and later outcomes. This makes classifying subgroups of PD relevant to clinical research and practice, particularly if they are prognostically relevant. Subgroups have been defined both on the basis of motor and nonmotor features, and subgroups have been determined either empirically, based on clinical observation, or using data‐driven analytic techniques. Previous studies have examined both the overall number and the nature of nonmotor symptoms and signs in tremor‐dominant compared with non‐tremor‐dominant subtypes, and longitudinal studies identify nonmotor symptoms as important markers of prognosis and important defining features of PD subtypes. Autonomic features seem to preferentially affect individuals with non‐tremor‐dominant PD subtype early in the disease. Later in the disease cognitive disturbance distinguishes this phenotype. Pathological and neuroimaging studies provide substantial evidence for fundamental biological differences between tremor‐dominant and postural instability gait disorder/akinetic‐rigid subtypes. Biomarker studies point toward non‐tremor‐dominant PD as representing more advanced and diffuse neurodegeneration than tremor‐dominant PD, encompassing dopaminergic and nondopaminergic as well as synuclein and nonsynuclein (Abeta) pathologies. This aligns with clinical studies that find a higher burden of nonmotor symptoms in non‐tremor‐dominant PD. The mounting evidence for the relevance of nonmotor features in PD subtypes behooves us to begin to investigate the biological underpinnings of subtypes defined by both motor and nonmotor features. This may be challenging, as PD subtypes are unlikely to be distinct nonoverlapping entities but are more likely to represent typical phenotypes within a multidimensional spectrum resulting from variable contributions of a number of simultaneous pathological processes. © 2016 International Parkinson and Movement Disorder Society
Topics

No keywords indexed for this article. Browse by subject →

References
68
[8]
Unified staging system for Lewy body disorders: correlation with nigrostriatal degeneration, cognitive impairment and motor dysfunction

Thomas G. Beach, Charles H. Adler, LihFen Lue et al.

Acta Neuropathologica 10.1007/s00401-009-0538-8
[9]
Staging of brain pathology related to sporadic Parkinson’s disease

Heiko Braak, Kelly Del Tredici, Udo Rüb et al.

Neurobiology of Aging 10.1016/s0197-4580(02)00065-9
[33]
Chaudhuri KR "A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non‐motor assessments: meeting an unmet need" PLoS One (2013)
[38]
Course in Parkinson disease subtypes

A. H. Rajput, A. Voll, M. L. Rajput et al.

Neurology 10.1212/wnl.0b013e3181ae7af1
[43]
Eggers C "Parkinson's disease subtypes show a specific link between dopaminergic and glucose metabolism in the striatum" PLoS One (2014)

Showing 50 of 68 references

Cited By
293
Similarities, differences and overlaps between frailty and Parkinson's disease

Junya Ebina, Satoru Ebihara · 2022

Geriatrics & Gerontology Intern...
The Logic and Pitfalls of Parkinson's Disease as “Brain‐First” Versus “Body‐First” Subtypes

Conor Fearon, Anthony E. Lang · 2021

Movement Disorders
In vivo modeling of prodromal stage of Parkinson’s disease

Silvia Cerri, Fabio Blandini · 2020

Journal of Neuroscience Methods
Brain-First versus Gut-First Parkinson’s Disease: A Hypothesis

Per Borghammer, Nathalie Van Den Berge · 2019

Journal of Parkinson’s Disease
Overall and Disease Related Mortality in Parkinson’s Disease – a Longitudinal Cohort Study

Jeroen Hoogland, Bart Post · 2019

Journal of Parkinson’s Disease
Comparison of clinical features among Parkinson's disease subtypes: A large retrospective study in a single center

Takuya Konno, Angela Deutschländer · 2018

Journal of the Neurological Science...
Metrics
293
Citations
68
References
Details
Published
Feb 10, 2016
Vol/Issue
31(8)
Pages
1095-1102
License
View
Authors
C
Connie Marras

Toronto Western Hospital Morton and Gloria Shulman Mov Disord Centre and the Edmond J. Safra Program in PD University of Toronto Toronto Ontario Canada

K
K. Ray Chaudhuri

National Parkinson Foundation Centre of Excellence Kings College Hospital and University Hospital Lewisham; and Kings College and Institute of Psychiatry London UK

Cite This Article
Connie Marras, K. Ray Chaudhuri (2016). Nonmotor features of Parkinson's disease subtypes. Movement Disorders, 31(8), 1095-1102. https://doi.org/10.1002/mds.26510
Related

You May Also Like

Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results

Christopher G. Goetz, Barbara C. Tilley · 2008

6,563 citations

MDS clinical diagnostic criteria for Parkinson's disease

Ronald B. Postuma, Daniela Berg · 2015

6,533 citations

Systematic review of levodopa dose equivalency reporting in Parkinson's disease

Claire L. Tomlinson, Rebecca Stowe · 2010

3,808 citations

Clinical diagnostic criteria for dementia associated with Parkinson's disease

Murat Emre, Dag Aarsland · 2007

2,609 citations

Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines

Irene Litvan, Jennifer G. Goldman · 2012

2,301 citations