Clinical Study of 668 Indian Subjects with Juvenile, Young, and Early Onset Parkinson’s Disease

Abstract

Objective: To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20–40 years), and early onset (EOPD, 40–50 years) Parkinson’s disease (PD) in India. Materials and Methods: We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included. Results: A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years). Conclusion: This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.

Genome‐Wide Polygenic Score Predicts Large Number of High Risk Individuals in Monogenic Undiagnosed Young Onset Parkinson's Disease Patients from India

“…[6,16] With the aim of initiating a population based genetic analysis of PD in South Asian populations, we established the YOPD cohort. [5] As part of our pilot phase genetic analysis, we performed whole genome sequencing on 90 patients with deep clinical data. We analyzed this data for novel variants and SNVs/ InDels in primary PD and associated gene sets.…”

“…[4] Genomic analysis of PD from diverse populations groups will help identify additional causal genomic alterations and risk modifiers leading to better disease management and therapeutic development. [5][6][7] The genetic architecture of PD has been determined from familial studies, [8,9] large-scale "sporadic" PD cases, [10][11][12] and characterization of young onset PD (young onset Parkinson's disease (YOPD)-AAO < 50 yrs). [13,14] Genome-wide association studies (GWAS) involving sporadic PD cases have identified 90 loci, each of which has a relatively small contribution to the disease development.…”

Obsessive-Compulsive Disorder and Risk of Parkinson Disease: A Nationwide Longitudinal Study

“…Stratified Cox regression analysis on each matched pair (the patient and their 10 matched controls in a 1:10 fashion) with adjustment for age, CCI score, mental comorbidities (major depressive disorder, autism spectrum disorder, tic disorder), and all-cause clinical visits was applied to investigate the PD risk between the OCD and the control groups. Given that PD with onset age of <50 years was classified as early-onset PD (19), subanalyses stratified by age group (<50 versus ≥50 years) and sex were further performed. Among patients with OCD, Cox regression analysis with adjustment of demographic data, medical comorbidities, mental comorbidities, CCI score, and all-cause clinical visits was examined for the OCD severity with subsequent PD risk.…”

Age Cutoff for Early‐Onset Parkinson's Disease: Recommendations from the International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinson's Disease

“…Czech Republic 40-45 [32][33][34] Finland 55 21 Germany 50 35 Greece 50 Hungary 50 36 Iceland 50 37 Ireland 50 38 Italy 40-50 22,39 Kazakhstan 50 40 Luxembourg 50 41 Netherlands 40-50 18 Norway 45 42 Poland 40 43 Portugal 50 44 Russia 40 45,46 Serbia 50 47 Slovakia 40 48,49 Spain 50 50 Sweden 50 51 United Kingdom 40-50 11 Americas Argentina 40 52 Brazil 20-45 53,54 Canada 40 55 Colombia 50 56 Ecuador 50 56 Mexico 45 57 United States 40-55 14,15,17,25 Asia-Pacific Middle East, North Africa, and South Asia: consensus from the MDS Task Force for the Middle East 50 58 Australia 50 59 China 40 60 (Continues) Guam 51 61 India 40-50 [62][63][64] New Zealand 60 65 South Korea 40-50 66 Vietnam 50 67 Japan 40-50 28 Africa Morocco 45 68 Nigeria 50…”