Is Parkinson's disease of early onset a separate disease entity?

Ludin, Sabina; Ludin, H. P.

doi:10.1007/bf00314500

Cited by 27 publications

(13 citation statements)

References 21 publications

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“…Our results are in agreement with these studies, which consistently identified a cohort of PD patients with young onset of disease. [34][35][36] This subgroup demonstrates a slower rate of disease progression, 5 29 37 38 less cognitive impairment, 29 38 39 and a greater potential to develop motor fluctuations 4 17 (possibly as a consequence of the prolonged exposure to L-dopa) compared with subgroups with later disease onset, as also shown with our cluster analysis solution.…”

Section: Discussionsupporting

confidence: 72%

Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach

Lewis

Foltynie²,

Blackwell³

et al. 2005

Journal of Neurology, Neurosurgery & Psychiatry

502

426

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Objective: To investigate the heterogeneity of idiopathic Parkinson's disease (PD) in a data driven manner among a cohort of patients in the early clinical stages of the disease meeting established diagnostic criteria. Methods: Data on demographic, motor, mood, and cognitive measures were collected from 120 consecutive patients in the early stages of PD (Hoehn and Yahr I-III) attending a specialist PD research clinic. Statistical cluster analysis of the data allowed the existence of the patient subgroups generated to be explored. Results: The analysis revealed four main subgroups: (a) patients with a younger disease onset; (b) a tremor dominant subgroup of patients; (c) a non-tremor dominant subgroup with significant levels of cognitive impairment and mild depression; and (d) a subgroup with rapid disease progression but no cognitive impairment. Conclusions: This study complements and extends previous research by using a data driven approach to define the clinical heterogeneity of early PD. The approach adopted in this study for the identification of subgroups of patients within Parkinson's disease has important implications for generating testable hypotheses on defining the heterogeneity of this common condition and its aetiopathological basis and thus its treatment.

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Section: Discussionsupporting

confidence: 72%

Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach

Lewis

Foltynie²,

Blackwell³

et al. 2005

Journal of Neurology, Neurosurgery & Psychiatry

502

426

View full text Add to dashboard Cite

show abstract

“…Previous studies on the relevance of this factor have produced controversial results. Some found no differences in the prevalence of dyskinesias between patients with earlier or with older onset patients with Parkinson's disease [5,7,15], whereas others report that early-onset patients develop earlier and more frequently dyskinesias than those with late onset [6,8,10,14,22]. Differences may be explained in part by methodological factors related to sample's size or the confounding effect of other variables such as levodopa dose or duration of levodopa treatment.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for levodopa-induced dyskinesias in Parkinson's disease

Grandas

Galiano²,

Tabernero

1999

Journal of Neurology

131

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To identify putative risk factors for levodopa-induced dyskinesias we studied the effect of several clinical variables on the occurrence of dyskinesias in a series of 168 consecutive patients with Parkinson's disease treated for at least 6 months with levodopa. Of these, 108 (64%) developed dyskinesias after a mean duration of levodopa treatment of 51.4 +/- 43.3 months. Patients tended to suffer dyskinesias on the side of the body first affected by Parkinson's disease. The overall probability of developing dyskinesias increased with levodopa treatment duration, about 10% per year during the first 7 years. Univariate and multivariate logistic regression analysis identified the age at onset of Parkinson's disease (OR 0.923; 95% CI 0.883-0.964) and the initial levodopa dose (mean dose of the first 6 months of treatment; OR 1.004; 95% CI 1.002-1.006) as the main independent predictors. Survival curves showed that onset of Parkinson's disease at age 50 years or before (logrank, P < 0.05) and initial levodopa treatment with more than 600 mg/day (logrank, P < 0.05) were associated with a higher risk for the appearance of dyskinesias.

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“…However, most of these papers have included juvenile-onset PD. It is possible that cases of PD in patients under 40 years of age may reflect environmental and genetic factors in the disease etiology [3]. Although patients with PD are mostly of advanced age [4,5], few papers have described the clinical features of PD occurring in patients up to middle age.…”

Section: Introductionmentioning

confidence: 99%

Initial Symptoms of Parkinson’s Disease with Elderly Onset

et al. 2000

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Background/Objective: As the incidence of Parkinson’s disease (PD) is related to aging, we consider it important to determine how the initial symptoms change with age in order to diagnose early elderly cases of PD accurately. Methods: 84 patients (age at onset 70.7 ± 9.0 years; mean ± 1 SD) were studied to see whether the initial symptoms change according to age. Results: The prevalence of resting tremor was significantly lower in patients of advanced age (p = 0.041). In contrast, the incidence of postural and gait disorders increased significantly with aging (p = 0.032). The prevalences of rigidity and kinetic disorders, which are important clinical features of PD, were not influenced by aging. Conclusion: These findings suggest that the cause of PD is not related to the aging process itself, since the prevalences of all symptoms were not influenced by aging. Knowledge of the prevalence of the inital symptoms of PD may contribute to the accurate diagnosis in early and elderly cases.

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Is Parkinson's disease of early onset a separate disease entity?

Cited by 27 publications

References 21 publications

Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach

Heterogeneity of Parkinson's disease in the early clinical stages using a data driven approach

Risk factors for levodopa-induced dyskinesias in Parkinson's disease

Initial Symptoms of Parkinson’s Disease with Elderly Onset

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