Introduction

One of the latest subtyping systems of Parkinson disease (PD) identifies motor severity, cognitive dysfunction, dysautonomia, and rapid eye movement behavior disorder as key features for phenotyping patients into three different subtypes (i.e., mild motor-predominant, diffuse-malignant and intermediate). Since PD subtypes are clinically most relevant if they are mutually exclusive and consistent over-time, we explored the impact of disease stage and duration on these novel subtypes.

Methods

One-hundred-twenty-two consecutive patients, with a disease duration ranging from 0 to 20 years, were allocated as suggested into these three subtypes. The relationship between either disease duration or stage, as measured by the Hoehn and Yahr staging, and subtype allocation was explored.

Results

Significant differences in subtype distribution were observed across patients stratified according to either disease duration or staging, with the diffuse-malignant subtypes increasing in prevalence as the disease advanced. Both disease duration and staging were independent predictors of subtype allocation.

Conclusions

These novel PD subtypes are significantly influenced by disease duration and staging, which might suggest that they do not represent mutually exclusive disease pathways. This should be taken into account when attempting correlations with putative biomarkers of disease progression.

中文翻译：

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疾病持续时间和严重程度对帕金森病新型临床亚型的作用。

介绍

帕金森病（PD）的最新分型系统之一将运动严重性，认知功能障碍，自主神经功能障碍和快速眼球运动行为障碍确定为将患者分为三种不同亚型（即轻度运动为主，弥漫性恶性和中度）的关键特征）。由于PD亚型在临床上相互排斥且随着时间的推移而保持一致，因此在临床上最相关。因此，我们探讨了疾病分期和病程对这些新型亚型的影响。

方法

根据建议，将132例疾病持续时间为0至20年的连续患者分配到这三种亚型中。探索了通过Hoehn和Yahr分期测量的疾病持续时间或阶段与亚型分配之间的关系。

结果

在根据疾病持续时间或分期进行分层的患者中，观察到亚型分布的显着差异，随着疾病的进展，弥漫性-恶性亚型的患病率增加。疾病持续时间和分期都是亚型分配的独立预测因子。

结论

这些新的PD亚型受疾病持续时间和分期的影响很大，这可能表明它们并不代表相互排斥的疾病途径。在尝试与疾病进展的假定生物标志物建立关联时应考虑到这一点。