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早期帕金森病的异质性:对未经治疗的新诊断患者的聚类分析。

The heterogeneity of early Parkinson's disease: a cluster analysis on newly diagnosed untreated patients.

机构信息

Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL), London, United Kingdom.

出版信息

PLoS One. 2013 Aug 1;8(8):e70244. doi: 10.1371/journal.pone.0070244. Print 2013.

Abstract

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.

摘要

背景

帕金森病的临床表型存在差异,这似乎表明该疾病存在几种亚型。为了验证这一假说,我们对一大群新诊断未治疗的 PD 患者进行了一项使用评估运动和非运动症状的聚类分析。

方法

我们收集了 100 名连续新诊断未治疗的门诊患者的人口统计学、运动和整个非运动症状的数据。统计聚类分析允许识别不同的亚组,随后对这些亚组进行了探索。

结果

数据驱动方法确定了四个不同的患者群体,我们分别标记为:1)良性单纯运动;2)良性混合运动-非运动;3)非运动主导;和 4)运动主导。

结论

我们的结果证实了早期 PD 患者存在不同的亚组。聚类分析显示了根据运动和非运动症状的相关性对不同类型患者进行分类的存在。识别这些亚型可能对产生发病机制假说和治疗策略具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dea0/3731357/2301887a52e2/pone.0070244.g001.jpg

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