Brendel Matthew, Su Chang, Hou Yu, Henchcliffe Claire, Wang Fei
Institute for Computational Biomedicine, Department of Physiology and Biophysics, Weill Cornell Medicine of Cornell University, New York, NY, 10065, USA.
Department of Health Service Administration and Policy, Temple University, Philadelphia, PA, 19122, USA.
NPJ Parkinsons Dis. 2021 Sep 17;7(1):83. doi: 10.1038/s41531-021-00228-0.
Parkinson's disease (PD) is a complex neurodegenerative disorder with diverse clinical manifestations. To better understand this disease, research has been done to categorize, or subtype, patients, using an array of criteria derived from clinical assessments and biospecimen analyses. In this study, using data from the BioFIND cohort, we aimed at identifying subtypes of moderate-to-advanced PD via comprehensively considering motor and non-motor manifestations. A total of 103 patients were included for analysis. Through the use of a patient-wise similarity matrix fusion technique and hierarchical agglomerative clustering analysis, three unique subtypes emerged from the clustering results. Subtype I, comprised of 60 patients (58.3%), was characterized by mild symptoms, both motor and non-motor. Subtype II, comprised of 20 (19.4%) patients, was characterized by an intermediate severity, with a high tremor score and mild non-motor symptoms. Subtype III, comprised of 23 (~22.3%) patients, was characterized by more severe motor and non-motor symptoms. These subtypes show statistically significant differences when looking at motor (on and off medication) clinical features and non-motor clinical features, while there was no clear difference in demographics, biomarker levels, and genetic risk scores.
帕金森病(PD)是一种具有多种临床表现的复杂神经退行性疾病。为了更好地理解这种疾病,人们开展了研究,使用一系列源自临床评估和生物样本分析的标准对患者进行分类或分型。在本研究中,我们利用BioFIND队列的数据,旨在通过全面考虑运动和非运动表现来识别中重度帕金森病的亚型。共有103名患者纳入分析。通过使用患者层面的相似性矩阵融合技术和层次凝聚聚类分析,聚类结果中出现了三种独特的亚型。I型包含60名患者(约58.3%),其特征是运动和非运动症状均较轻。II型包含20名患者(约19.4%),其特征是严重程度中等,震颤评分高且非运动症状较轻。III型包含23名患者(约22.3%),其特征是运动和非运动症状更严重。在观察运动(服药和未服药时)临床特征和非运动临床特征时,这些亚型显示出统计学上的显著差异,而在人口统计学、生物标志物水平和遗传风险评分方面没有明显差异。