Wang Jian-Yong, Zeng Guo-Ling, Tang Rong-Ting, Luo Hai-Tao, Song Yu-Lian, Zhou Yang-Yang, Huang Jie-Fan, Zhu Shi-Guo, Zhang Dao-Lu, Liu Dan-Ni, Liu Rong-Pei, Huang Shi-Shi, Yuan Cheng-Xiang, Zhu Jian-Hong, Zhang Xiong
Department of Neurology and Institute of Geriatric Neurology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Institute of Nutrition and Diseases and Center for Research, School of Public Health, Wenzhou Medical University, Wenzhou, Zhejiang, China.
CNS Neurosci Ther. 2025 Apr;31(4):e70408. doi: 10.1111/cns.70408.
Parkinson disease (PD) is highly heterogeneous in response to antiparkinsonian drugs. We herein aimed to identify PD subtypes based on dopamine responsiveness in three key motor signs (resting tremor, rigidity, and bradykinesia).
The acute levodopa challenge test was performed. Improvement rates in resting tremor, rigidity, and bradykinesia were calculated. A total of 228 PD patients were included for further analysis. Subtypes were determined by k-means clustering based on the improvement rates.
Four subtypes were identified: rt-r-b, moderate improvement in resting tremor, rigidity, and bradykinesia; RT-r-b, marked improvement in resting tremor but moderate improvement in rigidity and bradykinesia; RT-R-B, marked improvement in resting tremor, rigidity, and bradykinesia; rt-R-B, moderate improvement in resting tremor but marked improvement in rigidity and bradykinesia. These subtypes also differed in other motor and nonmotor symptoms.
Our study reveals four distinct subtypes in PD patients based on dopamine responsiveness. Our findings provide a novel insight into understanding PD heterogeneity and facilitate precision treatment.
帕金森病（PD）在对抗帕金森病药物的反应方面具有高度异质性。我们在此旨在基于三种关键运动症状（静止性震颤、肌强直和运动迟缓）中的多巴胺反应性来识别PD亚型。
进行急性左旋多巴激发试验。计算静止性震颤、肌强直和运动迟缓的改善率。共纳入228例PD患者进行进一步分析。根据改善率通过k均值聚类确定亚型。
识别出四种亚型：rt-r-b，静止性震颤、肌强直和运动迟缓均有中度改善；RT-r-b，静止性震颤有显著改善但肌强直和运动迟缓有中度改善；RT-R-B，静止性震颤、肌强直和运动迟缓均有显著改善；rt-R-B，静止性震颤有中度改善但肌强直和运动迟缓有显著改善。这些亚型在其他运动和非运动症状方面也存在差异。
我们的研究基于多巴胺反应性揭示了PD患者的四种不同亚型。我们的发现为理解PD异质性提供了新的见解，并有助于精准治疗。
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