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Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease
OBJECTIVE: Patients with Parkinson’s disease (PD) are commonly classified into subtypes based on motor symptoms. The aims of the present study were to determine the consistency between PD motor subtypes, to assess the stability of PD motor subtypes over time, and to explore the variables influencing...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957002/ https://www.ncbi.nlm.nih.gov/pubmed/33732106 http://dx.doi.org/10.3389/fnins.2021.637896 |
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author | Ren, Jingru Pan, Chenxi Li, Yuqian Li, Lanting Hua, Ping Xu, Ligang Zhang, Li Zhang, Wenbin Xu, Pingyi Liu, Weiguo |
author_facet | Ren, Jingru Pan, Chenxi Li, Yuqian Li, Lanting Hua, Ping Xu, Ligang Zhang, Li Zhang, Wenbin Xu, Pingyi Liu, Weiguo |
author_sort | Ren, Jingru |
collection | PubMed |
description | OBJECTIVE: Patients with Parkinson’s disease (PD) are commonly classified into subtypes based on motor symptoms. The aims of the present study were to determine the consistency between PD motor subtypes, to assess the stability of PD motor subtypes over time, and to explore the variables influencing PD motor subtype stability. METHODS: This study was part of a longitudinal study of de novo PD patients at a single center. Based on three different motor subtype classification systems proposed by Jankovic, Schiess, and Kang, patients were respectively categorized as tremor-dominant/indeterminate/postural instability and gait difficulty (TD/indeterminate/PIGD), TD(S)/mixed(S)/akinetic-rigid(S) (ARS), or TD(K)/mixed(K)/AR(K) at baseline evaluation and then re-assessed 1 month later. Demographic and clinical characteristics were recorded at each evaluation. The consistency between subtypes at baseline evaluation was assessed using Cohen’s kappa coefficient (κ). Additional variables were compared between PD subtype groups using the two-sample t-test, Mann–Whitney U-test or Chi-squared test. RESULTS: Of 283 newly diagnosed, untreated PD patients, 79 were followed up at 1 month. There was fair agreement between the Jankovic, Schiess, and Kang classification systems (κ(S) = 0.383 ± 0.044, κ(K) = 0.360 ± 0.042, κ(SK) = 0.368 ± 0.038). Among the three classification systems, the Schiess classification was the most stable and the Jankovic classification was the most unstable. The non-motor symptoms questionnaire (NMSQuest) scores differed significantly between PD patients with stable and unstable subtypes based on the Jankovic classification (p = 0.008), and patients with a consistent subtype had more severe NMSQuest scores than patients with an inconsistent subtype. CONCLUSION: Fair consistency was observed between the Jankovic, Schiess, and Kang classification systems. For the first time, non-motor symptoms (NMSs) scores were found to influence the stability of the TD/indeterminate/PIGD classification. Our findings support combining NMSs with motor symptoms to increase the effectiveness of PD subtypes. |
format | Online Article Text |
id | pubmed-7957002 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79570022021-03-16 Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease Ren, Jingru Pan, Chenxi Li, Yuqian Li, Lanting Hua, Ping Xu, Ligang Zhang, Li Zhang, Wenbin Xu, Pingyi Liu, Weiguo Front Neurosci Neuroscience OBJECTIVE: Patients with Parkinson’s disease (PD) are commonly classified into subtypes based on motor symptoms. The aims of the present study were to determine the consistency between PD motor subtypes, to assess the stability of PD motor subtypes over time, and to explore the variables influencing PD motor subtype stability. METHODS: This study was part of a longitudinal study of de novo PD patients at a single center. Based on three different motor subtype classification systems proposed by Jankovic, Schiess, and Kang, patients were respectively categorized as tremor-dominant/indeterminate/postural instability and gait difficulty (TD/indeterminate/PIGD), TD(S)/mixed(S)/akinetic-rigid(S) (ARS), or TD(K)/mixed(K)/AR(K) at baseline evaluation and then re-assessed 1 month later. Demographic and clinical characteristics were recorded at each evaluation. The consistency between subtypes at baseline evaluation was assessed using Cohen’s kappa coefficient (κ). Additional variables were compared between PD subtype groups using the two-sample t-test, Mann–Whitney U-test or Chi-squared test. RESULTS: Of 283 newly diagnosed, untreated PD patients, 79 were followed up at 1 month. There was fair agreement between the Jankovic, Schiess, and Kang classification systems (κ(S) = 0.383 ± 0.044, κ(K) = 0.360 ± 0.042, κ(SK) = 0.368 ± 0.038). Among the three classification systems, the Schiess classification was the most stable and the Jankovic classification was the most unstable. The non-motor symptoms questionnaire (NMSQuest) scores differed significantly between PD patients with stable and unstable subtypes based on the Jankovic classification (p = 0.008), and patients with a consistent subtype had more severe NMSQuest scores than patients with an inconsistent subtype. CONCLUSION: Fair consistency was observed between the Jankovic, Schiess, and Kang classification systems. For the first time, non-motor symptoms (NMSs) scores were found to influence the stability of the TD/indeterminate/PIGD classification. Our findings support combining NMSs with motor symptoms to increase the effectiveness of PD subtypes. Frontiers Media S.A. 2021-03-01 /pmc/articles/PMC7957002/ /pubmed/33732106 http://dx.doi.org/10.3389/fnins.2021.637896 Text en Copyright © 2021 Ren, Pan, Li, Li, Hua, Xu, Zhang, Zhang, Xu and Liu. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Ren, Jingru Pan, Chenxi Li, Yuqian Li, Lanting Hua, Ping Xu, Ligang Zhang, Li Zhang, Wenbin Xu, Pingyi Liu, Weiguo Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title | Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title_full | Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title_fullStr | Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title_full_unstemmed | Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title_short | Consistency and Stability of Motor Subtype Classifications in Patients With de novo Parkinson’s Disease |
title_sort | consistency and stability of motor subtype classifications in patients with de novo parkinson’s disease |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957002/ https://www.ncbi.nlm.nih.gov/pubmed/33732106 http://dx.doi.org/10.3389/fnins.2021.637896 |
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