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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...

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Autores principales: Ren, Jingru, Pan, Chenxi, Li, Yuqian, Li, Lanting, Hua, Ping, Xu, Ligang, Zhang, Li, Zhang, Wenbin, Xu, Pingyi, Liu, Weiguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
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.
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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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