Prashanth L Kukkle1,2, Vinay Goyal3,4, Thenral S Geetha5, Kandadai R Mridula6, Hrishikesh Kumar7, Rupam Borgohain6, Adreesh Mukherjee8, Pettarusp M Wadia9, Ravi Yadav10, Soaham Desai11, Niraj Kumar12, Ravi Gupta5, Atanu Biswas8, Pramod K Pal10, Uday Muthane2, Shymal K Das8, Niall Quinn13, Vedam L Ramprasad5. 1. Center for Parkinson's Disease and Movement Disorders, Department of Neurology, Vikram Hospital, Bangalore, Karnataka, India. 2. Parkinson and Ageing Research Foundation, Bangalore, Karnataka, India. 3. Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi, India. 4. Department of Neurology, Medanta Hospital, New Delhi, India. 5. MedGenome Labs Pvt Ltd, Bangalore, Karnataka, India. 6. Movement Disorders Clinic, Department of Neurology, Nizams Institute of Medical Sciences (NIMS), Hyderabad, Telangana, India. 7. Center for Movement Disorders, Institute of Neurosciences Kolkata, Kolkata, West Bengal, India. 8. Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education and Research (IPGME&R), Kolkata, West Bengal, India. 9. Department of Neurology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. 10. Movement Disorders Clinic, Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India. 11. Department of Neurology, Shree Krishna Hospital and Pramukhaswami Medical college, Karamsad, Gujarat, India. 12. Department of Neurology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. 13. Department of Neurology, UCL Queen Square Institute of Neurology, University College London, London, UK.
Abstract
OBJECTIVE: To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20-40 years), and early onset (EOPD, 40-50 years) Parkinson's disease (PD) in India. MATERIALS AND METHODS: We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included. RESULTS: A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years). CONCLUSION: This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.
OBJECTIVE: To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20-40 years), and early onset (EOPD, 40-50 years) Parkinson's disease (PD) in India. MATERIALS AND METHODS: We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included. RESULTS: A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years). CONCLUSION: This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.