Jingru Ren1, Chenxi Pan1, Yuqian Li1, Lanting Li1, Ping Hua1, Ligang Xu1, Li Zhang2, Wenbin Zhang3, Pingyi Xu4, Weiguo Liu1. 1. Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China. 2. Department of Geriatrics, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China. 3. Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China. 4. Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Abstract
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.
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.
Authors: Stephanie M van Rooden; Willem J Heiser; Joost N Kok; Dagmar Verbaan; Jacobus J van Hilten; Johan Marinus Journal: Mov Disord Date: 2010-06-15 Impact factor: 10.338
Authors: J Jankovic; M McDermott; J Carter; S Gauthier; C Goetz; L Golbe; S Huber; W Koller; C Olanow; I Shoulson Journal: Neurology Date: 1990-10 Impact factor: 9.910
Authors: Kallol Ray Chaudhuri; Pablo Martinez-Martin; Anthony H V Schapira; Fabrizio Stocchi; Kapil Sethi; Per Odin; Richard G Brown; William Koller; Paolo Barone; Graeme MacPhee; Linda Kelly; Martin Rabey; Doug MacMahon; Sue Thomas; William Ondo; David Rye; Alison Forbes; Susanne Tluk; Vandana Dhawan; Annette Bowron; Adrian J Williams; Charles W Olanow Journal: Mov Disord Date: 2006-07 Impact factor: 10.338
Authors: R Erro; M Picillo; M Amboni; R Savastano; S Scannapieco; S Cuoco; G Santangelo; C Vitale; M T Pellecchia; P Barone Journal: Eur J Neurol Date: 2019-05-17 Impact factor: 6.089