Course in Parkinson disease subtypes: A 39-year clinicopathologic study
| Autor: | Christopher A. Robinson, A. H. Rajput, A. Voll, Michele L. Rajput |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Pathology Time Factors Autopsy Comorbidity Gastroenterology Cohort Studies Central nervous system disease Degenerative disease Internal medicine Tremor medicine Humans Dementia Longitudinal Studies Age of Onset Aged Aged 80 and over Brain Chemistry Lewy body business.industry Brain Parkinson Disease Middle Aged medicine.disease Muscle Rigidity Akinetic Mutism Disease Progression Female Neurology (clinical) Age of onset business Follow-Up Studies Cohort study |
| Zdroj: | Neurology. 73:206-212 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0b013e3181ae7af1 |
| Popis: | Background: Individual variations in the course of Lewy body Parkinson disease (PD) are well known. Patients have been classified into different clinical subtypes to identify differences in the course among the subgroups. Several studies indicate that the outcome is more favorable in tremor dominant (TD) cases but others report no difference. A majority of progression studies are based on cross-sectional single point data or short-term clinical observations. The lack of longitudinally followed autopsy-confirmed PD cohort remains a major weakness in the literature. Biochemical studies of brain indicate most pronounced abnormalities in akinetic/rigid (AR) and the least in TD cases. We postulate that PD course in these subtypes is concordant with the biochemical findings. Objective: To compare the course in TD, mixed (MX), and AR subtypes of PD. Methods: Longitudinal clinical follow-up and autopsy studies were performed on 166 patients with PD over 39 years (1968–2006). Patients were classified into TD, AR, and MX based on the entire clinical course. Only the pathologically confirmed PD cases were included. Results: Sixty-six percent of cases had MX, 26% AR, and 8% TD profile. The age at onset was younger ( p p = 0.016) in the TD cases. Dementia was most common in AR ( p = 0.039) and the least common in TD. In general, the course was most favorable in TD, followed by MX and AR subgroups. Conclusion: The three subtypes of Parkinson disease have different courses which are concordant with the differences in brain biochemical abnormalities. |
| Databáze: | OpenAIRE |
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