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. 2013 Aug 1;8(8):e70244.
doi: 10.1371/journal.pone.0070244. Print 2013.

The heterogeneity of early Parkinson's disease: a cluster analysis on newly diagnosed untreated patients

Roberto Erro  1 , Carmine Vitale, Marianna Amboni, Marina Picillo, Marcello Moccia, Katia Longo, Gabriella Santangelo, Anna De Rosa, Roberto Allocca, Flavio Giordano, Giuseppe Orefice, Giuseppe De Michele, Lucio Santoro, Maria Teresa Pellecchia, Paolo Barone
Affiliations

The heterogeneity of early Parkinson's disease: a cluster analysis on newly diagnosed untreated patients

Roberto Erro et al. PLoS One. .

Abstract

Background: The variability in the clinical phenotype of Parkinson's disease seems to suggest the existence of several subtypes of the disease. To test this hypothesis we performed a cluster analysis using data assessing both motor and non-motor symptoms in a large cohort of newly diagnosed untreated PD patients.

Methods: We collected data on demographic, motor, and the whole complex of non-motor symptoms from 100 consecutive newly diagnosed untreated outpatients. Statistical cluster analysis allowed the identification of different subgroups, which have been subsequently explored.

Results: The data driven approach identified four distinct groups of patients, we have labeled: 1) Benign Pure Motor; 2) Benign mixed Motor-Non-Motor; 3) Non-Motor Dominant; and 4) Motor Dominant.

Conclusion: Our results confirmed the existence of different subgroups of early PD patients. Cluster analysis revealed the presence of distinct subtypes of patients profiled according to the relevance of both motor and non-motor symptoms. Identification of such subtypes may have important implications for generating pathogenetic hypotheses and therapeutic strategies.

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Conflict of interest statement

Competing Interests: Dr. Carmine Vitale has received honoraria for symposia from Boehringer Ingelheim, Lundbeck, Novartis, Schwarz Pharma/UCB, GSK. Dr. Gabriella Santangelo has received honoraria for symposia from Lundbeck. Prof Paolo Barone has received honoraria as a Consultant & Advisory Board Memberships for Novartis, Schwarz Pharma/UCB, Merck-Serono, Eisai, Solvay, General Electric and Lundbeck. He has received research support from Boehringer Ingelheim, Novartis, Schwarz Pharma/UCB, Merck-Serono, Solvay, and Lundbeck. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Summary of main features of the clusters according to clinical involvement, severity and age at onset.
See this image and copyright information in PMC

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