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Multicenter Study
. 2015;5(4):947-59.
doi: 10.3233/JPD-150662.

Tracking Parkinson's: Study Design and Baseline Patient Data

Naveed Malek  1 , Diane M A Swallow  1 , Katherine A Grosset  1 , Michael A Lawton  2 , Sarah L Marrinan  3 , Alexander C Lehn  3 , Catherine Bresner  4 , Nin Bajaj  5 , Roger A Barker  6 , Yoav Ben-Shlomo  2 , David J Burn  3 , Thomas Foltynie  7 , John Hardy  8 , Huw R Morris  9 , Nigel M Williams  4 , Nicholas Wood  10 , Donald G Grosset  1 ; PRoBaND
Collaborators, Affiliations
Free PMC article
Multicenter Study

Tracking Parkinson's: Study Design and Baseline Patient Data

Naveed Malek et al. J Parkinsons Dis. 2015.
Free PMC article

Abstract

Background: There is wide variation in the phenotypic expression of Parkinson's disease (PD), which is driven by both genetic and epidemiological influences.

Objectives: To define and explain variation in the clinical phenotype of PD, in relation to genotypic variation.

Methods: Tracking Parkinson's is a multicentre prospective longitudinal epidemiologic and biomarker study of PD. Patients attending specialist clinics in the United Kingdom with recent onset (<3.5 years) and young onset (diagnosed <50 years of age) PD were enrolled. Motor, non-motor and quality of life assessments were performed using validated scales. Cases are followed up 6 monthly up to 4.5 years for recent onset PD, and up to 1 year for young onset PD. We present here baseline clinical data from this large and demographically representative cohort.

Results: 2247 PD cases were recruited (1987 recent onset, 260 young onset). Recent onset cases had a mean (standard deviation, SD) age of 67.6 years (9.3) at study entry, 65.7% males, with disease duration 1.3 years (0.9), MDS-UPDRS 3 scores 22.9 (12.3), LEDD 295 mg/day (211) and PDQ-8 score 5.9 (4.8). Young onset cases were 53.5 years old (7.8) at study entry, 66.9% male, with disease duration 10.2 years (6.7), MDS-UPDRS 3 scores 27.4 (15.3), LEDD 926 mg/day (567) and PDQ-8 score 11.6 (6.1).

Conclusions: We have established a large clinical PD cohort, consisting of young onset and recent onset cases, which is designed to evaluate variation in clinical expression, in relation to genetic influences, and which offers a platform for future imaging and biomarker research.

Keywords: Parkinson’s disease; genotype; heterogeneity; phenotype.

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Figures

Fig.1
Fig.1
Assessments and timeline for recent onset patients. Visits occur every 6 months, with repeated observations and blood sampling every 18 months.
Fig.2
Fig.2
Clinical impression of severity index scores in 2247 PD patients. Recent onset cases had a significantly shorter disease duration than young onset cases, explaining their milder motor features and disability, while the cognitive pattern was more equal, given the greater risk of cognitive impairment with age.
Fig.3
Fig.3
Antiparkinson medication at baseline in 2247 PD patients. Most patients were already on antiparkinson medication at recruitment. Young onset cases had a longer disease duration than recent onset cases, which will affect usage rates and the proportions on more than one drug class. MAOB-I = monoamine oxidase B inhibitor; COMT-I = catechol-O-methyl transferase inhibitor.
See this image and copyright information in PMC

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