PD Subtypes

Though PD exhibits great variability in clinical presentation, patterns have been observed and there is growing interest in a reassessment of how PD is defined. Some proposals for this reassessment include classifying PD as a syndrome of multiple ‘parkinsonism types' (Weiner, 2008) and giving greater weight to the whole host of motor and non-motor' features that may precede or follow the cardinal motor symptoms of PD (Langston, 2006).

Examples of subtypes include 'tremor dominant' (TD-PD) vs. 'postural instability gait disorder' (PIGD-PD), a distinction that has long been recognized in the clinic and has more recently become a focus of study.  In addition, certain genetic forms of PD present with characteristic patterns of symptoms (Pchelina et al., 2008; Klein et. al., 2000).

Reference: 
Langston WJ. The Parkinson's complex: parkinsonism is just the tip of the iceberg. Ann Neurol. 2006;59(4):591-6.
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Weiner WJ. There is no Parkinson disease. Arch Neurol. 2008;65(6):705-8.
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Pchelina SN, Yakimovskii AF, Emelyanov AK, Ivanova ON, Schwarzman AL, Singleton AB. Screening for LRRK2 mutations in patients with Parkinson's disease in Russia: identification of a novel LRRK2 variant. Eur J Neurol. 2008;15(7):692-6.
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Klein C, Pramstaller PP, Kis B, Page CC, Kann M, Leung J, et al. Parkin deletions in a family with adult-onset, tremor-dominant parkinsonism: expanding the phenotype. Ann Neurol. 2000;48(1):65-71.
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Contributions:
gene-drug interaction may define subtypes
MJFF Asks: What should the next funding program on PD Subtypes look like?
Haydeh Payami, Wadsworth
23 Dec 2009
I think the answer is yes, and here is evidence. Part of this work was presented at the XVIII WFN World Congress on Parkinson's Disease and Related Disorders. ABSTRACT ... 
How do we define PD?
World Congress on PD & Related Disorders
Anthony E Lang, UofT
23 Dec 2009
Dr. Anthony Lang has posted his slides from his introductory presentation on "How Do We Define PD?" at the 2009 WFN World Congress:  ... 
PD subtypes as orphan diseases?
MJFF Asks: What should the next funding program on PD Subtypes look like?
alfred stracher, SUNY Downstate
24 Nov 2009
The delineation of PD into subtypes may have some commercial and/or grant funding advantages since the subtypes may be classified as "orphan diseases" which place them in  a different funding ... 
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Research Questions:
MJFF Asks: What should the next funding program on PD Subtypes look like?
23 Dec 2009
What are the next practical steps for identifying Parkinson’s disease subtypes that can be useful in guiding treatment and therapeutic development?  ... 
Responses: 8
What are the potential PD subtypes, and how do they differ clinically and/or genetically?
15 Jul 2009
There is some evidence that different forms of Parkinson's disease exist and that the severity of disease course may be linked to these possible subtypes. To date, there is little understanding of ... 
Responses: 7
News:
PET imaging found to distinguish between parkinsonian disorders
Another report this week from David Eidelberg and colleagues demonstrates imaging-based classification was predictive of idiopathic Parkinson's disease, multiple system atrophy and progressive ... 
12 Jan 2010
MJFF Needs Your Help: What should the next funding program on PD Subtypes look like?
The Michael J. Fox Foundation is reaching out to the entire scientific community by posting a Request for Information right here on PD Online. PD Subtypes is a 'Priority Area' for MJFF. The outcomes ... 
24 Aug 2009