Data-Driven Subtypes of Parkinson Disease Based on Dopamine Responsiveness

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-04-24 DOI:10.1111/cns.70408

Jian-Yong Wang, Guo-Ling Zeng, Rong-Ting Tang, Hai-Tao Luo, Yu-Lian Song, Yang-Yang Zhou, Jie-Fan Huang, Shi-Guo Zhu, Dao-Lu Zhang, Dan-Ni Liu, Rong-Pei Liu, Shi-Shi Huang, Cheng-Xiang Yuan, Jian-Hong Zhu, Xiong Zhang

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Abstract

Aims

Parkinson disease (PD) is highly heterogeneous in response to antiparkinsonian drugs. We herein aimed to identify PD subtypes based on dopamine responsiveness in three key motor signs (resting tremor, rigidity, and bradykinesia).

Methods

The acute levodopa challenge test was performed. Improvement rates in resting tremor, rigidity, and bradykinesia were calculated. A total of 228 PD patients were included for further analysis. Subtypes were determined by k-means clustering based on the improvement rates.

Results

Four subtypes were identified: rt-r-b, moderate improvement in resting tremor, rigidity, and bradykinesia; RT-r-b, marked improvement in resting tremor but moderate improvement in rigidity and bradykinesia; RT-R-B, marked improvement in resting tremor, rigidity, and bradykinesia; rt-R-B, moderate improvement in resting tremor but marked improvement in rigidity and bradykinesia. These subtypes also differed in other motor and nonmotor symptoms.

Conclusion

Our study reveals four distinct subtypes in PD patients based on dopamine responsiveness. Our findings provide a novel insight into understanding PD heterogeneity and facilitate precision treatment.

Abstract Image

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基于多巴胺反应的帕金森病数据驱动亚型

目的帕金森病（PD）对抗帕金森药物的反应具有高度异质性。在此，我们旨在根据多巴胺对三种主要运动症状（静止性震颤、僵直和运动迟缓）的反应来确定帕金森病亚型。方法进行急性左旋多巴挑战试验。计算静止性震颤、僵直和运动迟缓的改善率。共纳入 228 名帕金森病患者进行进一步分析。根据改善率，通过 K-均值聚类确定了亚型。结果确定了四种亚型：RT-R-B，静止性震颤、僵直和运动迟缓中度改善；RT-R-B，静止性震颤明显改善，但僵直和运动迟缓中度改善；RT-R-B，静止性震颤、僵直和运动迟缓明显改善；RT-R-B，静止性震颤中度改善，但僵直和运动迟缓明显改善。这些亚型在其他运动和非运动症状方面也存在差异。结论我们的研究揭示了基于多巴胺反应性的四种截然不同的帕金森病亚型。我们的研究结果为了解帕金森病的异质性提供了新的视角，有助于进行精准治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.