ArticleMovement disorders : official journal of the Movement Disorder Society2025
Distinct Longitudinal Clinical-Neuroanatomical Trajectories in Parkinson's Disease Clinical Subtypes: Insight toward Precision Medicine.
Article in Movement disorders : official journal of the Movement Disorder Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Impulse Control Disorders Are Independent of Parkinson Disease Motor Subtypes.medRxiv : the preprint server for health sciences · 2026Article
- Brain-first and body-first subtypes of Lewy body disease.Nature reviews. Neurology · 2026Review
- Clustering Algorithm Reveals Dopamine-Motor Mismatch in Cognitively Preserved Parkinson's Disease.Annals of clinical and translational neurology · 2026Article
- Clinical and Imaging Characteristics of Parkinson's Disease with Negative Alpha-Synuclein Seed Amplification Assay.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Neuroimaging and Pathology Biomarkers in Parkinson's Disease and Parkinsonism.Brain sciences · 2026Article
- Parkinson's disease beyond motor symptoms: a review of the validity and limitations of current classification of non-motor symptoms.Frontiers in psychiatry · 2026Review
- Longitudinal brain morphometry in Parkinson's disease clinical subtypes: Distinct signatures forecast behavioral change within subtypes.Parkinsonism & related disorders · 2026Article
- Quantifying brain atrophy in Frontotemporal Dementia: a head-to-head comparison of neuroimaging techniques.medRxiv : the preprint server for health sciences · 2025Article
- Screening for a "trifecta" of executive function patterns in a large cohort of individuals with Parkinson's disease.Journal of the International Neuropsychological Society : JINS · 2025Article
- Apathy progression is associated with brain atrophy and white matter damage in Parkinson's disease.Brain communications · 2025Article
- Precision neurodiversity: personalized brain network architecture as a window into cognitive variability.Frontiers in human neuroscience · 2025Review
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8 authors.
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Abstract
backgroundParkinson's disease (PD) varies widely across individuals in clinical manifestations and course of progression. Identification of distinct biological subtypes could explain this heterogeneity, identify its pathophysiology, and predict disease progression.
objectivesOur aim was to compare longitudinal clinical trajectories and brain atrophy patterns between clinical subtypes defined at the baseline de novo PD.
methodsWe analyzed data from 421 PD patients (mean follow-up: 8.2 years) in the Parkinson's Progression Markers Initiative (PPMI). Using multi-domain motor and non-motor criteria, de novo patients were classified into "mild motor-predominant" (n = 223), "intermediate" (n = 146), and "diffuse-malignant" (n = 52) subtypes. Deformation-based morphometry was performed on T1-weighted magnetic resonance imaging (MRIs) from 128 PD patients with at least two MRIs (71 mild motor-predominant, 42 intermediate, and 15 diffuse-malignant) and 60 controls, with an average MRI follow-up duration of 3.4 ± 1.1 in the PD cohort. Mixed-effects models compared clinical progression and longitudinal pattern of regional atrophy across subtypes.
resultsThe diffuse-malignant subtype exhibited faster worsening of motor severity (P = 0.007), cognition (P < 0.0001), and activities of daily living (P < 0.0001) compared to mild motor-predominant subtype over 8 years. These findings remained statistically significant after an age-matched subgroup analysis and adjustment for the levodopa treatment. Accelerated atrophy was observed in the precuneus, temporal and fusiform gyri, cerebellum, and other regions (corrected-P < 0.05).
conclusionsLongitudinal analysis revealed distinct patterns of clinical progression and regional atrophy in PD subtypes, with the diffuse-malignant subtype showing more severe neurodegeneration and clinical deterioration suggesting existence of diverse pathophysiological mechanisms in PD. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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