ArticleNPJ Parkinson's disease2026
Comparative analysis of progression milestones across Parkinson's disease clinical, pathological, and data-driven subtypes: a 10-year follow-up.
Article in NPJ Parkinson's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Brain functional mechanisms of acupuncture treatment for early-stage non-tremor Parkinson's disease: a resting-state fMRI study.Frontiers in neurology · 2026Observational
- Machine learning models for the prediction of levodopa response to tremor in Parkinson's disease.Frontiers in aging neuroscience · 2025Article
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4 authors.
Funding
Abstract
Parkinson's disease (PD) heterogeneity complicates disease-modification clinical trial design and lead to ambiguous results, necessitating robust subtyping frameworks to identify rapid progressors. This study compared progression milestones across previously defined clinical (tremor-dominant [TD], postural instability/gait difficulty [PIGD], indeterminate), pathological (brain-first, body-first), and data-driven (diffuse malignant [DM], intermediate [IM], mild motor-predominant [MMP]) PD subtypes. Using data from the Parkinson's Progression Markers Initiative (PPMI), we analyzed milestone attainment across six functional domains and performed Cox proportional hazards regression. Randomized controlled trial sample size simulations evaluated the impact of subtyping on trial efficiency. Data-driven subtypes exhibited the highest progression rates, with DM patients attaining 63.0% of milestones, surpassing PIGD (55.6%) and body-first (54.0%) subtypes. Cox proportional hazards regression confirmed that DM patients had the highest hazard of progression compared to MMP, after adjusting for age at enrollment. Trial power simulations demonstrated that enrolling DM patients could reduce sample size requirements by approximately 50% using standard trial durations compared to unstratified PD cohorts. This analysis showed that data-driven subtyping, particularly the identification of the DM subtype, offers a promising strategy to optimize disease-modification trials in PD by capturing patients who meet progression milestones earlier.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.