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Journal of Zhejiang University SCIENCE B 2011 Vol.12 No.9 P.694-703

10.1631/jzus.B1100069


Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis


Author(s):  Ping Liu, Tao Feng, Yong-jun Wang, Xuan Zhang, Biao Chen

Affiliation(s):  Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China, Department of Neurology, Beijing Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Corresponding email(s):   happyft@sina.com

Key Words:  Parkinson’, s disease, Heterogeneity, Subtype, Cluster analysis


Ping Liu, Tao Feng, Yong-jun Wang, Xuan Zhang, Biao Chen. Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis[J]. Journal of Zhejiang University Science B, 2011, 12(2): 694-703.

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author="Ping Liu, Tao Feng, Yong-jun Wang, Xuan Zhang, Biao Chen",
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doi="10.1631/jzus.B1100069"
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%T Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis
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%A Tao Feng
%A Yong-jun Wang
%A Xuan Zhang
%A Biao Chen
%J Journal of Zhejiang University SCIENCE B
%V 12
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%P 694-703
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%D 2011
%I Zhejiang University Press & Springer

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T1 - Clinical heterogeneity in patients with early-stage Parkinson’s disease: a cluster analysis
A1 - Ping Liu
A1 - Tao Feng
A1 - Yong-jun Wang
A1 - Xuan Zhang
A1 - Biao Chen
J0 - Journal of Zhejiang University Science B
VL - 12
IS - 9
SP - 694
EP - 703
%@ 1673-1581
Y1 - 2011
PB - Zhejiang University Press & Springer
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Abstract: 
The aim of this study was to investigate the clinical heterogeneity of parkinson’;s disease (PD) among a cohort of Chinese patients in early stages. Clinical data on demographics, motor variables, motor phenotypes, disease progression, global cognitive function, depression, apathy, sleep quality, constipation, fatigue, and L-dopa complications were collected from 138 Chinese PD subjects in early stages (Hoehn and Yahr stages 1–3). The PD subject subtypes were classified using k-means cluster analysis according to the clinical data from five- to three-cluster consecutively. Kappa statistical analysis was performed to evaluate the consistency among different subtype solutions. The cluster analysis indicated four main subtypes: the non-tremor dominant subtype (NTD, n=28, 20.3%), rapid disease progression subtype (RDP, n=7, 5.1%), young-onset subtype (YO, n=50, 36.2%), and tremor dominant subtype (TD, n=53, 38.4%). Overall, 78.3% (108/138) of subjects were always classified between the same three groups (52 always in TD, 7 in RDP, and 49 in NTD), and 98.6% (136/138) between five- and four-cluster solutions. However, subjects classified as NTD in the four-cluster analysis were dispersed into different subtypes in the three-cluster analysis, with low concordance between four- and three-cluster solutions (kappa value=−0.139, P=0.001). This study defines clinical heterogeneity of PD patients in early stages using a data-driven approach. The subtypes generated by the four-cluster solution appear to exhibit ideal internal cohesion and external isolation.

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