Parkinson Disease Clinical Subtypes: Validation, Clinical Utility, and Biological Correlates

摘要 帕金森病(PD)是一种进行性神经退行性疾病，其特征是运动、认知和 由蛋白质异常沉积和神经递质缺陷引起的精神症状。这个 临床表现和进展的变异性可能反映了不同的PD亚型，这可能与 大脑病理中的潜在变异性。尽管目前的治疗方法在运动方面提供了巨大的好处 帕金森病，它们未能缓解步态损害和非运动症状的某些方面，并可能加剧 认知和精神特征。开发更个性化的干预措施来治疗、预防或预防这些 特征，更多关于PD亚型的信息对于患者选择和分层、预测 新疗法的进展和评价。因此，我们建议检查临床和预后。 通过纵向行为学评估PD亚型的实用性及其稳定性；确定生物学上的 来自多模式神经成像、脑脊液和脑尸检数据的帕金森病亚型的标记；并翻译帕金森病 临床环境下的亚型。

ABSTRACT Parkinson disease (PD) is a progressive neurodegenerative disease characterized by motor, cognitive, and psychiatric manifestations resulting from abnormal protein deposition and neurotransmitter deficits. The variability in clinical presentation and progression likely reflects different PD subtypes, which may be associated with the underlying variability in brain pathology. Although current treatments provide dramatic motor benefit in PD, they fail to alleviate some aspects of gait impairment and non-motor symptoms and may exacerbate cognitive and psychiatric features. To develop more personalized interventions to treat, forestall or prevent these features, more information regarding PD subtypes is necessary for patient selection and stratification, predicting progression, and evaluation of novel treatments. Therefore, we propose to examine the clinical and prognostic utility of PD subtypes and their stability through longitudinal behavioral assessments; determine the biological markers of PD subtypes from multimodal neuroimaging, CSF, and brain autopsy data; and translate the PD subtypes to a clinical setting.