The Pathophysiological Correlates of Parkinson’s Disease Clinical Subtypes

Daniele Belvisi, A. Fabbrini, M.I. De Bartolo, M. Costanzo, N. Manzo, G. Fabbrini, G. Defazio, A. Conte and A. Berardelli

Selezionato dal Lettore: Assunta Trinchillo Policlinico di Napoli - Università Federico II

Motivation: 

Originality of the work: Researchers propose a new method of obtaining Parkinson desease’s early diagnosis and of predict the most likely prognosis.

Methodology: In this study researchers perform a hierarchical cluster analysis. The use TMS to test neurophysiological assessment, motor cortex excitability and plasticity. To evaluate motor performance, they perform a kinematic analysis of fast index finger abduction. To investigate sensory function and sensorimotor mechanisms, they measure thesomatosensory temporal discrimination threshold at restand during movement, respectively

Data presentation: they compare results using Multivariate Logistic Regression Analysis. They introduce a new way to divide Parkinson’s phenotypes, basing on their results, that is Cluster I (“mild motor-predominant”), which includes patients who had milder motor and nonmotor symptoms severity and than cluster II (“diffuse malignant”), which includes patients, who had a combination of severe motor and nonmotor manifestations. So this differentiation has not only a clinical basement but also a neurophisyological one. 

Relevance clinical/scientific: this is a study in which authors presented a new diagnostic prospective. They demonstrate how is important to make a difference between this two kind of Parkinson’s manifestations because of their clinical and pathophysiological mechanisms. Neurophysiological parameters may represent promising biomarkers to evaluate PD subtypes and their progression in order to treat differently and early cluster II patients to ameliorate their QoL.