Disease progression in proposed brain-first and body-first Parkinson’s disease subtypes

• Published in: NPJ Parkinson's Disease Vol. 10; no. 1; p. 111
• Main Authors: Xu, Zhiheng, Hu, Tianyu, Xu, Chenqin, Liang, Xiaoniu, Li, Shiyu, Sun, Yimin, Liu, Fengtao, Wang, Jian, Tang, Yilin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group 04.06.2024; Nature Publishing Group UK; Nature Portfolio
• Subjects: Hypotheses; Longitudinal studies; Nervous system; Neurosciences; Parkinson's disease; Pathology; Questionnaires
• ISSN: 2373-8057; 2373-8057
• DOI: 10.1038/s41531-024-00730-1

A new Parkinson’s disease (PD) subtyping model has been recently proposed based on the initial location of α-synuclein inclusions, which divides PD patients into the brain-first subtype and the body-first subtype. Premotor RBD has proven to be a predictive marker of the body-first subtype. We found compared to PD patients without possible RBD (PDpRBD–, representing the brain-first subtype), PD patients with possible premotor RBD (PDpRBD+, representing the body-first subtype) had lower Movement Disorders Society Unified Parkinson’s Disease Rating Scale part III (MDS UPDRS-III) score (p = 0.022) at baseline but presented a faster progression rate (p = 0.009) in MDS UPDRS-III score longitudinally. The above finding indicates the body-first subtype exhibited a faster disease progression in motor impairments compared to the brain-first subtype and further validates the proposed subtyping model.