Age at onset and Parkinson disease phenotype

Gennaro Pagano, Nicola Ferrara, David J. Brooks, Nicola Pavese

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Objective: To explore clinical phenotype and characteristics of Parkinson disease (PD) at different ages at onset in recently diagnosed patients with untreated PD. Methods: We have analyzed baseline data from the Parkinson's Progression Markers Initiative database. Four hundred twenty-two patients with a diagnosis of PD confirmed by DaTSCAN imaging were divided into 4 groups according to age at onset (onset younger than 50 years, 50-59 years, 60-69 years, and 70 years or older) and investigated for differences in side, type and localization of symptoms, occurrence/severity of motor and nonmotor features, nigrostriatal function, and CSF biomarkers. Results: Older age at onset was associated with a more severe motor and nonmotor phenotype, a greater dopaminergic dysfunction on DaTSCAN, and reduction of CSF α-synuclein and total tau. The most common presentation was the combination of 2 or 3 motor symptoms (bradykinesia, resting tremor, and rigidity) with rigidity being more common in the young-onset group. In about 80% of the patients with localized onset, the arm was the most affected part of the body, with no difference across subgroups. Conclusions: Although the presentation of PD symptoms is similar across age subgroups, the severity of motor and nonmotor features, the impairment of striatal binding, and the levels of CSF biomarkers increase with age at onset. The variability of imaging and nonimaging biomarkers in patients with PD at different ages could hamper the results of future clinical trials.

Original languageEnglish
Pages (from-to)1400-1407
Number of pages8
JournalNeurology
Volume86
Issue number15
DOIs
Publication statusPublished - Apr 12 2016

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Parkinson Disease
Age of Onset
Phenotype
Biomarkers
Synucleins
Corpus Striatum
Hypokinesia
Tremor
Human Body
Parkinson Disease 10
Clinical Trials
Databases

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Pagano, G., Ferrara, N., Brooks, D. J., & Pavese, N. (2016). Age at onset and Parkinson disease phenotype. Neurology, 86(15), 1400-1407. https://doi.org/10.1212/WNL.0000000000002461

Age at onset and Parkinson disease phenotype. / Pagano, Gennaro; Ferrara, Nicola; Brooks, David J.; Pavese, Nicola.

In: Neurology, Vol. 86, No. 15, 12.04.2016, p. 1400-1407.

Research output: Contribution to journalArticle

Pagano, G, Ferrara, N, Brooks, DJ & Pavese, N 2016, 'Age at onset and Parkinson disease phenotype', Neurology, vol. 86, no. 15, pp. 1400-1407. https://doi.org/10.1212/WNL.0000000000002461
Pagano G, Ferrara N, Brooks DJ, Pavese N. Age at onset and Parkinson disease phenotype. Neurology. 2016 Apr 12;86(15):1400-1407. https://doi.org/10.1212/WNL.0000000000002461
Pagano, Gennaro ; Ferrara, Nicola ; Brooks, David J. ; Pavese, Nicola. / Age at onset and Parkinson disease phenotype. In: Neurology. 2016 ; Vol. 86, No. 15. pp. 1400-1407.
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