The emerging postural instability phenotype in idiopathic Parkinson disease

Identification of individuals at high risk for rapid progression of motor and cognitive signs in Parkinson disease (PD) is clinically significant. Postural instability and gait dysfunction (PIGD) are associated with greater motor and cognitive deterioration. We examined the relationship between base...

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Bibliographic Details
Published in:NPJ Parkinson's Disease 2022-03, Vol.8 (1), p.28-28, Article 28
Main Authors: Skidmore, Frank M., Monroe, William S., Hurt, Christopher P., Nicholas, Anthony P., Gerstenecker, Adam, Anthony, Thomas, Jololian, Leon, Cutter, Gary, Bashir, Adil, Denny, Thomas, Standaert, David, Disbrow, Elizabeth A.
Format: Article
Language:English
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692/617/375/1718
692/617/375/346/1718
Balance
Biomedical and Life Sciences
Biomedicine
Computer engineering
Dementia
Dopamine
Gait
Genotype & phenotype
Neurology
Neurosciences
Parkinson's disease
Posture
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Summary:Identification of individuals at high risk for rapid progression of motor and cognitive signs in Parkinson disease (PD) is clinically significant. Postural instability and gait dysfunction (PIGD) are associated with greater motor and cognitive deterioration. We examined the relationship between baseline clinical factors and the development of postural instability using 5-year longitudinal de-novo idiopathic data ( n  = 301) from the Parkinson’s Progressive Markers Initiative (PPMI). Logistic regression analysis revealed baseline features associated with future postural instability, and we designated this cohort the emerging postural instability (ePI) phenotype. We evaluated the resulting ePI phenotype rating scale validity in two held-out populations which showed a significantly higher risk of postural instability. Emerging PI phenotype was identified before onset of postural instability in 289 of 301 paired comparisons, with a median progression time of 972 days. Baseline cognitive performance was similar but declined more rapidly in ePI phenotype. We provide an ePI phenotype rating scale (ePIRS) for evaluation of individual risk at baseline for progression to postural instability.
ISSN:2373-8057
2373-8057
DOI:10.1038/s41531-022-00287-x