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Prediction of Death, Dementia, Disability, Depression from the Time Course of UPDRS Motor Status

Parkinson’s disease is progressive. Early on, its effects are relatively minor, affecting mainly movement and causing shaking of the limbs. Later on, serious events -- early death, dementia, disability and depression -- occur in some patients. We are going to carefully describe the individual rate of progression of movement difficulties and tremor, as well as their response to medications, to discover if these features of parkinsonism are predictors of the occurrence of more serious events. If we can use the speed of progression to predict those patients who are more likely to have these events, then further research can focus on treatments to prevent these complications.

Final Outcome

Using long-term follow-up of patients in the DATATOP study, Drs. Holford and Nutt focused on developing computational models of the progression of the cardinal features of PD (tremor, bradykinesia, rigidity, and posture/gait). They then used these models to predict the time to PD clinical outcomes such as dementia, depression, and other measures of disability.

The researchers’ results emphasized the importance of the rate of progression in predicting disease prognosis. They concluded that it was possible that subtypes may in fact represent different stages of progression rather than distinct forms of disease and that the progression of symptoms, not disease subtype, was of primary importance in predicting patient prognosis (defined as onset of clinically significant events such as cognitive dysfunction or falls).

As a result of their successful creation of computational models to study subtypes, the researchers received supplemental funding from MJFF to develop computational models that would determine potentially disease-modifying effects of current anti-parkinsonian treatments.


Researchers

  • Nick Holford, MBChB, FRACP

    Auckland New Zealand


  • John G. Nutt, MD

    Portland, OR United States


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