Picture this: you’re at a fashion show, observing the different outfits on display. Some people start in one style but then switch it up over time, while others stick to their signature look. Similarly, a recent study explored the stability of motor-nonmotor subtypes in early-stage Parkinson’s disease (PD) patients. The findings revealed that many patients experienced changes in their subtypes during the five-year follow-up period. Like the fashionistas at the show, some PD patients switched between subtypes, while others remained consistent. Interestingly, the agreement between the baseline and follow-up subtypes was lower for motor-nonmotor subtypes compared to motor subtypes. This highlights the dynamic nature of PD and suggests that the progression of the disease is not always straightforward. In fact, baseline motor-nonmotor subtypes were found to be a determinant of having the diffuse malignant subtype at the fifth-year visit. This insight opens up new avenues for understanding PD and emphasizing the need for further research on subtyping methods. If you want to delve deeper into this exciting study, be sure to check out the full article!

BackgroundThe different clinical characteristics and prognostic values of the motor-nonmotor subtypes of Parkinson’s disease (PD) have been established by previous studies. However, the consistency of motor-nonmotor subtypes in patients with early-stage Parkinson’s disease required further investigation. The present study aimed to evaluate the consistency of motor-nonmotor subtypes across five years of follow-up in a longitudinal cohort.Materials and methodsPatients were classified into different subtypes (mild-motor–predominant, intermediate, diffuse malignant; or tremor-dominant, indeterminate, postural instability and gait difficulty) according to previously verified motor-nonmotor and motor subtyping methods at baseline and at every year of follow-up. The agreement between subtypes was examined using Cohen’s kappa and total agreement. The determinants of having the diffuse malignant subtype as of the fifth-year visit were explored using logistic regression.ResultsA total of 421 patients were included. There was a fair degree of agreement between the baseline motor-nonmotor subtype and the subtype recorded at the one-year follow-up visit (κ = 0.30 ± 0.09; total agreement, 60.6%) and at following years’ visits. The motor-nonmotor subtype had a lower agreement between baseline and follow-up than did the motor subtype. The baseline motor-nonmotor subtype was the determinant of diffuse malignant subtype at the fifth-year visit.ConclusionMany patients experienced a change in their motor-nonmotor subtype during follow-up. Further studies of consistency in PD subtyping methods should be conducted in the future.

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