Unraveling Parkinson's disease heterogeneity using subtypes based on multimodal data
(2022) In Parkinsonism and Related Disorders 102. p.19-29- Abstract
Background: Parkinson's disease (PD) is a clinically and neuroanatomically heterogeneous neurodegenerative disease characterized by different subtypes. To this date, no studies have used multimodal data that combines clinical, motor, cognitive and neuroimaging assessments to identify these subtypes, which may provide complementary, clinically relevant information. To address this limitation, we subtyped participants with mild-moderate PD based on a rich, multimodal dataset of clinical, cognitive, motor, and neuroimaging variables. Methods: Cross-sectional data from 95 PD participants from our randomized EXPANd (EXercise in PArkinson's disease and Neuroplasticity) controlled trial were included. Participants were subtyped using clinical,... (More)
Background: Parkinson's disease (PD) is a clinically and neuroanatomically heterogeneous neurodegenerative disease characterized by different subtypes. To this date, no studies have used multimodal data that combines clinical, motor, cognitive and neuroimaging assessments to identify these subtypes, which may provide complementary, clinically relevant information. To address this limitation, we subtyped participants with mild-moderate PD based on a rich, multimodal dataset of clinical, cognitive, motor, and neuroimaging variables. Methods: Cross-sectional data from 95 PD participants from our randomized EXPANd (EXercise in PArkinson's disease and Neuroplasticity) controlled trial were included. Participants were subtyped using clinical, motor, and cognitive assessments as well as structural and resting-state MRI data. Subtyping was done by random forest clustering. We extracted information about the subtypes by inspecting their neuroimaging profiles and descriptive statistics. Results: Our multimodal subtyping analysis yielded three PD subtypes: a motor-cognitive subtype characterized by widespread alterations in brain structure and function as well as impairment in motor and cognitive abilities; a cognitive dominant subtype mainly impaired in cognitive function that showed frontoparietal structural and functional changes; and a motor dominant subtype impaired in motor variables without any brain alterations. Motor variables were most important for the subtyping, followed by gray matter volume in the right medial postcentral gyrus. Conclusions: Three distinct PD subtypes were identified in our multimodal dataset. The most important features to subtype PD participants were motor variables in addition to structural MRI in the sensorimotor region. These findings have the potential to improve our understanding of PD heterogeneity, which in turn can lead to personalized interventions and rehabilitation.
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- author
- Albrecht, Franziska ; Poulakis, Konstantinos ; Freidle, Malin ; Johansson, Hanna ; Ekman, Urban ; Volpe, Giovanni ; Westman, Eric ; Pereira, Joana B. LU and Franzén, Erika
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Clustering, Magnetic resonance imaging, Parkinson's disease, Physical activity, Random forest, Subtyping
- in
- Parkinsonism and Related Disorders
- volume
- 102
- pages
- 11 pages
- publisher
- Elsevier
- external identifiers
-
- pmid:35932584
- scopus:85135407730
- ISSN
- 1353-8020
- DOI
- 10.1016/j.parkreldis.2022.07.014
- language
- English
- LU publication?
- yes
- id
- 0bf7cb71-29d1-42b3-a8f7-6446117990c5
- date added to LUP
- 2022-10-07 12:16:07
- date last changed
- 2024-08-09 00:51:55
@article{0bf7cb71-29d1-42b3-a8f7-6446117990c5, abstract = {{<p>Background: Parkinson's disease (PD) is a clinically and neuroanatomically heterogeneous neurodegenerative disease characterized by different subtypes. To this date, no studies have used multimodal data that combines clinical, motor, cognitive and neuroimaging assessments to identify these subtypes, which may provide complementary, clinically relevant information. To address this limitation, we subtyped participants with mild-moderate PD based on a rich, multimodal dataset of clinical, cognitive, motor, and neuroimaging variables. Methods: Cross-sectional data from 95 PD participants from our randomized EXPANd (EXercise in PArkinson's disease and Neuroplasticity) controlled trial were included. Participants were subtyped using clinical, motor, and cognitive assessments as well as structural and resting-state MRI data. Subtyping was done by random forest clustering. We extracted information about the subtypes by inspecting their neuroimaging profiles and descriptive statistics. Results: Our multimodal subtyping analysis yielded three PD subtypes: a motor-cognitive subtype characterized by widespread alterations in brain structure and function as well as impairment in motor and cognitive abilities; a cognitive dominant subtype mainly impaired in cognitive function that showed frontoparietal structural and functional changes; and a motor dominant subtype impaired in motor variables without any brain alterations. Motor variables were most important for the subtyping, followed by gray matter volume in the right medial postcentral gyrus. Conclusions: Three distinct PD subtypes were identified in our multimodal dataset. The most important features to subtype PD participants were motor variables in addition to structural MRI in the sensorimotor region. These findings have the potential to improve our understanding of PD heterogeneity, which in turn can lead to personalized interventions and rehabilitation.</p>}}, author = {{Albrecht, Franziska and Poulakis, Konstantinos and Freidle, Malin and Johansson, Hanna and Ekman, Urban and Volpe, Giovanni and Westman, Eric and Pereira, Joana B. and Franzén, Erika}}, issn = {{1353-8020}}, keywords = {{Clustering; Magnetic resonance imaging; Parkinson's disease; Physical activity; Random forest; Subtyping}}, language = {{eng}}, pages = {{19--29}}, publisher = {{Elsevier}}, series = {{Parkinsonism and Related Disorders}}, title = {{Unraveling Parkinson's disease heterogeneity using subtypes based on multimodal data}}, url = {{http://dx.doi.org/10.1016/j.parkreldis.2022.07.014}}, doi = {{10.1016/j.parkreldis.2022.07.014}}, volume = {{102}}, year = {{2022}}, }