Prognosis and neuropathologic correlation of clinical subtypes of Parkinson disease
Open accessAbstract
Importance: Clinical subtyping of Parkinson disease at diagnosis is useful in estimating disease course and survival. Severity and rate of progression of neuropathologies are important determinants of clinical Parkinson subtypes. Objective: To provide longitudinal clinical disease-course data and neuropathologic correlation for newly proposed Parkinson disease subtypes. Design, Setting, and Participants: Retrospective cohort study of consecutive patients with autopsy-confirmed Parkinson disease who were regularly seen throughout their disease course by hospital specialists in the United Kingdom and donated their brain at death to the Queen Square Brain Bank between January 2009 and December 2017. Patients with additional neuropathologic diagnoses, monogenic forms of parkinsonism, or insufficiently detailed clinical information were excluded. Based on severity of motor symptoms, rapid eye movement sleep behavior disorder, and autonomic and cognitive function at diagnosis, patients were classified adapting a subtyping classification into mild-motor predominant, intermediate, or diffuse malignant subtypes. Main Outcomes and Measures: Time from diagnosis to disease milestones (recurrent falls, wheelchair dependence, dementia, and care home placement) and death were compared between subtypes, and their risk was estimated using Cox hazard regression models. Severity and distribution of Lewy pathology and Alzheimer disease-related pathology were assessed using staging systems. Results: From a total of 146 patients, 111 patients were included (67 men [60.4%]; mean [SD] age at diagnosis, 62.5 [11.5] years). The diffuse malignant subtype had earlier development of milestones and reduced survival. Cox proportional hazard regression showed an increased adjusted risk of any disease milestone (hazard ratio, 10.90; 95% CI, 5.51-21.58; P < .001) and death (hazard ratio, 3.65; 95% CI, 1.98-6.75; P < .001) in the diffuse malignant group. Age at diagnosis was the only additional variable with statistical significance (adjusted hazard ratio for death, 1.14; 95% CI, 1.11-1.17; P <.001). Staging of Lewy pathology and Alzheimer disease-related pathology did not differ between subtypes, although they showed different rates of progression, and the latter was associated with age at death. Conclusions and Relevance: Parkinson clinical subtypes at diagnosis may estimate disease course and survival, which may be useful in providing a more accurate prognosis in individual patients in clinical practice and helping to stratify subgroups in clinical trials. Different severity and progression of neuropathologies are important determinants of Parkinson subtypes, and age at diagnosis should be included in future subtype classifications.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A barrier to clinical use of passive digital biomarkers has been insufficient computing resources to store and automatically process and analyze the large, continuously collected data.
“One barrier to the clinical implementation of passive digital biomarkers, however, has been the lack of computing resources for storing and automatically processing and analyzing the large amount of data collected from passive digital tools that continuously monitor behavior over long periods of time.120”
From Review of Artificial Intelligence for Clinical Use in Alzheimer's Disease and Related Dementias (2026) · cites this paper as [120]
The Study Design and Strengths and Limitations sections describe a retrospective Parkinson disease cohort and limitations in recording clinical symptoms. A search of our copy for passive digital biomarkers and computing, storage, and automated-processing barriers found no passage addressing the claimed barrier to clinical implementation. The copy is not marked as truncated. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Staging of brain pathology related to sporadic Parkinson’s disease
Braak, H., Tredici, K. D., Rüb, U., de Vos, R. A. I., Jansen Steur, E. N. H., & Braak, E. (2003) · Neurobiology of Aging · doi:10.1016/s0197-4580(02)00065-9 · Cited by 10,777 · see citing works
Mirra, S. S., Heyman, A., McKeel, D., Sumi, S. M., Crain, B. J., Brownlee, L. M., Vogel, F. S., Hughes, J. P., Belle, G. V., Berg, L., et al. (1991) · Neurology · doi:10.1212/wnl.41.4.479 · Cited by 4,961 · see citing works
Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium
McKeith, I. G., Boeve, B. F., Dickson, D. W., Halliday, G., Taylor, J.-P., Weintraub, D., Aarsland, D., Galvin, J., Attems, J., Ballard, C. G., et al. (2017) · Neurology · doi:10.1212/wnl.0000000000004058 · Cited by 4,476 · see citing works
Systematic review of levodopa dose equivalency reporting in Parkinson's disease
Tomlinson, C. L., Stowe, R. L., Patel, S., Rick, C., Gray, R. G., & Clarke, C. E. (2010) · Movement Disorders · doi:10.1002/mds.23429 · Cited by 4,232 · see citing works
Phases of Aβ-deposition in the human brain and its relevance for the development of AD
Thal, D. R., Rüb, U., Orantes, M., & Braak, H. (2002) · Neurology · doi:10.1212/wnl.58.12.1791 · Cited by 3,490 · see citing works
Braak, H., Alafuzoff, I., Arzberger, T., Kretzschmar, H., & Del Tredici, K. (2006) · Acta Neuropathologica · doi:10.1007/s00401-006-0127-z · Cited by 3,172 · see citing works
Montine, T. J., Phelps, C. H., Beach, T. G., Bigio, E. H., Cairns, N. J., Dickson, D. W., Duyckaerts, C., Frosch, M. P., Masliah, E., Mirra, S. S., et al. (2012) · Acta Neuropathologica · doi:10.1007/s00401-011-0910-3 · Cited by 2,992 · see citing works
The Parkinson Progression Marker Initiative (PPMI)
MAREK, K. L., Jennings, D. L., Lasch, S., Siderowf, A. D., Tanner, C. M., Simuni, T., Coffey, C. S., Kieburtz, K. D., Flagg, E., Chowdhury, S., et al. (2011) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2011.09.005 · Cited by 1,888 · see citing works
Improved accuracy of clinical diagnosis of Lewy body Parkinson’s disease
Hughes, A. J., Daniel, S. E., & Lees, A. J. (2001) · Neurology · doi:10.1212/wnl.57.8.1497 · Cited by 807 · see citing works
Self-citationClinical criteria for subtyping Parkinson’s disease: biomarkers and longitudinal progression
Fereshtehnejad, S., Zeighami, Y., Dagher, A., & Postuma, R. B. (2017) · Brain · doi:10.1093/brain/awx118 · Cited by 619 · see citing works
Fereshtehnejad, S.-M., Romenets, S. R., Anang, J. B. M., Latreille, V., Gagnon, J.-F., & Postuma, R. B. (2015) · JAMA Neurology · doi:10.1001/jamaneurol.2015.0703 · Cited by 615 · see citing works
Lewy- and Alzheimer-type pathologies in Parkinson's disease dementia: which is more important?
Compta, Y., Parkkinen, L., O’Sullivan, S. S., Vandrovcová, J., Holton, J. L., Collins, C., Lashley, T., Kallis, C., Williams, D. R., de Silva, R., et al. (2011) · Brain · doi:10.1093/brain/awr031 · Cited by 585 · see citing works
Self-citationLow clinical diagnostic accuracy of early vs advanced Parkinson disease
Adler, C. H., Beach, T. G., Hentz, J. G., Shill, H. A., Caviness, J. N., Driver‐Dunckley, E. D., Sabbagh, M. N., Sue, L. I., Jacobson, S. A., Belden, C. M., et al. (2014) · Neurology · doi:10.1212/wnl.0000000000000641 · Cited by 503 · see citing works
Alafuzoff, I., Arzberger, T., Al‐Sarraj, S., Bodi, I., Bogdanovic, N., Braak, H., Bugiani, O., Del‐Tredici, K., Ferrer, I., Gelpi, E., et al. (2008) · Brain Pathology · doi:10.1111/j.1750-3639.2008.00147.x · Cited by 467 · see citing works
A clinico-pathological study of subtypes in Parkinson's disease
Selikhova, M. V., Williams, D. R., Kempster, P. A., Holton, J. L., Révész, T., & Lees, A. J. (2009) · Brain · doi:10.1093/brain/awp234 · Cited by 462 · see citing works
Self-citationClinical outcomes of progressive supranuclear palsy and multiple system atrophy
O’Sullivan, S. S., Massey, L. A., Williams, D. R., Silveira‐Moriyama, L., Kempster, P. A., Holton, J. L., Révész, T., & Lees, A. J. (2008) · Brain · doi:10.1093/brain/awn065 · Cited by 423 · see citing works
Self-citationRelationships between age and late progression of Parkinson's disease: a clinico-pathological study
Kempster, P. A., O’Sullivan, S. S., Holton, J. L., Révész, T., & Lees, A. J. (2010) · Brain · doi:10.1093/brain/awq059 · Cited by 411 · see citing works
Self-citationThe progression of pathology in longitudinally followed patients with Parkinson’s disease
Halliday, G. M., Hely, M. A., Reid, W. G. J., & Morris, J. G. (2008) · Acta Neuropathologica · doi:10.1007/s00401-008-0344-8 · Cited by 410 · see citing works
Is increased blinking a form of blepharospasm?
(2013) · CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) · doi:10.1212/wnl · Cited by 355 · see citing works
Nonmotor features of Parkinson's disease subtypes
Marras, C., & Chaudhuri, К. R. (2016) · Movement Disorders · doi:10.1002/mds.26510 · Cited by 327 · see citing works
Staging/typing of Lewy body related α-synuclein pathology: a study of the BrainNet Europe Consortium
Alafuzoff, I. I., Ince, P. G., Arzberger, T., Al‐Sarraj, S., Bell, J. E., Bódi, I., Bogdanović, N., Bugiani, O., Ferrer, I., Gelpí, E., et al. (2009) · Acta Neuropathologica · doi:10.1007/s00401-009-0523-2 · Cited by 314 · see citing works
The heterogeneity of idiopathic Parkinson's disease
Foltynie, T., Brayne, C., & Barker, R. A. (2002) · Journal of Neurology · doi:10.1007/pl00007856 · Cited by 255 · see citing works
Parkinson's disease subtypes: lost in translation?
Marras, C., & Lang, A. E. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-303455 · Cited by 253 · see citing works
Association of Autonomic Dysfunction With Disease Progression and Survival in Parkinson Disease
Pablo‐Fernández, E. D., Tur, C., Révész, T., Lees, A. J., Holton, J. L., & Warner, T. T. (2017) · JAMA Neurology · doi:10.1001/jamaneurol.2017.1125 · Cited by 239 · see citing works
Self-citationThe identification of Parkinson's disease subtypes using cluster analysis: A systematic review
van Rooden, S. M., Heiser, W. J., Kok, J. N., Verbaan, D., van Hilten, J. J., & Marinus, J. (2010) · Movement Disorders · doi:10.1002/mds.23116 · Cited by 238 · see citing works
Clinical subtypes of Parkinson's disease
van Rooden, S. M., Colas, F., Martínez‐Martín, P., Jeukens‐Visser, M., Verbaan, D., Marinus, J., Chaudhuri, К. R., Kok, J. N., & van Hilten, J. J. (2010) · Movement Disorders · doi:10.1002/mds.23346 · Cited by 228 · see citing works
Patterns of levodopa response in Parkinson's disease: a clinico-pathological study.
Kempster, P., Williams, D. R., Selikhova, M., Holton, J., Révész, T., & Lees, A. J. (2007) · Brain : a journal of neurology · doi:10.1093/brain/awm142 · Cited by 198 · see citing works
Self-citationDeveloping and validating Parkinson’s disease subtypes and their motor and cognitive progression
Lawton, M., Ben‐Shlomo, Y., May, M., Baig, F., Barber, T. R., Klein, J. C., Swallow, D. M. A., Malek, N., Grosset, K. A., Bajaj, N. P. S., et al. (2018) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2018-318337 · Cited by 179 · see citing works
Subtypes of Parkinson’s Disease: What Do They Tell Us About Disease Progression?
Fereshtehnejad, S., & Postuma, R. B. (2017) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-017-0738-x · Cited by 178 · see citing works
Clinical clusters and dopaminergic dysfunction in de-novo Parkinson disease
Erro, R., Picillo, M., Vitale, C., Palladino, R., Amboni, M., Moccia, M., Pellecchia, M. T., & Barone, P. (2016) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2016.04.026 · Cited by 76 · see citing works
Subtypes of Parkinson's disease
Marras, C. (2015) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000219 · Cited by 58 · see citing works
Relation of clinical subtypes in Parkinson's disease with survival
de Lau, L. M. L., Verbaan, D., van Rooden, S. M., Marinus, J., & van Hilten, J. J. (2013) · Movement Disorders · doi:10.1002/mds.25652 · Cited by 39 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Bloem, B. R., Okun, M. S., & Klein, C. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00218-x · Cited by 3,920 · see citing works
Diagnosis and Treatment of Parkinson Disease: A Review
Armstrong, M. J., & Okun, M. S. (2020) · JAMA · doi:10.1001/jama.2019.22360 · Cited by 2,924 · see citing works
Challenges in the diagnosis of Parkinson's disease
Tolosa, E., Garrido, A., Scholz, S. W., & Poewe, W. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00030-2 · Cited by 1,874 · see citing works
Parkinson’s disease: etiopathogenesis and treatment
Jankovic, J. J., & Tan, E. K. (2020) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2019-322338 · Cited by 1,185 · see citing works
The genetic architecture of Parkinson's disease
Blauwendraat, C., Nalls, M. A., & Singleton, A. B. (2020) · The Lancet Neurology · doi:10.1016/s1474-4422(19)30287-x · Cited by 1,114 · see citing works
Brain-First versus Gut-First Parkinson’s Disease: A Hypothesis
Borghammer, P., & Van Den Berge, N. (2019) · Journal of Parkinson’s Disease · doi:10.3233/jpd-191721 · Cited by 419 · see citing works
Prodromal Parkinson disease subtypes — key to understanding heterogeneity
Berg, D., Borghammer, P., Fereshtehnejad, S.-M., Heinzel, S., Horsager, J., Schaeffer, E., & Postuma, R. B. (2021) · Nature Reviews Neurology · doi:10.1038/s41582-021-00486-9 · Cited by 409 · see citing works
Motor and non-motor circuit disturbances in early Parkinson disease: which happens first?
Blesa, J., Foffani, G., Dehay, B., Bezard, E., & Obeso, J. A. (2022) · Nature Reviews Neuroscience · doi:10.1038/s41583-021-00542-9 · Cited by 232 · see citing works
Sex differences in movement disorders
Meoni, S., Macerollo, A., & Moro, E. (2020) · Nature Reviews Neurology · doi:10.1038/s41582-019-0294-x · Cited by 207 · see citing works
Roles of Glutamate Receptors in Parkinson’s Disease
Zhang, Z., Zhang, S., Fu, P., Zhang, Z., Lin, K., Ko, J. K.-S., & Yung, K. K. L. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20184391 · Cited by 159 · see citing works
Tau accelerates α-synuclein aggregation and spreading in Parkinson’s disease
Pan, L., Li, C., Meng, L., Tian, Y., He, M., Yuan, X., Zhang, G., Zhang, Z., Xiong, J., Chen, G., et al. (2022) · Brain · doi:10.1093/brain/awac171 · Cited by 154 · see citing works
Sleep in Parkinson's disease: A systematic review and meta-analysis of polysomnographic findings
Zhang, Y., Ren, R., Sanford, L. D., Yang, L., Zhou, J., Tan, L., Li, T., Zhang, J., Wing, Y. K., Shi, J., et al. (2020) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2020.101281 · Cited by 151 · see citing works
Parkinson’s Disease Subtypes: Critical Appraisal and Recommendations
Mestre, T., Fereshtehnejad, S.-M., Berg, D., Bohnen, N. I., Dujardin, K., Erro, R., Espay, A. J., Halliday, G. M., van Hilten, J. J., Hu, M. T., et al. (2021) · Journal of Parkinson s Disease · doi:10.3233/jpd-202472 · Cited by 140 · see citing works
Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review
Ben-Joseph, A., Marshall, C. R., Lees, A. J., & Noyce, A. J. (2019) · Journal of Parkinson s Disease · doi:10.3233/jpd-191763 · Cited by 135 · see citing works
Self-citationDisease modification and biomarker development in Parkinson disease
Espay, A. J., Kalia, L. V., Gan‐Or, Z., Williams‐Gray, C. H., Bedard, P. L., Rowe, S. M., Morgante, F., Fasano, A. A., Stecher, B., Kauffman, M. A., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000009107 · Cited by 134 · see citing works
Pathological Influences on Clinical Heterogeneity in Lewy Body Diseases
Coughlin, D. G., Hurtig, H. I., & Irwin, D. J. (2019) · Movement Disorders · doi:10.1002/mds.27867 · Cited by 130 · see citing works
Performance of αSynuclein RT-QuIC in relation to neuropathological staging of Lewy body disease
Hall, S., Orru, C. D., Serrano, G. E., Galasko, D. R., Hughson, A. G., Groveman, B. R., Adler, C. H., Beach, T. G., Caughey, B. W., & Hansson, O. (2022) · Acta Neuropathologica Communications · doi:10.1186/s40478-022-01388-7 · Cited by 125 · see citing works
Innate and adaptive immune responses in Parkinson's disease
Schonhoff, A. M., Williams, G. P., Wallen, Z. D., Standaert, D. G., & Harms, A. S. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2019.10.006 · Cited by 115 · see citing works
How Does Deep Brain Stimulation Change the Course of Parkinson's Disease?
Mahlknecht, P., Foltynie, T., Limousin, P., & Poewe, W. (2022) · Movement Disorders · doi:10.1002/mds.29052 · Cited by 100 · see citing works
The brain-first vs. body-first model of Parkinson’s disease with comparison to alternative models
Borghammer, P. (2023) · Journal of Neural Transmission · doi:10.1007/s00702-023-02633-6 · Cited by 104 · see citing works
Therapy of Parkinson's Disease Subtypes
Marras, C., Chaudhuri, К. R., Titova, N., & Mestre, T. (2020) · Neurotherapeutics · doi:10.1007/s13311-020-00894-7 · Cited by 97 · see citing works
Pilotto, A., Romagnolo, A., Tuazon, J. A., Vizcarra, J. A., Marsili, L., Zibetti, M., Rosso, M., Rodriguez‐Porcel, F. E., Borroni, B., Rizzetti, M. C., et al. (2019) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2019-320846 · Cited by 96 · see citing works
Severson, K., Chahine, L. M., Smolensky, L., Dhuliawala, M., Frasier, M. A., Ng, K., Ghosh, S., & Hu, J. (2021) · The Lancet Digital Health · doi:10.1016/s2589-7500(21)00101-1 · Cited by 95 · see citing works
Sorrentino, Z. A., Goodwin, M. S., Riffe, C. J., Dhillon, J.-K. S., Xia, Y., Gorion, K.-M. M., Vijayaraghavan, N., McFarland, K. N., Golbe, L. I., Yachnis, A. T., et al. (2019) · Acta Neuropathologica Communications · doi:10.1186/s40478-019-0787-2 · Cited by 84 · see citing works
Ng, A. S. L., Tan, Y. J., Yong, A. C. W., Saffari, S. E., Lu, Z., Ng, E. Y., Ng, S. Y., Chia, N. S. Y., Choi, X., Heng, D. L., et al. (2020) · Molecular Neurodegeneration · doi:10.1186/s13024-020-00385-5 · Cited by 85 · see citing works
Ogunjobi, T. T., Ohaeri, P. N., Akintola, O. T., Atanda, D. O., Orji, F. P., Adebayo, J. O., Abdul, S. O., Eji, C. A., Asebebe, A. B., Shodipe, O. O., et al. (2024) · Medinformatics · doi:10.47852/bonviewmedin42022335 · Cited by 85 · see citing works
Deep Brain Stimulation Selection Criteria for Parkinson’s Disease: Time to Go beyond CAPSIT-PD
Artusi, C. A., Lopiano, L., & Morgante, F. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9123931 · Cited by 81 · see citing works
Nicoletti, A. S. Q., Baschi, R., Cicero, C. E., Iacono, S., Re, V. L., Luca, A., Schirò, G., & Monastero, R. (2023) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2023.111821 · Cited by 76 · see citing works
Neurogenesis in Neurodegenerative Diseases: Role of MFG-E8
Cheyuo, C., Aziz, M., & Wang, P. (2019) · Frontiers in Neuroscience · doi:10.3389/fnins.2019.00569 · Cited by 75 · see citing works
Animal models of brain-first and body-first Parkinson's disease
Berge, N. V. D., & Ulusoy, A. (2021) · Neurobiology of Disease · doi:10.1016/j.nbd.2021.105599 · Cited by 78 · see citing works
Prodromal Parkinson's disease: hype or hope for disease-modification trials?
Mahlknecht, P., Marini, K., Werkmann, M., Poewe, W., & Seppi, K. (2022) · Translational Neurodegeneration · doi:10.1186/s40035-022-00286-1 · Cited by 58 · see citing works
Tönges, L., Buhmann, C., Klebe, S., Klucken, J., Kwon, E. H., Müller, T. H., Pedrosa, D. J., Schröter, N., Riederer, P. F., & Lingor, P. (2022) · Journal of Neural Transmission · doi:10.1007/s00702-022-02498-1 · Cited by 68 · see citing works
Andersen, K. B., Krishnamurthy, A., Just, M. K., Berge, N. V. D., Skjærbæk, C., Horsager, J., Knudsen, K., Vogel, J. W., Toledo, J. B., Attems, J., et al. (2025) · Nature Neuroscience · doi:10.1038/s41593-025-01910-9 · Cited by 67 · see citing works
Parkinson’s disease clinical milestones and mortality
González, M. C., Dalen, I., Maple‐Grødem, J., Tysnes, O., & Alves, G. W. (2022) · npj Parkinson s Disease · doi:10.1038/s41531-022-00320-z · Cited by 65 · see citing works
Two distinct trajectories of clinical and neurodegeneration events in Parkinson’s disease
Zhou, C., Wang, L., Cheng, W., Lv, J., Guan, X., Guo, T., Wu, J., Zhang, W., Gao, T., Liu, X., et al. (2023) · npj Parkinson s Disease · doi:10.1038/s41531-023-00556-3 · Cited by 65 · see citing works
Cruz, B. G. S., Husch, A., & Hertel, F. (2023) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2023.1216163 · Cited by 69 · see citing works
Clinical severity in Parkinson’s disease is determined by decline in cortical compensation
Johansson, M. E., Toni, I., Kessels, R. P. C., Bloem, B. R., & Helmich, R. C. G. (2023) · Brain · doi:10.1093/brain/awad325 · Cited by 63 · see citing works
Apathy in Parkinson’s Disease: Clinical Patterns and Neurobiological Basis
Béreau, M., Waes, V. V., Servant, M., Magnin, É., Tatu, L., & Anheim, M. (2023) · Cells · doi:10.3390/cells12121599 · Cited by 66 · see citing works
Sleep Disorders Associated with Neurodegenerative Diseases
Anghel, L., Ciubară, A., Nechita, A., Nechita, L., Manole, C., Baroiu, L., Ciubară, A. B., & Mușat, C. L. (2023) · Diagnostics · doi:10.3390/diagnostics13182898 · Cited by 62 · see citing works
Update on the diagnosis and management of Parkinson's disease
Kobylecki, C. (2020) · Clinical Medicine · doi:10.7861/clinmed.2020-0220 · Cited by 61 · see citing works
Ruíz‐Barrio, I., Miki, Y., Jaunmuktane, Z., Warner, T. T., & Pablo‐Fernández, E. D. (2022) · Neurology · doi:10.1212/wnl.0000000000201659 · Cited by 58 · see citing works
Self-citationParkinson’s Disease and Dementia with Lewy Bodies: One and the Same
Borghammer, P., Okkels, N., & Weintraub, D. A. (2024) · Journal of Parkinson s Disease · doi:10.3233/jpd-240002 · Cited by 57 · see citing works
Motor Onset Topography and Progression in Parkinson's Disease: the Upper Limb Is First
Monje, M. H. G., Sánchez‐Ferro, Á., Pineda‐Pardo, J. A., Vela, L., Alonso‐Frech, F., & Obeso, J. A. (2021) · Movement Disorders · doi:10.1002/mds.28462 · Cited by 56 · see citing works
Protein–protein interactions regulating α-synuclein pathology
Wang, J., Dai, L., Chen, S., Zhang, Z., Fang, X., & Zhang, Z. (2024) · Trends in Neurosciences · doi:10.1016/j.tins.2024.01.002 · Cited by 56 · see citing works
Cognata, V. L., Morello, G., & Cavallaro, S. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22094820 · Cited by 56 · see citing works
Bonilauri, A., Intra, F. S., Pugnetti, L., Baselli, G., & Baglio, F. (2020) · Diagnostics · doi:10.3390/diagnostics10080581 · Cited by 55 · see citing works
Multimodal phenotypic axes of Parkinson’s disease
Markello, R. D., Shafiei, G., Tremblay, C., Postuma, R. B., Dagher, A., & Mišić, B. (2021) · npj Parkinson s Disease · doi:10.1038/s41531-020-00144-9 · Cited by 51 · see citing works
The inconsistency and instability of Parkinson's disease motor subtypes
von Coelln, R., Gruber‐Baldini, A. L., Reich, S. G., Armstrong, M. J., Savitt, J. M., & Shulman, L. M. (2021) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2021.05.016 · Cited by 53 · see citing works
Neuroprotective Trials in REM Sleep Behavior Disorder
Postuma, R. B. (2022) · Neurology · doi:10.1212/wnl.0000000000200235 · Cited by 52 · see citing works
Time for a New Image of Parkinson Disease
Armstrong, M. J., & Okun, M. S. (2020) · JAMA Neurology · doi:10.1001/jamaneurol.2020.2412 · Cited by 52 · see citing works
Transitioning from Subtyping to Precision Medicine in Parkinson's Disease: A Purpose‐Driven Approach
Marras, C., Fereshtehnejad, S., Berg, D., Bohnen, N. I., Dujardin, K., Erro, R., Espay, A. J., Halliday, G. M., van Hilten, J. J., Hu, M. T., et al. (2024) · Movement Disorders · doi:10.1002/mds.29708 · Cited by 51 · see citing works
Clinical Parkinson disease subtyping does not predict pathology
Espay, A. J., & Marras, C. (2019) · Nature Reviews Neurology · doi:10.1038/s41582-019-0153-9 · Cited by 47 · see citing works
Cognitive impairment in Parkinson's disease: A clinical and pathophysiological overview
Brandão, P. R. D. P., Munhoz, R. P., Grippe, T. C., Cardoso, F., Castro, B. M. D. A. E., Titze‐de‐Almeida, R., Tomaz, C. A. B., & Tavares, M. C. H. (2020) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2020.117177 · Cited by 47 · see citing works
Benign versus malignant Parkinson disease: the unexpected silver lining of motor complications
Merola, A., Romagnolo, A., Dwivedi, A. K., Padovani, A., Berg, D., Ruiz, P., Fabbri, M., Artusi, C. A., Zibetti, M., Lopiano, L., et al. (2020) · Journal of Neurology · doi:10.1007/s00415-020-09954-6 · Cited by 44 · see citing works
Parkinson disease clinical subtypes: key features & clinical milestones
Campbell, M. C., Myers, P. S., Weigand, A. J., Foster, E. R., Cairns, N. J., Jackson, J. J., Lessov‐Schlaggar, C. N., & Perlmutter, J. S. (2020) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51102 · Cited by 44 · see citing works
Pablo‐Fernández, E. D., Courtney, R. J., Rockliffe, A., Gentleman, S., Holton, J. L., & Warner, T. T. (2021) · Neuropathology and Applied Neurobiology · doi:10.1111/nan.12728 · Cited by 43 · see citing works
Self-citationGlymphatic system dysfunction and risk of clinical milestones in patients with Parkinson disease
Zhou, C. Y., Jiang, X., Guan, X., Guo, T., Wu, J., Wu, H., Wu, C., Chen, J., Wen, J., Tan, S., et al. (2024) · European Journal of Neurology · doi:10.1111/ene.16521 · Cited by 40 · see citing works
Overlapping genetic architecture between Parkinson disease and melanoma
Dube, U., Ibáñez, L., Budde, J., Benítez, B. A., Davis, A. A., Harari, O., Iles, M. M., Law, M. H., Brown, K. M., & Cruchaga, C. (2019) · Acta Neuropathologica · doi:10.1007/s00401-019-02110-z · Cited by 40 · see citing works
The Logic and Pitfalls of Parkinson's Disease as “Brain‐First” Versus “ Body‐First ” Subtypes
Fearon, C., Lang, A. E., & Espay, A. J. (2021) · Movement Disorders · doi:10.1002/mds.28493 · Cited by 40 · see citing works
Targeting N-Methyl-d-Aspartate Receptors in Neurodegenerative Diseases
Carles, A., Freyssin, A., Perin-Dureau, F., Rubinstenn, G., & Maurice, T. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25073733 · Cited by 42 · see citing works
Association of specific biotypes in patients with Parkinson disease and disease progression
Wang, L., Cheng, W., Rolls, E. T., Dai, F., Gong, W., Du, J., Zhang, W., Wang, S., Liu, F., Wang, J., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000010498 · Cited by 38 · see citing works
Health and Disease Are Dynamic Complex-Adaptive States Implications for Practice and Research
Sturmberg, J. P. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.595124 · Cited by 38 · see citing works
Lee, S. H., Park, S., Yeo, S. S., Kwon, O., Lee, M., Yoo, H.-R., Ahn, E. K., Jang, J. Y., & Jang, J.-H. (2022) · Diagnostics · doi:10.3390/diagnostics12010112 · Cited by 36 · see citing works
Ryu, D.-W., Han, K., & Cho, A.-H. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1236296 · Cited by 35 · see citing works
Herman, T., Barer, Y., Bitan, M., Sobol, S., Giladi, N., & Hausdorff, J. M. (2023) · npj Parkinson s Disease · doi:10.1038/s41531-023-00600-2 · Cited by 35 · see citing works
Zamanian, M. Y., Bazmandegan, G., Sureda, A., Sobarzo‐Sánchez, E., Yousefi‐Manesh, H., & Shirooie, S. (2020) · Current Neuropharmacology · doi:10.2174/1570159x18666200510020744 · Cited by 35 · see citing works
Two-year clinical progression in focal and diffuse subtypes of Parkinson’s disease
Johansson, M. E., van Lier, N. M., Kessels, R. P. C., Bloem, B. R., & Helmich, R. C. G. (2023) · npj Parkinson s Disease · doi:10.1038/s41531-023-00466-4 · Cited by 34 · see citing works
Islet amyloid polypeptide triggers α-synuclein pathology in Parkinson’s disease
Meng, L., Li, Y., Liu, C., Zhang, G., Chen, J., Xiong, M., Pan, L., Zhang, X., Chen, G., Xiong, J., et al. (2023) · Progress in Neurobiology · doi:10.1016/j.pneurobio.2023.102462 · Cited by 33 · see citing works
Long‐Duration Progressive Supranuclear Palsy: Clinical Course and Pathological Underpinnings
Ječmenica‐Lukić, M., Respondek, G., Kurz, C., Compta, Y., Gelpí, E., Ferguson, L. W., Rajput, A. H., Troakes, C., the MDS‐endorsed PSP study group, Swieten, J. C. V., et al. (2022) · Annals of Neurology · doi:10.1002/ana.26455 · Cited by 31 · see citing works
Yao, L., Chen, R., Zheng, Z., Hatami, M., Koç, S., Wang, X., Bai, Y., Yao, C., Lu, G., & Skutella, T. (2024) · International Journal of Surgery · doi:10.1097/js9.0000000000002081 · Cited by 31 · see citing works
Parkinson's disease subtypes: Approaches and clinical implications
Deng, X., Mehta, A., Xiao, B., Chaudhuri, К. R., Tan, E., & Tan, L. C. (2024) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2024.107208 · Cited by 31 · see citing works
The Nigral Coup in Parkinson’s Disease by α-Synuclein and Its Associated Rebels
Sian‐Hülsmann, J., & Riederer, P. F. (2021) · Cells · doi:10.3390/cells10030598 · Cited by 30 · see citing works
Acupuncture for Parkinson’s disease: From theory to practice
Fan, J., Lu, W.-J., Tan, W., Feng, W.-C., & Zhuang, L. (2022) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2022.112907 · Cited by 31 · see citing works
Cheng, Y., Tong, Q., Yuan, Y., Song, X., Jiang, W., Wang, Y., Li, W., Li, Y., & Zhang, K. (2023) · Journal of Neuroinflammation · doi:10.1186/s12974-023-02720-1 · Cited by 31 · see citing works
Béreau, M., Kibleur, A., Servant, M., Clément, G., Dujardin, K., Rolland, A., Wirth, T., Lagha‐Boukbiza, O., Voirin, J., Santin, M. D. N., et al. (2023) · Brain · doi:10.1093/brain/awad324 · Cited by 30 · see citing works
Vallelonga, F., Romagnolo, A., Merola, A., Sobrero, G., Stefano, C. D., Milazzo, V., Burrello, J., Burrello, A., Zibetti, M., Milan, A., et al. (2019) · Hypertension Research · doi:10.1038/s41440-019-0267-x · Cited by 31 · see citing works
Antonini, A., Bravi, D., Sandre, M., & Bubacco, L. (2020) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2020.1771693 · Cited by 30 · see citing works
Boccalini, C., Carli, G., Pilotto, A., Padovani, A., & Perani, D. (2022) · Neurobiology of Disease · doi:10.1016/j.nbd.2022.105668 · Cited by 30 · see citing works
Erro, R., Picillo, M., Amboni, M., Savastano, R., Scannapieco, S., Cuoco, S., Santangelo, G., Vitale, C., Pellecchia, M. T., & Barone, P. (2019) · European Journal of Neurology · doi:10.1111/ene.13968 · Cited by 30 · see citing works
Disease modification in Parkinsonism: obstacles and ways forward
Höllerhage, M., Klietz, M., & Höglinger, G. U. (2022) · Journal of Neural Transmission · doi:10.1007/s00702-022-02520-6 · Cited by 29 · see citing works
Brain MRI Reveals Ascending Atrophy in Parkinson's Disease Across Severity
Blair, J. C., Barrett, M. J., Patrie, J. T., Flanigan, J. L., Sperling, S. A., Elias, W. J., & Druzgal, T. J. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.01329 · Cited by 27 · see citing works
Motor Complications in Parkinson's Disease: Results from 3343 Patients Followed for up to 12 Years
Gandhi, S. E., Zerenner, T., Nodehi, A., Lawton, M., Marshall, V. L., Alhajraf, F., Grosset, K. A., Morris, H. R., Hu, M. T., Ben‐Shlomo, Y., et al. (2024) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.14044 · Cited by 27 · see citing works
Parietal Perfusion Alterations in Parkinson's Disease Patients Without Dementia
Pelizzari, L., Tella, S. D., Rossetto, F., Laganà, M. M., Bergsland, N., Pirastru, A., Meloni, M., Nemni, R., & Baglio, F. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00562 · Cited by 28 · see citing works
Tang, X., Zhang, Y., Liu, D., Hu, Y., Jiang, L., & Zhang, J. (2021) · Neurology · doi:10.1212/wnl.0000000000011894 · Cited by 27 · see citing works
White matter alterations in early Parkinson’s disease: role of motor symptom lateralization
Pelizzari, L., Tella, S. D., Laganà, M. M., Bergsland, N., Rossetto, F., Nemni, R., & Baglio, F. (2019) · Neurological Sciences · doi:10.1007/s10072-019-04084-y · Cited by 27 · see citing works
Clinical milestones in Parkinson's disease: Past, present, and future
Marsili, L., & Mahajan, A. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.120082 · Cited by 25 · see citing works
Shu, Z.-Y., Pang, P., Wu, X., Cui, S., Xu, Y.-Y., & Zhang, M.-M. (2020) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2020.548616 · Cited by 24 · see citing works
Personalized Care in Late-Stage Parkinson’s Disease: Challenges and Opportunities
Fabbri, M., Coelho, M. M., Garon, M., Biundo, R., Mestre, T., & Antonini, A. (2022) · Journal of Personalized Medicine · doi:10.3390/jpm12050813 · Cited by 24 · see citing works
Traditional Chinese medicine-based neurorestorative therapy for Alzheimer’s and Parkinson’s disease
Zhang, Z., Zhang, S., Lui, C. N. P., Zhu, P., Zhang, Z., Lin, K., Dai, Y., & Yung, K. K. L. (2019) · Journal of Neurorestoratology · doi:10.26599/jnr.2019.9040026 · Cited by 24 · see citing works
Hopfner, F., Höglinger, G. U., German Parkinson’s Guidelines Group, Bähr, M., Becktepe, J., Berg, D., Brockmann, K., Ceballos-Baumann, A., Claßen, J., Deuschl, C., et al. (2024) · Journal of Neurology · doi:10.1007/s00415-024-12687-5 · Cited by 23 · see citing works
Increased Mortality in Young-Onset Parkinson’s Disease
Hustad, E., Myklebust, T. Å., Gulati, S., & Aasly, J. O. (2021) · Journal of Movement Disorders · doi:10.14802/jmd.21029 · Cited by 23 · see citing works
Can We Treat Neurodegenerative Proteinopathies by Enhancing Protein Degradation?
Engelender, S., Stefanis, L., Oddo, S., & Bellucci, A. (2022) · Movement Disorders · doi:10.1002/mds.29058 · Cited by 23 · see citing works
Fereshtehnejad, S., Moqadam, R., Azizi, H., Postuma, R. B., Dadar, M., Lang, A. E., Marras, C., & Zeighami, Y. (2025) · Movement Disorders · doi:10.1002/mds.30229 · Cited by 22 · see citing works
Deep phenotyping for precision medicine in Parkinson's disease
Schalkamp, A., Rahman, N. F., Monzón‐Sandoval, J., & Sandor, C. (2022) · Disease Models & Mechanisms · doi:10.1242/dmm.049376 · Cited by 22 · see citing works
Long-Term Cognitive Decline Related to the Motor Phenotype in Parkinson’s Disease
Wojtala, J., van der Wurp, H., Kalbe, E., Rehberg, S., Storch, A., Linse, K., Schneider, C., Gräber, S., Berg, D., Dams, J., et al. (2022) · Journal of Parkinson s Disease · doi:10.3233/jpd-212787 · Cited by 22 · see citing works
Kulisevsky, J. (2022) · Revista de Neurología · doi:10.33588/rn.75s04.2022217 · Cited by 22 · see citing works
Baytaş, İ. M. (2024) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2024.3373703 · Cited by 21 · see citing works
Clinically probable RBD is an early predictor of malignant non-motor Parkinson’s disease phenotypes
Martinez-Nunez, A. E., Hutchinson, H., Coutinho, P., Sarmento, F. P., Lavu, V. S., Yuan, Q., Dwarampudi, J. M. R., Gunduz, A., Pontone, G. M., Okun, M. S., et al. (2025) · npj Parkinson s Disease · doi:10.1038/s41531-025-00874-8 · Cited by 21 · see citing works
Fu, Y., & Halliday, G. M. (2025) · Nature Reviews Neurology · doi:10.1038/s41582-025-01090-x · Cited by 21 · see citing works
Zhu, S., Zhong, M., Bai, Y., Wu, Z., Gu, R., Jiang, X., Shen, B., Zhu, J., Pan, Y., Dong, J., et al. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.663232 · Cited by 21 · see citing works
- Authors
- De Pablo-Fernández, E., Lees, A. J., Holton, J. L., & Warner, T. T.
- Affiliations
- Reta Lila Weston Institute of Neurological Studies, University College London Queen Square Institute of Neurology, London, England
- National Hospital for Neurology and Neurosurgery (GB)
- Corresponding author
- Warner, Thomas T.
- Venue
- JAMA Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2019-04-01
- Volume
- 76
- Issue
- 4
- Pages
- 470
- ISSN
- 2168-6149 (ISSN-L)
- PMC
- PMC6459129
- OpenAlex
- W2909700430
- Cited by
- 332
- References
- 31
- Citations by year
- 2026: 23 · 2025: 53 · 2024: 45 · 2023: 42 · 2022: 46 · 2021: 39 · 2020: 63 · 2019: 20
- FWCI
- 28.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Medical Research Council (MR/L023784/2, MR/L023784/1)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, clinical subtypes, prognosis, disease progression, survival, Lewy body pathology, rapid eye movement sleep behavior disorder, dementia, wheelchair dependence, nursing home admission, age at death, autonomic dysfunction, cognitive function, brain donation
- MeSH terms
- Aged, Autonomic Nervous System Diseases, Autopsy, Brain, Female, Humans, Male, Middle Aged, Parkinson Disease, Prognosis, Retrospective Studies, Severity of Illness Index, Survival Rate, Proportional Hazards Models, Lewy Bodies, Neurofibrillary Tangles, Age of Onset, Disease Progression, REM Sleep Behavior Disorder, Plaque, Amyloid, Cognitive Dysfunction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
