The different subtypes of Parkinson’s

Parkinson’s is different for everyone — but did you know there are also different subtypes of the condition? It’s an idea that has been around for a few years now, so what progress has been made towards diagnosing different subtypes of Parkinson’s?

Dr Beckie Port
Oct 28 · 10 min read
Photo by Diomari Madulara on Unsplash

Overview:

  • Parkinson’s itself is now regarded as an umbrella term for several conditions that have different symptoms and progression rates.
  • Being able to identify these subtypes would improve the use of treatments we have today, and also speed up the search for new and better treatments and a cure.
  • Researchers have been trying to categorise different combinations of symptoms into subtypes and to find out which subtypes progress faster or slower than average.

Are there types of Parkinson’s?

Over the last decade, it has become apparent that the way we currently diagnose Parkinson’s as a single condition is an oversimplification. This is likely impacting both the quality of care people with Parkinson’s receive, as well as research into new and better treatments.

  • What symptoms will I develop? and,
  • How fast will my Parkinson’s progress?

Progress in subtyping Parkinson’s

To find out how far we have come, we have to look back at developments that have been made into subtyping Parkinson’s.

The Oxford Parkinson’s Disease Centre

We started writing about this topic in 2015, at the time there were a few papers detailing small scale studies about how Parkinson’s affects people differently, but it was clear that more data was needed.

Different types of symptoms

One of the first attempts to separate Parkinson’s into different subtypes based on symptoms experienced came from the Oxford Parkinson’s Disease Centre a couple of years later. In a condition where every individual is different, this pioneering study had discovered 5 potential subtypes by analysing both the movement (motor) and non-movement (non-motor) symptoms that 769 people with Parkinson’s experienced. You can read about these types in a previous blog.

Using subtypes to predict the progression of Parkinson’s

Over the course of the next couple of years several more studies were published that further explored the ability to use the subtypes of Parkinson’s to predict the progression of Parkinson’s. Here are the highlights from a few of them:

1. Tracking Parkinson’s joins forces with the Oxford Parkinson’s Disease Centre

In 2018, Tracking Parkinson’s was the largest, in-depth study of the condition ever attempted, a title it still holds to this date. The project had been running for 5 years and had data from 2,600 participants (people with Parkinson’s and their siblings) across 70 hospitals in the UK.

2. Italian researchers also find subtypes are linked to progression

In the same year, another smaller study was published that identified three main subtypes of Parkinson’s based on the main motor symptom that people experienced.

3. Further support from a US based study

In 2019, data from 446 newly diagnosed people with Parkinson’s participating in the Parkinson’s Progression Markers Initiative (PPMI) was published.

From subtypes to better treatments

With the identification of different subtypes of Parkinson’s progressing, researchers at UCL wanted to find out if they could use donated tissue from the Parkinson’s UK Brian Bank to retrospectively subtype Parkinson’s. They wanted to look at the early symptoms of Parkinson's to see if it could predict how Parkinson’s would progress.

  1. ‘intermediate’.
  2. ‘diffuse malignant’ — the more severe type of Parkinson’s often diagnosed later in life (on average 70.3 years) that was faster progressing and more likely to develop complications such as dementia.

“This analysis suggests that we may be able to use this type of classification to help guide treatment, as well as help patients better understand their disease course.”

More data = more success

With researchers seeing the potential of these subtypes to change the way to treat and manage Parkinson’s, it is clear why this is a growing area of research. But, we do not yet have a definitive set of subtypes for Parkinson’s. One of the reasons for this, is the complexity of the condition and the way it fluctuates hour to hour, and day to day.


Parkinson’s UK

Get the latest research news, discover more about Parkinson’s and read about how others are getting involved. For information and support, visit www.parkinsons.org.uk

Thanks to Katherine Fletcher

Dr Beckie Port

Written by

Research Communications Manager at @ParkinsonsUK. Ex-researcher in oncology and virology.

Parkinson’s UK

Get the latest research news, discover more about Parkinson’s and read about how others are getting involved. For information and support, visit www.parkinsons.org.uk

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