Fortschr Neurol Psychiatr 2025; 93(06): 243-254
DOI: 10.1055/a-2521-3214
Fort- und Weiterbildung

Subtypen der Parkinson-Krankheit

Subtypes of Parkinsonʼs disease
Georg Ebersbach

Parkinson ist ein Krankheitsbild mit von Mensch zu Mensch sehr unterschiedlichen Symptomkonstellationen und Verlaufsformen. Im klinischen Alltag werden oft für die Gesamtgruppe der Betroffenen definierte Therapiestrategien eingesetzt, die dann allerdings zu sehr variablen Ergebnissen führen. Die Definition von verschiedenen Parkinson-Subtypen soll dazu dienen, den individuellen Krankheitsverlauf besser einschätzen zu können und die für verschiedene Untergruppen am besten geeigneten Behandlungsmöglichkeiten zu finden.

Abstract

Parkinsonʼs disease is characterized by a large inter-individual variability of symptom constellations and courses. In routine clinical practice, standard treatment strategies are often used, but outcomes differ considerably from patient to patient. The definition of different Parkinson's subtypes may help to better predict the individual course of the disease and to find the most suitable treatment options for different patient groups.



Publication History

Article published online:
10 June 2025

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  • Literatur

  • 1 Weiner WJ. There is no Parkinson disease. Arch Neurol 2008; 65: 705-708
  • 2 Marras C, Fereshtehnejad SM, Berg D. Transitioning from subtyping to precision medicine in parkinsonʼs disease: a purpose-driven approach. Mov Disord 2024; 39: 462-471
  • 3 von Coelln R, Gruber-Baldini AL, Reich SG. The inconsistency and instability of Parkinsonʼs disease motor subtypes. Parkinsonism Relat Disord 2021; 88: 13-18
  • 4 Mestre TA, Fereshtehnejad SM, Berg D. Parkinsonʼs disease subtypes: critical appraisal and recommendations. J Parkinsons Dis 2021; 11: 395-404
  • 5 Betrouni N, Delval A, Chaton L. Electroencephalography-based machine learning for cognitive profiling in Parkinsonʼs disease: preliminary results. Mov Disord 2019; 34: 210-217
  • 6 Landau S, Harris V, Burn DJ. Anxiety and anxious-depression in Parkinsonʼs disease over a 4-year period: a latent transition analysis. Psychol Med 2016; 46: 657-667
  • 7 Jankovic J, McDermott M, Carter J. Variable expression of Parkinsonʼs disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group. Neurology 1990; 40: 1529-1534
  • 8 van der Heeden JF, Marinus J, Martinez-Martin P. Postural instability and gait are associated with severity and prognosis of Parkinson disease. Neurology 2016; 86: 2243-2250
  • 9 Simuni T, Caspell-Garcia C, Coffey C. How stable are Parkinsonʼs disease subtypes in de novo patients: analysis of the PPMI cohort?. Parkinsonism Relat Disord 2016; 28: 62-67
  • 10 Pagano G, Ferrara N, Brooks DJ. Age at onset and Parkinson disease phenotype. Neurology 2016; 86: 1400-1407
  • 11 Mehanna R, Smilowska K, Fleisher J. Age cutoff for early-onset Parkinsonʼs disease: recommendations from the International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinsonʼs Disease. Mov Disord Clin Pract 2022; 9: 869-878
  • 12 Marras C, Chaudhuri KR. Nonmotor features of Parkinsonʼs disease subtypes. Mov Disord 2016; 31: 1095-1102
  • 13 Borghammer P, Horsager J. Neuropathological evidence of body-first vs. brain-first Lewy body disease. Neurobiol Dis 2021; 161: 105557
  • 14 Knudsen K, Fedorova TD, Horsager J. Asymmetric dopaminergic dysfunction in brain-first versus body-first Parkinsonʼs disease subtypes. J Parkinsons Dis 2021; 11: 1677-1687
  • 15 Fereshtehnejad SM, Postuma RB. Subtypes of Parkinsonʼs disease: what do they tell us about disease progression?. Curr Neurol Neurosci Rep 2017; 17: 34
  • 16 De Pablo-Fernandez E, Lees AJ. Prognosis and neuropathologic correlation of clinical subtypes of Parkinson disease. JAMA Neurol 2019; 76: 470-479
  • 17 Lawton M, Ben-Shlomo Y, May MT. Developing and validating Parkinsonʼs disease subtypes and their motor and cognitive progression. J Neurol Neurosurg Psychiatry 2018; 89: 1279-1287
  • 18 Trezzi JP, Galozzi S, Jaeger C. Distinct metabolomic signature in cerebrospinal fluid in early parkinsonʼs disease. Mov Disord 2017; 32: 1401-1408
  • 19 Iwaki H, Blauwendraat C, Leonard HL. Genetic risk of Parkinson disease and progression: an analysis of 13 longitudinal cohorts. Neurol Genet 2019; 5: e348
  • 20 Sidransky E, Nalls MA, Aasly JO. Multicenter analysis of glucocerebrosidase mutations in Parkinsonʼs disease. N Engl J Med 2009; 361: 1651-1661
  • 21 Brockmann K, Srulijes K, Pflederer S. GBA-associated Parkinsonʼs disease: reduced survival and more rapid progression in a prospective longitudinal study. Mov Disord 2015; 30: 407-411
  • 22 Healy DG, Falchi M, OʼSullivan SS. Phenotype, genotype, and worldwide genetic penetrance of LRRK2-associated Parkinsonʼs disease: a case-control study. Lancet Neurol 2008; 7: 583-590
  • 23 Pirker W, Katzenschlager R, Hallett M. Pharmacological treatment of tremor in Parkinsonʼs disease revisited. J Parkinsons Dis 2023; 13: 127-144
  • 24 Li H, Han S, Feng J. Delirium after Deep Brain Stimulation in Parkinsonʼs Disease. Parkinsons Dis 2021; 2021: 8885386
  • 25 Dafsari HS, Reker P, Stalinski L. Quality of life outcome after subthalamic stimulation in Parkinsonʼs disease depends on age. Mov Disord 2018; 33: 99-107
  • 26 Marras C, Chaudhuri KR, Titova N. Therapy of Parkinsonʼs disease subtypes. Neurotherapeutics 2020; 17: 1366-1377
  • 27 Chan GH. The role of genetic data in selecting device-aided therapies in patients with advanced Parkinsonʼs disease: a mini-review. Front Aging Neurosci 2022; 14: 895430
  • 28 Pagano G, Taylor KI, Anzures-Cabrera J. Trial of prasinezumab in early-stage Parkinsonʼs disease. N Engl J Med 2022; 387: 421-432
  • 29 Cavallieri F, Fraix V, Bove F. Predictors of long-term outcome of subthalamic stimulation in Parkinson disease. Ann Neurol 2021; 89: 587-597
  • 30 Cheshire P, Bertram K, Ling H. Influence of single nucleotide polymorphisms in COMT, MAO-A and BDNF genes on dyskinesias and levodopa use in Parkinsonʼs disease. Neurodegener Dis 2014; 13: 24-28
  • 31 Weintraub D, Posavi M, Fontanillas P. Genetic prediction of impulse control disorders in Parkinsonʼs disease. Ann Clin Transl Neurol 2022; 9: 936-949
  • 32 Titova N, Chaudhuri KR. Personalized medicine in Parkinsonʼs disease: Time to be precise. Mov Disord 2017; 32: 1147-1154