Predicting progression in Parkinsons disease

Predicting the rate of motor progression in Parkinson’s disease (PD) at the time of diagnosis remains challenging.

Several early clinical features have been associated with differences in motor progression, but evidence supporting these associations has been inconsistent and their combined prognostic value using only routinely available clinical information remains uncertain.

In a prospective PD cohort with long-term follow-up, older age, bilateral symmetric parkinsonism and rapid eye movement sleep behaviour disorder (RBD) at diagnosis were associated with faster progression to Hoehn and Yahr stage 3.

A simple prognostic model based on these three routinely available clinical variables showed good discriminative performance for predicting progression to Hoehn and Yahr stage 3 in both the development cohort and an independent external validation cohort from the Parkinson’s Progression Markers Initiative.

For a given age, the highest risk of progression was observed in patients with both bilateral...