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Clinical differences between early-onset and mid-and-late-onset Parkinson's disease: Data analysis of the Hellenic Biobank of Parkinson's disease

  • Efthalia Angelopoulou
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece

    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece

    Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Maria Bozi
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece
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  • Athina-Maria Simitsi
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece
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  • Christos Koros
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece
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  • Roubina Antonelou
    Affiliations
    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece
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  • Nikolaos Papagiannakis
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece

    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Matina Maniati
    Affiliations
    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Dafni Poula
    Affiliations
    Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Maria Stamelou
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece
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  • Demetrios K. Vassilatis
    Affiliations
    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Ioannis Michalopoulos
    Affiliations
    Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Styliani Geronikolou
    Affiliations
    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
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  • Nikolaos Scarmeas
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 710 West 168th Street, New York, NY 10032, USA
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  • Leonidas Stefanis
    Correspondence
    Corresponding author at: 1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece.
    Affiliations
    1st Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias 72-74, Athens 115 28, Greece

    2nd Department of Neurology, Attikon University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari 124 62, Greece

    Center of Clinical Research, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Soranou Efesiou 4, Athens 115 27, Greece
    Search for articles by this author
Published:September 01, 2022DOI:https://doi.org/10.1016/j.jns.2022.120405

      Highlights

      • Evidence of early-onset PD (EOPD) vs mid-and-late-onset (MLOPD) in Greece is scant.
      • 50 years of age at onset is the usual cut-off point for EOPD.
      • EOPD is more frequently associated with dystonia and motor complications.
      • Bilateral onset and autonomic dysfunction are more frequently associated with MLOPD.
      • These differences shed more light on understanding EOPD vs MLOPD pathophysiology.

      Abstract

      Background

      Age at onset is one of the most critical factors contributing to the clinical heterogeneity of Parkinson's disease (PD), and available evidence is rather conflicting.

      Objective

      The aim of this study is to investigate the clinical differences between early-onset PD (EOPD) and mid-and-late-onset PD (MLOPD) in the Greek population, based on the existing data of the Hellenic Biobank of PD (HBPD).

      Methods

      HBPD contains information of PD cases from two centers in Greece during 2006–2017. Patients with the A53T mutation in the SNCA gene or mutations in the GBA1 gene were excluded. Associations between clinical characteristics (motor and non-motor symptoms, side of onset, first symptom, motor complications) and MLOPD versus EOPD were explored with a single logistic regression model adjusting for gender, family history of PD, disease and dopaminergic therapy duration, disease severity (UPDRS III), levodopa equivalent daily dose, as well as each of the other clinical characteristics.

      Results

      675 patients (129 EOPD, 546 MLOPD) were included. EOPD was more frequently associated with dystonia (OR 0.19, 95% CI 0.08–0.50, p < 0.01) and motor complications (0.23, 0.07–0.76, 0.02), compared to MLOPD. Bilateral onset (9.38, 1.05–84.04, 0.045) and autonomic dysfunction (2.31, 1.04–5.11, 0.04) were more frequently associated with MLOPD.

      Conclusions

      EOPD and MLOPD display distinct clinical profiles, regarding motor and non-motor symptoms, side of onset and motor complications in the Greek population. These differences may reflect diverse pathophysiological backgrounds, potentially attributed to genetic or age-related epigenetic influences.

      Keywords

      Abbreviations:

      CSF (cerebrospinal fluid), EOPD (early-onset Parkinson's disease), HBPD (Hellenic Biobank of Parkinson's disease), LEDD (levodopa equivalent daily dose), LOPD (late-onset Parkinson's disease), MLOPD (mid-and-late-onset Parkinson's disease), MMSE (Mini-Mental State Exam), PD (Parkinson's disease), PPMI (Parkinson's Progression Markers Initiative), OR (Odds Ratio), UPDRS III (Unified Parkinson's Disease Rating Scale III)
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