Objective The clinical heterogeneity of Parkinson's disease (PD) may point at the existence of subtypes. Aim of this study is to assess the severity of depression in patients with PD of different clinical subtypes. Methods A broad spectrum of motor variables and nonmotor features, including tremor, rigidity, hypokinesia, postural instability gait disorder, fatigue, constipation, apathy, depression, global cognitive function, as well as the clinical data and demographics, including age, gender, age at disease onset, course of disease, were collected in 600 Chinese PD patients. The PD subtypes were classified using k-means (k=4) cluster analysis according to the clinical data. Their depression was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Results The cluster analysis indicated 4 main subtypes: Subtype 1 was mildly affected in all domains, and the ratio of tremor score to non-tremor score was the highest among the 4 clusters. Subtype 2 was severely in all motor and nonmotor symptoms. Subtype 3 showed intermediate severity in most domains. Subtype 4 was characterized by short course and rapid progression of disease. 43.5% of cases were identified as in depression. There was significant difference in scores of CES-D among the 4 subtypes (P<0.05). Conclusion Depression occurred frequently in patients with PD with some clinical heterogeneity.

Objective To assess the sleep disturbance in patients with early-stage idiopathic Parkinson's disease of different clinical subgroups. Methods Four hundred and eighty-six Chinese PD patients were selected as our subjects. Their clinical data including demographics,a broad spectrum of motor variables and non motor features,including tremor,rigidity,hypokinesia,PIGD,motor phenotypes,disease progression,fatigue, constipation,apathy,depression,global cognitive function and L-dopa complications were collected and analyzed by cluster analysis. The PD subtypes were classified by using k-means cluster analysis according to the clinical data. The cluster analysis indicated four main subtypes:subtype 1 was mildly affected in all domains;subtype 2 was severely affected on all motor and non motor symptoms;subtype 3 showed intermediate severity in most domains;subtype 4 characterized by short disease duration and rapid disease progression. Then compared the sleep disturbance among different subtypes with Pittsburgh Sleep Quality Index( PSQI). Results Two hundred and thirty-six cases(48. 6%)were identified as suffering from sleep disturbance. Of which,female PD with sleep disturbance rate was 55. 1%( 130/236 )and male was 44. 9%( 106/236 ). Female was prone to develop sleep disturbance at early stage than male. PSQI scores in subtype 1,2,3 and 4 were(6. 09 ± 3. 72),(9. 36 ± 4. 24), (7. 82 ±4. 35)and(9. 09 ± 4. 73)respectively and the difference was significant(F =14. 503,P =0. 000) . Conclusion Sleep disturbance occurs frequently in patients with early-stage Parkinson's disease and exist clinical heterogeneity.

ObjectiveTo investigate the relationship between polymorphism in the PITX3 gene and hereditary susceptibility of Parkinson's disease (PD). MethodsThree PITX3 single nucleotide polymorphisms ( SNPs ),including rs2281983,rs4919621 and rs3758549 were examined in 509 late-onset PD patients ( LOPD ),290 early-onset PD(EOPD) and 494 healthy controls.Genotyping was carried out in all subjects using a ligase detection reaction( LDR).ResultsAllele and genotype frequencies did not differ between the 799 PD patients and 494 controls ( P values of genotype were 0.494,0.343,0.951 ; P values of allele were 0.369,0.297,0.823 ),between 509 LOPD patients and 494 controls ( P values of genotype were 0.522,0.350,0.630 ; P values of allele were 0.413,0.328,0.571 ),between 290 EOPD patients and 494 controls ( P values of genotype were 0.499,0.492,0.552; P values of allele were 0.321,0.301,0.931 ),and between 509 LOPD and 290 EOPD patients ( P values of genotype were 0.577,0.710,0.127 ; P values of allele were 0.346,0.472,0.077 ) for all three SNPs (rs2281983,rs4919621 and rs3758549).There were no association petween the three PITX3 SNPs and PD.ConclusionThree PITX3 SNPs do not contribute to the risk of developing PD in Chinese population.

Objective:To investigate the characteristics and associated factors of depression in elderly patients with Parkinson's disease(PD).Methods:A total of 1138 elderly PD patients from Xuanwu Hospital of Capital Medical University were consecutively enrolled.The Hamilton Depression 17-item Scale(HAMD-17)was used to diagnose depression(scores ≥14). The depressive characteristics of PD patients with depression and those without depression were compared, and Logistic regression model was used to analyze the clinical risk factors of depression in PD patients.Results:Among the 1 138 PD patients, 233 cases had depression.The incidence of depression in PD patients was 20.5%, and the treatment rate was only 6.0%(14 cases). The main symptoms of depression in PD patients included sleep disturbance(101 cases, 43.3%), depression(57 cases, 24.5%), work and interest loss(49 cases, 21%). Compared to PD patients without depression, PD patients with depression were more likely women(49.4% vs36.3%), and had lower cognitive scores[(25.56 ± 4.22)scores vs(27.07 ± 3.08)scores], higher rate of freezing of gait(51.0% vs24.0%), higher incidence of disability(87.1% vs28.5%)( P<0.05). A comparison of each part of the unified Parkinson's disease rating scale(UPDRS)between the two groups revealed that the scores of activities of daily living[(16.52 ± 8.71)scores vs(10.15 ± 5.48)scores], the motor examination[(33.78 ± 19.48)scores vs(22.87 ±13.08)scores]and the complications of therapy[2.0(0.0, 6.0)scores vs0.0(0.0, 2.0)scores]were higher in the PD patients with depression group than in the PD patients without depression group( P<0.05). Logistic regression analysis showed that women( OR=1.532, 95% CI: 1.073-2.187, P=0.019), disability( OR=6.357, 95% CI: 4.399-9.186, P<0.001), activities of daily living evaluated by UPDRS( OR=1.093, 95% CI: 1.043-1.146, P<0.001)and motor complications( OR=1.100, 95% CI: 1.014-1.193, P=0.022)were independent risk factors for PD depression. Conclusions:Depression was common in PD patients and usually manifested as sleep disturbance and low motivation, women, motor complications, disability and decreased quality of daily living were independent risk factors for depression.

OBJECTIVETo study polymorphisms of catechol-O-methyltransferase (COMT) and monoamine oxidase B (MAO-B) genes among Chinese patients with Parkinson's disease.

METHODSGenotypes of the COMT and MAO-B genes of 1408 patients with Parkinson's disease was sequenced using Sanger method. And these patients were recruited by Chinese Parkinson Study Group from 29 research centers throughout the country.

RESULTSThe genotypic frequencies of COMT rs4680 AA, AG, GG were 8.9%, 42.0% and 49.1%. Those of rs4818 CC, CG, GG were 42.5%, 45.6% and 11.9%, respectively. The genotype frequencies of MAO-B rs1799836 A/AA, AG, G/GG were 74.4%, 14.1% and 11.5%, respectively. The haplotype formed by COMT rs4680 (GG) and MAO-B rs1799836 (A/AA) genotype has a frequency of 36.86%.

CONCLUSIONPolymorphisms of COMT and MAO-B genes has a unique characteristics among Chinese patients with Parkinson's disease. They may be related with differences in drug response in such patients.

Asian Continental Ancestry Group ; genetics ; Catechol O-Methyltransferase ; genetics ; Female ; Genotype ; Humans ; Male ; Monoamine Oxidase ; genetics ; Parkinson Disease ; genetics ; Polymorphism, Genetic