Article Text

Parkinson's disease subtypes: lost in translation?
  1. Connie Marras1,2,
  2. Anthony Lang1,2
  1. 1Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University of Toronto, Ontario, Canada
  2. 2The Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, University of Toronto, Ontario, Canada
  1. Correspondence to Dr C Marras, Toronto Western Hospital, Movement Disorders Centre, 399 Bathurst St 7 MCL, Toronto, ON M5T 2S8, Canada; cmarras{at}


Like many neurodegenerative disorders, Parkinson's disease (PD) is clinically highly heterogeneous. A number of studies have proposed and defined subtypes of PD based on clinical features that tend to cluster together. These subtypes present an opportunity to refine studies of aetiology, course and treatment responsiveness in PD, as clinical variability must represent underlying biological or pathophysiological differences between individuals. In this paper, we review what subtypes have been identified in PD and the validation they have undergone. We then discuss what the subtypes could tell us about the disease and how they have been incorporated into studies of aetiology, progression and treatment. Finally, with the knowledge that they have been incorporated very little into PD clinical research, we make recommendations for how subtypes should be used and make some practical recommendations to address this lack of knowledge translation.

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  • Funding CM is supported by a New Investigator Award from the Canadian Institutes of Health Research. The Morton and Gloria Shulman Movement Disorders Centre receives support from a Centre of Excellence grant from the National Parkinson's Foundation.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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