Related Experiment Video

Updated: Jan 18, 2026

Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
10:28

Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease

Published on: July 24, 2019

16.0K

Differences in Parkinson's Disease Populations: Teaching Hospitals Versus Other Settings and Implications for

Priti Gros1,2,3,4, Connie Marras1,2,3,4, Xuesong Wang4

  • 1Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network Toronto, Toronto, Ontario, Canada.

Movement Disorders : Official Journal of the Movement Disorder Society
|May 30, 2025
PubMed

Insights

Parkinson disease (PD) patients seen at teaching hospitals for disease-modifying therapy (DMT) trials are younger and socioeconomically advantaged. These findings suggest PD clinical trials may not represent the general PD population, highlighting health equity concerns.

Area of Science:

  • Neurology
  • Clinical Trials
  • Health Equity

Background:

  • Parkinson disease (PD) disease-modifying therapy (DMT) trials typically recruit participants from teaching hospitals.
  • It remains unclear if these trial participants accurately represent the broader PD population.

Purpose of the Study:

  • To compare individuals with PD seen by neurologists in teaching hospitals (early disease stage, proxy for DMT trial eligibility) with those seen in other settings.
  • To identify demographic and clinical differences between these groups.

Main Methods:

  • Retrospective cohort study utilizing population-based data from Ontario, Canada (1995-2017).
  • Identified individuals with PD and ≥1 visit to a teaching hospital neurologist within 3 years as a proxy for DMT trial eligibility.
  • Compared demographic factors (age, sex, income, rurality, marginalization) and comorbidities.
  • Assessed time to key clinical milestones (drug escalation, surgery/infusion, home care, dementia, long-term care, death).

Main Results:

  • Out of 19,948 individuals with PD, 22.0% were seen by a teaching hospital neurologist.
  • Individuals seen at teaching hospitals were younger, from more socioeconomically advantaged areas, and had fewer comorbidities.
  • They experienced more drug escalation, surgical/infusion therapies, and home care.
  • Conversely, they had less dementia, long-term care admission, and lower mortality rates compared to those seen in other settings.

Conclusions:

  • Individuals with PD seen early by teaching hospital neurologists differ significantly from the general PD population.
  • Disease-modifying therapy (DMT) trials in PD may potentially exclude individuals with faster disease progression and those from marginalized communities.
  • These disparities underscore significant health equity issues within PD research and care, impacting the generalizability of trial findings.
Abstract

Keywords:
Parkinson's diseaseclinical trialsdisease progressionhealth administrative dataneurologysocial determinants of health

More Related Videos

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation11:12

Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation

Published on: July 16, 2014

23.0K
Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults09:19

Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults

Published on: December 9, 2014

26.2K

Related Concept Videos

Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
995
Parkinson's Disease: Overview01:15

Parkinson's Disease: Overview

Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
1.8K
Clinical Trials01:16

Clinical Trials

Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
10.2K
Clinical Trials: Overview01:11

Clinical Trials: Overview

Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
4.6K
Neural Regulation01:37

Neural Regulation

Digestion begins with a cephalic phase that prepares the digestive system to receive food. When our brain processes visual or olfactory information about food, it triggers impulses in the cranial nerves innervating the salivary glands and stomach to prepare for food.
43.2K
Bioequivalence of Drugs: Drugs with Multiple Indications01:09

Bioequivalence of Drugs: Drugs with Multiple Indications

The concept of therapeutic equivalence (TE) in drugs with multiple indications is complex. A generic drug may be therapeutically equivalent to a brand-name product for one specific indication, but this doesn't necessarily mean it's equivalent for all other indications. Evidence of TE in one patient group and bioequivalence shown in healthy volunteers can support—but not confirm—TE for other indications. However, definitive proof requires individual clinical studies for each...
151