Related Experiment Video

Updated: Jul 12, 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

Disease-Duration-Specific Percentiles for Prospective Subtyping of Parkinson's Disease: A PPMI-Based Study

Ahmed Negida1, Nitai Mukhopadhyay2, Brian D Berman1

  • 1Parkinson's and Movement Disorders Center, Virginia Commonwealth University, Richmond, Virginia, USA.

Movement Disorders Clinical Practice
|July 10, 2026
PubMed
Abstract

Insights

This study establishes year-specific thresholds for Parkinson's disease (PD) subtypes, enabling better patient stratification in clinical trials. These new criteria help identify diffuse malignant (DM), intermediate (IM), and mild-motor predominant (MMP) PD progression more accurately.

Area of Science:

  • Neurology
  • Clinical Trials
  • Biostatistics

Background:

  • Parkinson's disease (PD) exhibits significant clinical heterogeneity, complicating clinical trial design due to variable progression rates.
  • Existing data-driven subtypes (DM, IM, MMP) show prognostic value but lack disease duration-specific thresholds for prospective trial use.

Purpose of the Study:

  • To define year-specific percentile thresholds for motor and non-motor measures within the first five years post-diagnosis.
  • To enable real-time PD subtyping and assess progression patterns across established subtypes.

Main Methods:

  • Analysis of de-identified PPMI data from 1030 idiopathic PD individuals.
  • Computation of annual percentiles for composite motor scores and non-motor measures (MoCA, RBDSQ, SCOPA-AUT).
  • Application of thresholds (75th percentile for motor/RBDSQ/SCOPA-AUT, 25th for MoCA) for annual DM/IM/MMP classification and assessment of subtype stability and progression using PPMI milestones.

Main Results:

  • Percentile thresholds progressively worsened over time, mirroring cohort decline.
  • Prevalence estimates: DM-PD (19.2-20.5%), IM-PD (41.8-44.4%), MMP-PD (35.1-38.8%).
  • DM-PD and IM-PD demonstrated significantly faster progression compared to MMP-PD.

Conclusions:

  • Established disease duration-specific percentiles for the DM/IM/MMP subtyping model.
  • Supports prospective application for patient stratification and enrichment in disease-modifying PD trials.
Keywords:
Parkinson's diseasediffuse‐malignantstrartificationsubtypestrial enrichment

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