Transitioning from Subtyping to Precision Medicine in Parkinson's Disease: A Purpose‐Driven Approach

Author:

Marras Connie1,Fereshtehnejad Seyed‐Mohammad2ORCID,Berg Daniela3,Bohnen Nicolaas I.4ORCID,Dujardin Kathy5ORCID,Erro Roberto6ORCID,Espay Alberto J.7,Halliday Glenda8ORCID,Van Hilten Jacobus J.9,Hu Michele T.10,Jeon Beomseok11ORCID,Klein Christine12,Leentjens Albert F.G.13ORCID,Mollenhauer Brit14ORCID,Postuma Ronald B.15ORCID,Rodríguez‐Violante Mayela16ORCID,Simuni Tanya17,Weintraub Daniel18,Lawton Michael19,Mestre Tiago A.120ORCID

Affiliation:

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

2. Division of Neurology, Department of Medicine The Ottawa Hospital, University of Ottawa Ottawa Ontario Canada

3. Department of Neurology Christian‐Albrechts‐University Kiel Germany

4. Departments of Radiology & Neurology University of Michigan, University of Michigan Udall Center Ann Arbor Michigan USA

5. Center of Excellence for Parkinson's Disease CHU Lille, Univ Lille, Inserm, Lille Neuroscience & Cognition Lille France

6. Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana” Neuroscience Section, University of Salerno Baronissi Italy

7. James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology University of Cincinnati Cincinnati Ohio USA

8. Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences University of Sydney Sydney New South Wales Australia

9. Department of Neurology Leiden University Medical Center Leiden The Netherlands

10. Nuffield Department of Clinical Neurosciences, Oxford University and John Radcliffe Hospital, West Wing, Neurology Department, Level 3 Oxford United Kingdom

11. Department of Neurology Seoul National University Hospital Seoul South Korea

12. Institute of Neurogenetics University of Luebeck Luebeck Germany

13. Department of Psychiatry Maastricht University Medical Center Maastricht The Netherlands

14. Paracelsus‐Elena‐Klinik, Kassel, Department of Neurology University Medical Center Goettingen Kassel Germany

15. Department of Neurology Montreal Neurological Institute, McGill University Montreal Quebec Canada

16. National Institute of Neurology and Neurosurgery Mexico City Mexico

17. Feinberg School of Medicine Northwestern University Chicago Illinois USA

18. Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania; Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center Philadelphia Pennsylvania USA

19. Population Health Sciences, Bristol Medical School University of Bristol Bristol United Kingdom

20. Parkinson's Disease and Movement Disorders Center, Division of Neurology, Department of Medicine The Ottawa Hospital Research Institute, The University of Ottawa Brain and Research Institute Ottawa Ontario Canada

Abstract

AbstractThe International Parkinson and Movement Disorder Society (MDS) created a task force (TF) to provide a critical overview of the Parkinson's disease (PD) subtyping field and develop a guidance on future research in PD subtypes. Based on a literature review, we previously concluded that PD subtyping requires an ultimate alignment with principles of precision medicine, and consequently novel approaches were needed to describe heterogeneity at the individual patient level. In this manuscript, we present a novel purpose‐driven framework for subtype research as a guidance to clinicians and researchers when proposing to develop, evaluate, or use PD subtypes. Using a formal consensus methodology, we determined that the key purposes of PD subtyping are: (1) to predict disease progression, for both the development of therapies (use in clinical trials) and prognosis counseling, (2) to predict response to treatments, and (3) to identify therapeutic targets for disease modification. For each purpose, we describe the desired product and the research required for its development. Given the current state of knowledge and data resources, we see purpose‐driven subtyping as a pragmatic and necessary step on the way to precision medicine. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Publisher

Wiley

Subject

Neurology (clinical),Neurology

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