{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:31:52Z","timestamp":1788474712824,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Various classifications have been proposed to subtype Parkinson's disease (PD) based on their motor phenotypes. However, the stability of these subtypes has not been properly evaluated.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> The goal of this study was to understand the distribution of PD motor subtypes, their stability over time, and baseline factors that predicted subtype stability.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Participants (<jats:italic>n<\/jats:italic> = 170) from two prospective cohorts were included: the Early PD Longitudinal Singapore (PALS) study and the National Neuroscience Institute Movement Disorders Database. Early PD patients were classified into tremor-dominant (TD), postural instability and gait difficulty (PIGD), and indeterminate subtypes according to the Movement Disorder Society's Unified PD Rating Scale (MDS-UPDRS) criteria and clinically evaluated for three consecutive years.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> At baseline, 60.6% patients were TD, 12.4% patients were indeterminate, and 27.1% patients were PIGD subtypes (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). After 3 years, only 62% of patients in TD and 50% of patients in PIGD subtypes remained stable. The mean levodopa equivalent daily dose (LEDD) was higher in the PIGD subtype (276.92 \u00b1 232.91 mg; <jats:italic>p<\/jats:italic> = 0.01). Lower LEDD [<jats:italic>p<\/jats:italic> &amp;lt; 0.05, odds ratio (OR) 0.99, 95% confidence interval (CI): 0.98\u20130.99] and higher TD\/PIGD ratios (<jats:italic>p<\/jats:italic> &amp;lt; 0.05, OR 1.77, 95% CI: 1.29\u20132.43) were independent predictors of stability of TD subtype with an area under the curve (AUC) of 0.787 (95%CI: 0.669\u20130.876), sensitivity = 57.8%, and specificity = 89.7%.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Only 50\u201362% of PD motor subtypes as defined by MDS-UPDRS remained stable over 3 years. TD\/PIGD ratio and baseline LEDD were independent predictors for TD subtype stability over 3 years.<\/jats:p>","DOI":"10.3389\/fneur.2021.704906","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:44:35Z","timestamp":1632530675000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Stability of MDS-UPDRS Motor Subtypes Over Three Years in Early Parkinson's Disease"],"prefix":"10.3389","volume":"12","author":[{"given":"Abhijeet K.","family":"Kohat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Y. E.","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan S. Y.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole S. 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