Abstract
Asymmetry of symptom onset in Parkinson’s disease (PD) is strongly linked to differential diagnosis, progression of disease, and clinical manifestation, suggesting its importance in terms of specifying a therapeutic strategy for each individual patient. To scrutinize the predictive value of this consequential clinical phenomenon as a neuromarker supporting a personalized therapeutic approach, we modeled symptom-side predominance at disease onset based on brain morphology assessed with magnetic resonance (MR) images by utilizing machine learning classification. The integration of multimodal MR imaging data into a multivariate statistical model led to predict left- and right-sided symptom onset with an above-chance accuracy of 96%. By absolute numbers, all but one patient were correctly classified. Interestingly, mainly hippocampal morphology supports this prediction. Considering a different disease formation of this single outlier and the strikingly high classification, this approach proves a reliable predictive model for symptom-side diagnostics in PD. In brief, this work hints toward individualized disease-modifying therapies rather than symptom-alleviating treatments.
Highlights
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases resulting in motor as well as in non-motor dysfunctions
Parkinsonian Syndrome (PS)) that clinically helps to differentiate from atypical forms of PS.[1]. Besides this important role in the definition of PD, side of disease onset and progression of motor impairment were reported to be strongly linked:[1] while a rightsided symptom onset is associated with a more favorable outcome in terms of cognitive impairment, a left-sided symptom onset appears to be associated with a better outcome regarding motor progression.[1,2,3]
We deemed to identify specific morphological markers between disease forms unraveling the enigma of variety in clinical pattern of disease
Summary
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases resulting in motor as well as in non-motor dysfunctions. Despite its heterogeneous clinical manifestation and course, the asymmetry of motor symptoms at the time of diagnosis is a pathological hallmark indicating PD
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
