Data-driven phenotypic clustering of Parkinson’s disease patients seeking deep brain stimulation (P6-11.008)

Abstract

<h3>Objective:</h3> To identify unique phenotypic clusters amongst participants in RAD-PD (Registry for the Advancement of Deep Brain Stimulation in Parkinson’s Disease). <h3>Background:</h3> RAD-PD is a longitudinal quality improvement registry that systematically characterizes participants through patient reported outcome measures and clinician administered scales, with the overarching goal of improving outcomes from deep brain stimulation (DBS) in PD. Multiple investigations demonstrate that DBS improves motor function and quality of life (QoL). Less is understood about non-motor outcomes and determinants. <h3>Design/Methods:</h3> A variety of demographic/social, disease-related, motor, non-motor, quality of life, and treatment-related datapoints are captured in RAD-PD. Continuous data variables from participants with complete pre-operative assessments were analyzed using R software. A pairs plot correlation analysis, principal component analysis (PCA) and hierarchical clustering analysis (HCA) with normalized data were conducted. <h3>Results:</h3> Data from 133 subjects were included. Amongst 32 categories of RAD-PD data covering demographic/disease (n=5), non-motor (n=18), motor (n=3), cognitive (n=3) and QoL (n=3) variables, all 3 QoL scale scores were strongly correlated with each other (r=0.47–0.64, p&lt;0.0001), and were otherwise most highly correlated (r&gt;0.4) with measures of depression, anxiety, sleep/fatigue, NMSS total, mood/cognition, IADLs, and MDS-UPDRS part 2. Motor and disease-related variables did not strongly correlate with other variables. PCA revealed two dimensions that together explain 38.7% of the variance in the data, driven mainly by quality of life, NMSS domain/total scores, and QUIP-RS subscores/total scores. HCA classified individuals into two groups that were differentiated based on non-motor (NMSS and ICD scores), cognitive, and QoL features. <h3>Conclusions:</h3> While recommendations for DBS in PD are often driven by motor disease features, QoL and non-motor symptoms are prominent features that are closely related and can be combined to classify phenotypic clusters. Such data-driven classifications can be used in the RAD-PD cohort for novel outcomes analyses and predictive modeling. <b>Disclosure:</b> Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Bracket Global LLC. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for St. Jude Medical, Inc. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Spark Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpha Omega. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BlueRock Therapeutics. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PhotoPharmics. The institution of Dr. Jimenez Shahed has received research support from Michael J Fox Foundation. The institution of Dr. Jimenez Shahed has received research support from Amneal. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with Movement Disorders Society. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Faculty with American Academy of Neurology. Dr. Jimenez Shahed has received personal compensation in the range of $500-$4,999 for serving as a Grant Reviewer with Parkinson Foundation. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant on Research Grant with Florida Atlantic University. Dr. Jimenez Shahed has received personal compensation in the range of $0-$499 for serving as a Speaker with Tourette Association of America. Dr. Jimenez Shahed has received personal compensation in the range of $10,000-$49,999 for serving as a Speaker with NACCME. The institution of Arthur Berg has received research support from U.S. Army Medical Research and Development Command