Abstract Details

Title Understanding Parkinson’s Disease Subtypes Through Patients’ Voice: A Data-driven Analysis of the Parkinson’s Disease Patient Report of Problems (PD-PROP)

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 17-004

Objective To explore heterogeneity and identify data-driven subtypes in early Parkinson’s disease (PD) derived from patients’ perspectives using self-reported most bothersome symptoms.

Background PD is a heterogeneous disorder with diverse motor and non-motor features across individuals. Traditional subtyping based on clinician-rated or biomarker measures may overlook aspects most meaningful to people with PD (PwP). The PD patient report of problems (PD-PROP), a large-scale collection of verbatim patient reports from the Fox Insight study, was curated using a human-in-the-loop natural language processing and machine-learning framework, enabling exploration of PD subtypes grounded in PwP’s own experiences.

Design/Methods Data were obtained from the Fox Insight longitudinal study via its online platform, the Fox DEN (Data Exploration Network), in July 2025, consisting of the PD-PROP, baseline demographics, and self-reported outcome variables namely the PDQ-8, UPDRS-II, NMS-QUEST, PDAQ-15, EQ-5D-5L, and a composite health score. We included 10,464 individuals (mean age 65.0±10.1 years; 54.5% male) with self-reported PD, PD diagnosis for <3 years and valid baseline PD-PROP. We classified 67 curated symptoms into 30 motor and non-motor domains by consensus. For exploratory subtyping, we conducted K-means clustering.

Results Among 10,464 participants with PD <3 years, a four-cluster solution emerged based on the silhouette statistic: Cluster 1 (excessive daytime sleepiness/fatigue), Cluster 2 (urinary, cognitive, and fluctuation symptoms), Cluster 3 (motor-dominant), and Cluster 4 (pain/dystonia). Cluster 3 comprised most participants (67.9%), Cluster 4 members were significantly younger, and Cluster 2 showed the highest rate of probable REM sleep behavior disorder (RBD) (62.2%) and lowest self-perceived overall health, highest PDQ-8 (poorest quality of life), highest UPDRS-II (highest motor burden), and lowest PDAQ-15 (worst cognitive-functional abilities).

Conclusions Patient-reported symptom profiles from the PD-PROP identified four distinct PD subtypes, highlighting the value of patient-reported data to evaluate clinical heterogeneity early in clinical disease.

Authors/Disclosures
Seyed-Mohammad Fereshtehnejad, MD, PhD (University of British Columbia) PRESENTER	Dr. Fereshtehnejad has nothing to disclose.
Tiago Mestre, MD, MSC (University of Ottawa)	Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CHDI. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for PTC. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ipsen. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Mestre has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. The institution of Dr. Mestre has received research support from CIHR. The institution of Dr. Mestre has received research support from Ontario Research Fund. The institution of Dr. Mestre has received research support from MJFF. The institution of Dr. Mestre has received research support from Parkinson Canada. The institution of Dr. Mestre has received research support from University of Ottawa/PRC.
Connie C. Marras, MD (Toronto Western Hospital)	Dr. Marras has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine Biosciences. The institution of Dr. Marras has received research support from Theravance Inc. The institution of Dr. Marras has received research support from Centogene.

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