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PD Motor Subtypes – Prognosis — SCE Neurology MCQ

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ModerateMovement DisordersPD Motor Subtypes – PrognosisSCE Neurology

A 60-year-old man with recently diagnosed Parkinson's disease asks about his prognosis. He has a tremor-dominant phenotype with minimal gait disturbance. What is known about PD motor subtypes and prognosis?

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Correct answer: C — Tremor-dominant PD generally has a slower rate of motor progression and better prognosis compared with the postural instability and gait difficulty (PIGD) dominant subtype

PD motor subtypes influence prognosis: tremor-dominant PD has slower motor progression, lower rates of cognitive decline, and better overall prognosis compared with the PIGD-dominant subtype (which has faster progression, earlier development of cognitive impairment, more falls, and higher mortality). The akinetic-rigid subtype has an intermediate prognosis. However, subtype can change over time — many tremor-dominant patients eventually develop PIGD features. A: Subtypes differ in prognosis. C: Tremor-dominant has the better prognosis. D: PIGD has the worse prognosis. E: Motor subtype significantly influences prognosis.

Reference: Jankovic PD Motor Subtypes; NICE NG71