Benign versus malignant Parkinson disease: the unexpected silver lining of motor complications
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Benign versus malignant Parkinson disease: the unexpected silver lining of motor complications Aristide Merola1 · Alberto Romagnolo2 · Alok K. Dwivedi3 · Alessandro Padovani4 · Daniela Berg5,6 · Pedro J. Garcia‑Ruiz7 · Margherita Fabbri2,8 · Carlo Alberto Artusi2 · Maurizio Zibetti2 · Leonardo Lopiano2 · Andrea Pilotto4,9 · Sonia Bonacina4 · Francesca Morgante10,11 · Kirsten Zeuner5 · Christopher Griewing5 · Eva Schaeffer5 · Federico Rodriguez‑Porcel12 · Marcelo Kauffman13 · Pierpaolo Turcano4 · Lais M. de Oliveira15 · Giovanni Palermo16 · Emily Shanks17 · Francesca Del Sorbo18 · Salvatore Bonvegna19 · Rodolfo Savica14 · Renato P. Munhoz20 · Roberto Ceravolo16 · Roberto Cilia19 · Alberto J. Espay17 Received: 10 March 2020 / Revised: 23 May 2020 / Accepted: 26 May 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective We sought to evaluate demographic, clinical, and habits/occupational variables between phenotypic extremes in Parkinson’s disease (PD). Methods Databases from nine movement disorders centers across seven countries were retrospectively searched for subjects meeting criteria for very slowly progressive, benign, PD (bPD) and rapidly progressive, malignant, PD (mPD). bPD was defined as Hoehn and Yahr (H&Y) stage ≤ 3, normal cognitive function, and Schwab and England (S&E) score ≥ 70 after ≥ 20 years of PD (≥ 10 years if older than 60 at PD onset); mPD as H&Y > 3, S&E score 60 years-old). (2) mPD was defined as the combination of H&Y stage > 3 (daily medication-ON condition), significant ADL impairment documented by a score
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