title: Exploring determinants of progression in Parkinson's disease. Is there a difference among Jewish ethnic groups?
abstract: BACKGROUND
  Parkinson's disease (PD) displays an individually variable rate of progression, of which the underlying mechanisms are largely unknown, but may involve genetic factors. In this study, we aimed to explore the effect of ethnic origin on PD progression rate in Israeli Jews, as expressed by time from onset until reaching Hoehn and Yahr stage 3 (HY3).
  
  
  METHODS
  Consecutive patients with PD followed bi-annually at the Movement Disorders Institute at Sheba Medical Center, were included. Demographic data and clinical information, including age at PD onset (AO), H&Y staging, and family history of PD, were collected. Ethnicity was determined based on the parents' origin and was categorized as Ashkenazi Jews (AJ), Yemenite Jews (YJ), North African Jews (NAJ) and Oriental Jews (OJ) excluding YJ. Associations between the above variables and the time to HY3 were determined using Cox proportional hazards model. Survival curves were derived from the model.
  
  
  RESULTS
  Of 707 patients [430 males, AJ: 458, YJ: 37, NAJ: 75 and OJ: 137] included in the analysis, 343 had reached HY3. In a multivariate analysis, a longer time to HY3 was significantly associated with a younger AO (HR = 1.07, p < 0.001). YJ showed a significantly shorter time to HY3 compared to AJ and OJ, but not compared to NAJ. Time to HY3 was significantly shorter for NAJ than for OJ.
  
  
  CONCLUSIONS
  Jewish PD patients of Yemenite and North African origin may have a more rapid progression of PD, compared to those of Ashkenazi and Oriental origin, suggesting distinctive genetic influences.
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Orlev
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Yahalom
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: O S
authors.initials: OS
authors.lastname: Cohen
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
authors.forename: S
authors.initials: S
authors.lastname: Elincx-Benizri
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Kozlova
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Inzelberg
authors.affiliation: Department of Epidemiology and Preventive Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: U
authors.initials: U
authors.lastname: Goldbourt
authors.affiliation: Parkinson Disease and Movement Disorders Institute, Sagol Neuroscience Center and Department of Neurology, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: shassin@post.tau.ac.il.
authors.forename: S
authors.initials: S
authors.lastname: Hassin-Baer
mesh_terms: D000352:Africa, Northern; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007599:Judaism; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology* / Q000208:ethnology*; D012737:Sex Factors; D016019:Survival Analysis; D015006:Yemen
keywords: Ashkenazi; Jewish; Oriental; Parkinson's disease; Progression; Yemenite