A study published today takes the first major steps toward predicting who will get Parkinson's disease and what the course of their progression will be.
A study published today takes the first major steps toward predicting who will get Parkinson's disease and what the course of their progression will be.
Now, there's no way of telling someone's vulnerability or path until after they've lived with the disease, which can include tremors, unsteady gait, depression and digestive problems.
"If we can't measure the disease's progression, we can't measure how to block it either," said Ole Isacson, a professor of neurology at Harvard Medical School, who was not involved in the study.
The new study, published in the journal JAMA Neurology, examined the spinal fluid of 63 people newly diagnosed with Parkinson's and 39 healthy people without the disease. It found subtle differences between their levels of certain proteins known to be involved in the disease.
The study also found a different pattern of proteins in people with the most physically debilitating form of the disease, suggesting for the first time that there may be different types of the disease with different potential treatments.
"If there really is different biology that predicts different symptoms, you might actually start to be able to segment the population by treatment, which we haven't been able to do in Parkinson's besides using trial and error," said Todd Sherer, chief executive officer of The Michael J. Fox Foundation, a leading funder of Parkinson's research, which supported the study.
The study is the first significant finding from the Parkinson's Progression Markers Initiative, a major multiyear trial tracking the biology of Parkinson's over time. The study will eventually examine 400 patients and 200 healthy people as a control group.
"By following people systematically you hope to gain the greatest insight into the many nooks and crannies of what is a complex disease process," said Leslie Shaw, a study leader and professor at the University of Pennsylvania.
"The hope that everyone has is that we'd be able to intervene earlier," Shaw said, which would be "better for helping those people have a better lifestyle."
As many as 1 million Americans and roughly 5 million others around the world are living with Parkinson's, the Fox Foundation estimates.
As with many age-related diseases, by the time Parkinson's becomes evident, it has been brewing in the body for years if not decades, said Sherer, a neuroscientist.
The study measured four proteins in the spinal fluid that are believed to gum up the brains of Parkinson's patients: alpha-synuclein and two types of tau, which can all clog the inside of the neurons, and beta-amyloid, which collects on the outside of cells.
"It's the management of the proteins that goes wrong" in Parkinson's, Isacson said. Those with the lowest levels of amyloid beta and tau were most likely to have a particularly challenging form of the disease — the first time different courses of the disease have been identifiable in the patients' biology.
By better understanding Parkinson's, Isacson said, we may also gain insights into normal aging. Parkinson's, he said, is a disease of the aging brain. "Eventually it affects everyone."
Later phases of the study will examine hundreds more patients to make sure these findings hold up, will look at people with risk factors to see if these protein indicators are present earlier, and will follow volunteers over time to see how the protein levels change.
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