Parkinson’s disease is a slowly progressing neurodegenerative disease resulting in motor symptoms such as a tremor, slowed movements and gait and balance issues. As the disease progresses, cognitive problems can develop as well. Yet thanks to advances in treatment, people with Parkinson’s can live complete, quality lives.
April is Parkinson’s Disease Awareness Month, and it’s with that in mind that I’m excited to look at where the science around Parkinson’s disease has come, and how we are on a cusp of treatment and diagnostic breakthroughs. Together with our patients, we as physicians and scientists hope to continue our mission to develop new ways to identify, slow and potentially reverse the effects of Parkinson’s disease over the next 10 years.
In Parkinson’s, specific nerve cells in the brain gradually break down and die, which limits the production of dopamine, the essential neurotransmitter for normal motor function in the human brain. This lack of dopamine alters brain function, causing slow movements and muscle rigidity. Why these cells die remains a mystery, and given the many causes of neurological disorders such as Parkinson’s, a precise cause may not be identified.
That said, major technological advances have revolutionized approaches to the care of Parkinson’s patients. The first hurdle is diagnosing the disease early, before the onset of disabling motor symptoms. Early diagnosis is the key to personalized therapy that can slow disease progression before disability becomes severe.
Helping us achieve this, advances in brain imaging techniques allow us to pinpoint the most affected parts of the brain, which can then be targeted by treatment. Maps of brain function obtained with PET and MRI scans allow us to pull back the curtain and track the disease’s progression over time. Our group at the Feinstein Institutes for Medical Research in New York also has developed computer algorithms that use imaging for early diagnosis and to track the disease in individual patients. With these tools in hand, we can test the efficacy of new treatments such as stem cell transplants and immunotherapies.
The world is now very familiar with the idea of immunotherapies. Think of the COVID-19 vaccine: It’s a way to introduce antibodies to the body to help protect against a virus. While there are no vaccines for Parkinson’s disease, scientists are working on methods to administer antibodies that target affected areas of the brain, thereby halting disease progression.
Lastly, there is growing interest in bioelectronic medicine – techniques to stimulate or inhibit critical brain circuits, thereby modulating the effects of disease on the whole brain. While deep brain stimulation has been used to treat Parkinson’s for over 20 years, novel applications of the technology continue to be developed in conjunction with the imaging tools.
These developments are important, but all require further investigation – and the participation of volunteers in research. Many of the new therapies are in the clinical trial phase, and it is imperative that the Parkinson’s diagnosis be confirmed before patient enrollment. Apart from affirming the diagnosis, patient participation in imaging studies is essential for the objective assessment of treatment outcomes. Indeed, the translation of drugs from the experimental laboratory to the doctor’s office will remain limited without considering new imaging measures, as well as genetic biomarkers, to help gauge their effects on disease pathways in individual patients.
As we take a moment to pause and think about Parkinson’s disease this month, I encourage you to sign up to be a participant in a research study. If you or someone you know has been diagnosed with Parkinson’s disease, consider helping yourself and those who may become diagnosed in the future by volunteering for an imaging study at the Feinstein Institutes. If you are interested in clinical trials, check out the government’s database at ClinicalTrials.gov.
With your help, coupled with the advancements in technology and medical science, we might be able to slow or even stop the progression of this disabling disorder within the next decade.