Researchers from the Radboudumc, together with six partners from other countries, have been awarded a €1.5 million EU grant for research into early symptoms of Parkinson's disease. They will link the development of Parkinson's from the first signs to MRI images, genetic analyses and complaints experienced by patients. In this way, the researchers are charting the various subtypes of the disease and hope to be able to recognize the early stages earlier in the future.
Long before a patient is diagnosed, there are already signs and symptoms that indicate a very early stage of Parkinson's disease. These symptoms differ largely between patients. Sometimes the disease begins with loss of smell. This process begins in the olfactory bulb, the brain area responsible for smell. Other people's first complaint is that they live out their dreams at night: they cry out in their sleep and bang around. The cause is loss of cells in the brain stem. In still others, depression is the first sign.
This indicates that Parkinson's disease can start in different parts of the brain. Neurologist Rick Helmich and neuroscientist Roshan Cools of the Radboudumc would like to know how Parkinson’s propagates through the brain in different ways and how those routes are linked to symptoms. To find out, they receive together with six international centers a grant of 1.5 million euros from the European Union's Joint Program Neurodegenerative Disease (JPND). Rick Helmich from the Donders Institute is coordinator of the three-year project, called CONTROL-PD.
"In the Netherlands sixty thousand patients are struggling with the disease, worldwide there are seven million. Parkinson's is one of the most rapidly growing diseases in the world," explains Helmich. "It was already known that nerve cells in the brain die, especially dopamine cells. But exactly how the process of decay occurs and how it travels through the brain, we don't know yet. In what order do different brain regions become affected, and what does this mean for symptoms that patients have? This is where we see major differences between patients. We want to find out how Parkinson's disease affects the brain."
For the study, the seven participating countries will merge their data sets with a total of thousands of patients. Some of these have already been diagnosed with Parkinson's, but the datasets also contain data from people with only early symptoms, such as loss of smell. MRI scans and blood are available from all those people. All participants in the study will perform a number of tasks on the computer, which allow the researchers to measure aspects of thinking very accurately.
Recognizing early stages
Helmich: "We want to focus on disturbed thinking in patients. These problems could consist of complaints with memory, planning, sensitivity to reward, or taking control. Next, we are going to link those cognitive differences to differences in brain structure using MRI scans, to clinical symptoms such as a bad sense of smell, and to genetics. This will allow us to identify different subtypes of Parkinson’s, and it will tell us about the different brain abnormalities in these subtypes. Hopefully this will provide knowledge about how to best recognize the earliest stages of Parkinson’s in the future."
At present, a treatment for Parkinson's disease does not yet exist. Helmich: "An important reason for this is that at the time of diagnosis, more than half of the dopamine cells are usually already gone, so there's not much we can recover or protect. Only if we detect early stages of disease, we can test new treatments aimed at neuroprotection. If we better understand how a symptom arises through different biological pathways, it also provides opportunities for developing new strategies for treatment."
Want to know more? Click here for the award announcement with the scientific summary of the project.