The process of diagnosing Parkinson’s disease is made much more complex by one thing – the lack of a definitive way to measure this disease. One that would aid not only in the diagnosis of Parkinson’s disease but also help determine the success of treatment. For example if you suspect someone has high cholesterol, then there are blood tests that a physician can order in order to determine if that is the case. Then the blood tests can be repeated at different intervals once treatment is initiated to see if the interventions made are successful at solving the problem; in this case lowering the cholesterol level. The same scenario exists with hypertension or high blood pressure.
Nothing like this however, exists in the field of Parkinson’s disease. And this is a true barrier not only for the adequate treatment of patients today but also for the development of better treatments for the future and the search for a cure.
What we need is a biomarker. A biomarker is any indicator that can be measured objectively in an individual with a specific disease. It changes with disease progression and also with disease improvement. Diabetes glucose levels are also an example of this. A glucometer is used to measure glucose levels in a patient multiple times per day. The glucose level indicates how well controlled (or not) their disease is and also dictates how they should manage their disease state – ie. take more or less insulin.
Finding a biomarker for Parkinson’s could transform patient diagnosis, treatment and the research field entirely. From a research point of view, being able to determine which potential therapies are promising and worth pursuing because of their effect on a measurable biomarker in the lab before the benefits are even seen clinically, is an amazing prospect. That way the focus could move from a vast number of research avenues and instead concentrate on those that promise the best results. Concentrating energy and financial investment into the most promising research areas would definitely speed treatment development.
Biomarkers would also play a significant role in the diagnosis of Parkinson’s disease. Currently we rely on clinical assessment by a physician to diagnose this illness. In clear-cut cases with typical symptoms and signs and no unusual presenting issues, clinical diagnosis is fairly easy. But early in the disease when the presentation is rather vague or in situations with atypical manifestations of the disease, having a biomarker that could either confirm or refute a diagnosis of Parkinson’s would be invaluable.
As you may know by the time the symptoms of Parkinson’s appear, almost 60% to 70% of the dopamine producing neurons have died. So taking it one step further, imagine being able to identify those at risk for developing Parkinson’s prior to their neurons being affected in a major way, prior to them developing symptoms. This would allow them to begin future preventative treatments once those are developed.
The search for a reliable biomarker has been high priority for years. In 2010 The Michael J. Fox Foundation for Parkinson’s Research launched a landmark study – The Parkinson’s Progression Marker Initiative (PPMI) to do just that. Taking place in over 30 clinical centers spanning 13 countries, researchers together are building a database and clinical specimen bank that is accessible to scientists around the world. Hundreds of volunteers enrolled in PPMI undergo close clinical examination along with regular blood tests, spinal taps and imaging studies. Their goal? To use the information collected to find a Parkinson’s biomarker.
A vital pursuit. sIn all areas of Parkinson’s , from diagnosis to treatment to research, finding a biomarker will undoubtedly impact the course of this disease and will play a key role in the development of better treatments and ultimately a cure.