A team of scientists from the Hebrew University of Jerusalem has developed a diagnostic technique that could revolutionize the treatment of Parkinson’s.
This progressive and debilitating disease of the brain, which over time compromises a person’s ability to walk and talk, is virtually impossible to diagnose in its early stages. Something that can change with this new technology.
According to the Israeli work, published in the journal Science Advances, “andhe usual method of visualizing the structure of the brain uses a technique most of us are familiar with called MRI. However, it is not sensitive enough to reveal the biological changes taking place in the brains of Parkinson’s patients and is currently only used primarily to rule out other possible diagnoses.”
But the researchers realized that the cellular changes in Parkinson’s could possibly be revealed by adapting a related technique, known as quantitative magnetic resonance imaging (qMRI).
This method has allowed them to observe microstructures within the deep part of the brain known as the striatum, an organ known to deteriorate during the progression of Parkinson’s disease.
Using a new method of analysis, biological changes in the cellular tissue of the striatum were clearly revealed. Furthermore, they were able to show that these changes were associated with the early stages of Parkinson’s and the patients’ movement dysfunction.
qMRI achieves its sensitivity by taking multiple MRI images using different energies, such as taking the same photograph with different colors of illumination.
“When you don’t have measurements, you don’t know what is normal brain structure and what is abnormal, and what is changing during the progression of the disease,” they explained.
The new information will facilitate early diagnosis of the disease and provide “markers” to monitor the effectiveness of future drug therapies. “What we have discovered,” she continued, “is the tip of the iceberg.” It is a technique that they will now extend to investigate microstructural changes in other regions of the brain. In addition, the team is now developing qMRI into a tool that can be used in a clinical setting, work that will take three to five years.
The research findings suggest that this type of analysis will allow the identification of subgroups within the Parkinson’s population, some of which may respond differently to some medications than to others. Ultimately, this analysis “may lead to personalized treatment, enabling future drug discovery with each patient receiving the most appropriate drug.”
While virtually anyone could be at risk of developing Parkinson’s, studies suggest that it affects more men than women. The reason is not clear, but there are several ongoing studies that seek to better understand the risk factors.
Although one of the indisputable risks is age: most people with Parkinson’s develop it after the age of 60. However, 5% to 10% of cases present early before the age of 50. These special cases have been linked to specific genetic mutations.
The prevalence of Parkinson’s in Latin America, about 8% of the older adult population. In the United States there are about 60,000 new diagnoses a year. Globally, 10 million people are living with the condition.
Symptoms start slowly, usually on one side of the body. Then they affect both sides. Some are:
- Tremor in the hands, arms, legs, jaw, and face
- Stiffness in the arms, legs, and trunk
- Slowness of movements
- Balance and coordination problems
Friends or family members may be the first to notice changes in someone with early-onset Parkinson’s disease. They may see that the person’s face lacks expression and animation (known as a “masked face”) or that the person moves more slowly.
Early symptoms of Parkinson’s disease can be subtle and come on gradually. Affected people may feel mild tremors or have difficulty getting up from a chair.
Activities may take longer than before to complete and people may notice some stiffness in addition to slowness. They may notice that they speak very softly or that they write slowly with small or difficult to understand letters. This early period can last a long time before the more classic and obvious motor (movement) symptoms appear.
As the disease progresses, the symptoms of Parkinson’s disease may begin to interfere with daily activities. Affected individuals may not be able to hold silverware firmly or may find that the tremor makes it difficult for them to read the newspaper.
People with Parkinson’s often develop a so-called parkinsonian gait which includes a tendency to lean forward, take small, quick, hurried steps and experience reduced movement in one or both arms. They may have trouble starting the movement (the initial hesitation) and may stop suddenly when walking (they “freeze”).
Scientists have identified several genetic mutations associated with the disease. Among the risk factors studied are:
Environmental. Exposure to certain toxicants has caused parkinsonian symptoms in rare circumstances (such as exposure to MPTP, an illicit drug, or in miners exposed to the metal manganese). Other environmental factors not yet identified can also cause the disease in genetically susceptible people.
mitochondria. There are several lines of research that propose that mitochondria, the energy-producing components of the cell, may play a role in the development of Parkinson’s disease. Mitochondria are important sources of free radicals, the molecules that damage membranes, proteins, DNA, and other parts of the cell. This damage is often referred to as oxidative stress.
Changes related to oxidative stress, including free radical damage to DNA, proteins, and fats, have been detected in the brains of people with Parkinson’s disease. Some changes that decrease mitochondrial function have been identified as causes of the disease.
There is currently no cure for Parkinson’s disease, but treatments are available to help relieve symptoms and maintain your quality of life. These include:
- supportive therapies, such as physical therapy
- medication (such as levodopa)
- surgery (for some people)
No treatment may be needed during the early stages of Parkinson’s disease, as symptoms are usually mild.But regular appointments with the specialist may need to be made so that the condition can be monitored.
A plan of care should be agreed upon with the health care team and the family or caregivers.
This will describe the treatments and help the person needs now and is likely to need in the future, and should be reviewed periodically.