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Parkinson's Research - A Status Report

The turn of the year 2021/22 is approaching and it's time to take a look at the status quo of Parkinson's research.

Just a few days ago I saw a TV show in which Frank Elstner was optimistic about his neurologist's expectations. As a result, major advances in Parkinson's treatment can be expected over the next 10 years. With a twinkle in his eye he noticed that he might then also be able to benefit from this progress.

Almost at the same time, the renowned German Society for Neurology published the headline “Alexa, do I get Parkinson’s?” a press release on the current state of research.

The press release confirms the optimism of Frank Elstner's neurologist, but he seems to have little chance of benefiting from it himself.

How can that be? Three main conclusions emerge from the neurologists' report:

  • it will be possible to reduce the progression of the disease, both in society itself and in the individual.
  • A regression, i.e. a restoration of lost skills, is currently not to be expected.
  • The beneficiaries of the development will be patients at an early stage of the disease and, above all, patients at risk who have not (yet) developed any clearly identifiable symptoms. 

If you are interested in the details, here is the full article from the 17.12.2021/XNUMX/XNUMX editor German Society for Neurology:

Various disease-modifying therapies for Parkinson's disease are expected in the next few years, but it is already known that these therapies only have the potential to stop the course of the disease if they are given early - preferably before the first typical Parkinson's symptoms appear to make noticable. Research now faces the challenge of identifying those affected at an early stage. A current work [1] shows that a simple analysis of the voice frequency modulation, as can be done by apps or systems such as Alexa, may allow this prediction in high-risk patients.

Around 250.000 to 400.000 people in Germany live with Parkinson's disease. The trend is rising - no other neurological disease has recorded such a rapid increase in the number of cases. Between 1990 and 2016 alone, the global prevalence of this neurodegenerative disease doubled [2]. In addition to age and gender, the risk factors include genetic predispositions (several genes associated with Parkinson's disease have already been identified) and environmental factors. Parkinson's disease is one of the so-called synucleinopathies, as pathological deposits of a protein, α-synuclein, occur in certain brain regions. The α-synuclein clusters (aggregations) in the nerve cells arise due to a faulty molecular structure, i.e. incorrect folding, of the α-synuclein - the smallest protein fibers (fibrils, filaments) are initially formed, which then clump and have a cell-toxic effect.

A number of promising therapy options are currently being developed, in which the “German Parkinson Study Group” [3], the world's second largest study group on Parkinson's disease, has a large share. On the one hand, there is the development of α-synuclein antibodies, some of which are already in the second and third phases of clinical trials. In addition, there are promising data for so-called “small molecules” such as Neuropore, which also aim to prevent pathological protein spheres and helices from sticking together. Furthermore, RNA-based therapeutic approaches are also being researched in order to prevent the pathogenic protein aggregations.

“We are very optimistic that we will have disease-modifying therapies for Parkinson's disease available within a few years. At the same time, we know from therapy studies on other neurodegenerative diseases that the success of treatment depends largely on how early in the course of the disease the disease occurs Therapy is used. Ideally, treatment should begin before the first typical symptoms of the disease develop,” explains Prof. Dr. Lars Timmermann, head of the Parkinson Center at the Marburg University Hospital, which was recently awarded the “Center of Excellence Award 2022” by the “International Parkinson Foundation”. “That is why it is now so important to identify valid biomarkers and characteristics for a reliable early diagnosis in addition to new therapeutic approaches. We need tools to stratify from the group of high-risk patients those who are almost certain to develop Parkinson's disease. This is the only way we can ensure that we do not burden anyone with unnecessary therapies and that we also comply with the cost-effectiveness requirements of the payers, because after all, new therapies are always expensive.”

The Marburg research group has now come a great deal closer to this goal in cooperation with Czech scientists. In a current study [1] (led by Dr. Annette Janzen, Prof. Lars Timmermann and Prof. Wolfgang Oertel) it could be shown that a simple, computer-aided analysis of speech frequency modulation could be suitable for such a stratification. The study examined high-risk patients who had a REM sleep behavior disorder (abbreviated as RBD). It is known that RBD is a common precursor of Parkinson's disease. It is estimated that 80% of people with REM sleep behavior disorder will develop alpha-synucleinopathy, the disease group to which Parkinson's disease belongs, within the next 15 years. Smell disorders are also a common early symptom of Parkinson's disease. In the study, 30 people with RBD and olfactory disorders, 17 with RBD without olfactory disorders, and 50 healthy controls were given speech tests. It was found that prosody (including accent, intonation, speaking speed, rhythm and speaking pauses) was significantly reduced in the high-risk group RBD with olfactory disorders compared to the other two groups. Another result: In this group, the dysprosody increased in the further course only in those patients who then also had an abnormal dopamine transporter scintigraphy (DaT-SPECT).

“This suggests that a decrease or decrease in prosody in people with RBD and olfactory disorders may be a very early and sure sign of Parkinson's disease. Nowadays, prosody can be measured quickly and easily with the aid of a computer. To put it bluntly: In theory, systems such as Alexa or voice apps on smartphones could then predict people with a high risk constellation for Parkinson's disease whether or not they will develop Parkinson's in the next 5-7 years - that is very impressive, ”emphasizes Prof. Timmermann. “Further larger surveys must now validate the present study result. If this is confirmed, then we have a safe and at the same time inexpensive way of early diagnosis that would pave the way for presymptomatic Parkinson's therapy. Together with the approval of disease-modifying therapies, this could bring about the long-awaited turnaround in the care of people with Parkinson's. "

Selected Literature

[1] Rusz j, Janzen A, Tykalová T et al. Dysprosody in Isolated REM Sleep Behavior Disorder with Impaired Olfaction but Intact Nigrostriatal Pathway. Movement Disorders. First published: November 26, 2021.

https://doi.org/10.1002/mds.28873

[2] Springer Medicine. The number of Parkinson's patients has doubled. InFo Neurologie 21, 17 (2019).

https: //doi.org/10.1007/s15005-019-0049-7

[3] 

https://www.kompetenznetz-parkinson.de/german-parkinson-studygroup "

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1 Comment
  1. Anonymous
    Anonymous sagte:

    I was diagnosed with Parkinson's in December 2020, confirmed again by Datscan in January 2021.
    So far, as of February 1.2.2022st, XNUMX, I am not taking any medication.
    There are some interesting healing methods which I have used or use myself!
    For example:
    – Neurolith TPS – already approved for Alzheimer’s!
    – Symbyx Biome – PDCare Laser
    – PS128 probiotic for the gut microbiome
    – Brain stimulation technology, e.g. from the company Vielight (Neuro Duo –
    brain PWM)
    – Stool transplantation/microbiome transfer
    on my home page, http://www.parkinsonclub.de there is all the information about it!
    Regards Tom

    Reply

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