Q. I read your newsletter this past Tuesday about the amazing new diagnostic tools and treatment options available for Alzheimer’s. Is there anything similar for Parkinson’s? My dad is 75 and suffers from Parkinson’s, and any new treatment options would be great to know about. Also, if anyone else in my family has symptoms of the disease, we’d love to know as early as possible, since it took a while to diagnose him initially. We’d love to be able to take part in any trials that are available and any treatments that can help stave off symptoms for as long as possible.
A. Thank you so much for your kind comments on this past Tuesday’s New Amazing Alzheimer’s Diagnostic Tools and Treatments article.
April is actually Parkinson’s Awareness Month. Parkinson’s disease is a neurodegenerative disease that leads to a loss of dopamine in the brain. It impacts a person’s movement, speech, and ability to think. About 90,000 Americans are diagnosed on the basis of these symptoms each year, according to a recent study.
Parkinson’s affects the nervous system and, in addition to movement-related symptoms, can cause problems such as depression, anxiety, cognitive impairment, trouble sleeping, hallucinations, and loss of smell. It’s not fatal, but it can have serious complications. Similar to Alzheimer’s, the exact cause is largely unknown.
As you experienced with your father, Parkinson’s disease can be hard to diagnose. Symptoms of Parkinson’s that are also signs of other diseases and sometimes normal aging include:
- Impaired balance or coordination;
- Falling more often;
- Muscle stiffness;
- Slowness of movement;
- Urinary problems;
- Constipation;
- Not sleeping well;
- Handwriting getting smaller in size;
- Depression.
New Parkinson’s Diagnostic Tools
The following are some amazing new diagnostic tools to assist medical professionals with accurately diagnosing Parkinson’s disease:
New Lab Test May Accelerate Parkinson’s Diagnosis and Research
A lab test that can tell doctors if someone has Parkinson’s disease is a long-sought goal of researchers. Just a couple of weeks ago, it was announced that new tests that are able to detect traces of a key protein called alpha-synuclein are now being developed and tested.
Two Tests Are Available to Test for Parkinson’s Protein
One test, SYNTap, which looks for seeds of this protein in spinal fluid, is being tested as part of the Parkinson’s Progression Marker’s Initiative, a large study undertaken by the Michael J. Fox Foundation for Parkinson’s Research. Several companies are developing versions of this type of test. SYNTap joins another test called Syn-One, which detects traces of the protein in skin. The test, which analyzes small skin biopsies collected from the patient in a physician’s office, aids in the diagnosis of several diseases, including Parkinson’s disease, Lewy Body Dementia, multiple system atrophy, and REM sleep behavior disorder (RBD). Syn-One has been available since 2019 and is being studied with funding from the National Institutes of Health.
In a study that was just published in the journal Lancet Neurology, the SYNTap test proved to be accurate when given to 1,100 participants, including people with Parkinson’s, people with genetic or clinical risk factors who had not been diagnosed, and healthy controls. Overall, the test correctly identified people with Parkinson’s disease 88 percent of the time and correctly ruled it out 96 percent of the time.
At this time, however, the test is very invasive and requires a painful procedure called a spinal tap, although researchers hope to soon translate their results to other kind of biological samples, such as blood or saliva, that would be easier to collect. Here are some findings from the study:
- The test was most accurate in people without any known genetic risks for Parkinson’s disease, who also had loss of their sense of smell. In this group, the test correctly detected the disease 99 percent of the time.
- If they didn’t have a loss of smell, the accuracy dropped to 78 percent.
- In people with the most common genetic risk, a mutation in their LRRK2 gene, the test correctly flagged Parkinson’s only about 67 percent of the time.
- In 18 people who had lost their sense of smell, the test detected alpha-synuclein in 16.
- In another group of 33 people with REM sleep behavior disorder (RBD), which makes people kick, punch, or hit in their sleep as they act out their dreams, the test detected alpha-synuclein in 28.
Because this group was so small, the researchers say, those tests will have to be repeated to learn whether it can detect the disease before movement is impaired.
The results “(s)how that this method is fairly accurate for detecting Parkinson’s disease, even in patients who do not yet have symptoms,” said Dr. Andrew Ko, a neurosurgeon at the University of Washington School of Medicine who was not involved in the research. “This is a big step forward showing that this type of test is accurate.”
Artificial Intelligence/Virtual Reality May Aid in Early Detection of Parkinson’s
VR/AI Neuro aims to diagnose Parkinson’s and other neurological disorders remotely using a low-cost method to reach an accurate diagnosis in less time. The system uses a commercially available VR display with an infrared camera integrated into the lens to construct a 3D virtual environment that evaluates patients’ eye movements in videos, while interfacing with a physician who is in a different location.
The VR/AI Neuro evaluates eye movements, such as fixating on a point, pursuing an object, or executing saccades. Saccades are quick, abrupt, and precise simultaneous movements of the eyes, important for reading.
For the diagnosis of neurodegenerative diseases, the system develops virtual tasks to elicit eye movements commonly associated with the neurological disorders, such as abnormal saccades, fixation instability, and ocular tremors.
The research and development of this system has been under way for some time and involves the Kansas University Medical Center, the Augusta University in the US, and Osaka University in Japan.
The company also is developing BrainTremor, a smart bracelet to detect and monitor tremors associated with Parkinson’s disease. This device can provide data for early Parkinson’s diagnosis and be a reliable tool to assess the effects of medication. The researchers are currently adjusting the device’s shape and size to create a prototype that can be tested in clinical evaluation.
New Treatments for Parkinson’s
When it comes to Parkinson’s treatments, they are tailored to each person’s unique symptoms, as there is no “one-size-fits-all” approach to Parkinson’s care. Most often, people start drug therapy when symptoms interfere with the ability to do what they want or need to do.
According to the Michael J. Fox Foundation, “(w)hen and which treatments to begin are personal decisions best made with your Parkinson’s doctor. When choosing therapies, consider your symptoms and how they interfere with your life, as well as potential benefits, side effects, and costs. Your doctor also will consider your age and other medical conditions and medications outside of Parkinson’s.”
These are some new treatments that are being tested:
Laser Light Helmet Therapy Helped Improve Motor Function in Patients
A new Parkinson’s disease clinical trial with patients wearing laser light helmets has shown promising results, as the therapy helped improve motor function for those facing the progressive neurological condition. The new infrared light therapy helmet helped patients living with Parkinson’s improve facial expression, upper limb coordination and movement, lower limb coordination and movement, walking gait, and tremor.
SYMBYX, an Australian medtech company developing light therapies for intractable disease conditions, developed the infrared light therapy helmet for patients living with Parkinson’s. In a study to test its effectiveness, 40 individuals with PD were split into either active treatment or placebo infrared helmet therapy. After the 12-week treatment period, those on placebo then received active treatment. In total, across the study, 70 percent of participants on active treatment and 55 percent of those on placebo were identified as medium to strong responders.
The group with the active treatment improved 24–58 percent over baseline across all five areas tested (facial expression, upper limb, lower limb, gait, and tremor), unlike the placebo group which only showed a statistically valid improvement in lower limb coordination and movement.
“Patients saw improvements in walking and in other daily activities that we take for granted,” said Dr. Geoffrey Herkes, the head of research at Sydney Adventist Hospital, which conducted the trial.
Light therapy is said to work in several ways to reduce Parkinson’s symptoms, including by targeting cell mitochondria, where chemical energy is produced. Low energy or fatigue is a common symptom of Parkinson’s. The light therapy also targets the gut where neurotransmitters, in short supply in Parkinson’s patients, are manufactured.
New Gene Therapy Delivers Treatment Directly to Brain
Thirty US studies testing gene therapy to the brain for various disorders are ongoing, according to the National Institutes of Health. One, led by Dr. Krystof Bankiewicz at Ohio State University, tests treatments for disorders such as Alzheimer’s, Parkinson’s, and Huntington’s.
Scientists say the evidence supporting this approach is mounting and can open a new frontier in the fight against disorders afflicting our brain. “There’s a lot of exciting times ahead of us,” said Bankiewicz, a neurosurgeon. “We’re seeing some breakthroughs.”
Scientists say there are challenges to overcome before this approach becomes widespread for more common brain diseases. For example, the timing of treatment is an issue. Generally, earlier in life is better because diseases can cause lots of problems over the years, but these disease aren’t typically diagnosed until later. Also, disorders with more complex causes — such as Alzheimer’s and Parkinson’s — are tougher to treat with gene therapy.
Scientists are also exploring ways to deliver gene therapy to the brain without the dangers of brain surgery. But that requires getting around the blood-brain barrier, a roadblock designed to keep viruses and other germs that may be circulating in the bloodstream out of the brain.
Drugmakers say they are committed to ensuring people get the treatments they need. And researchers are confident they can overcome the remaining scientific obstacles to this approach. Read more about gene therapy for Parkinson’s here.
Do you have a Loved One with Parkinson’s or Another Debilitating Disease?
Hopefully these diagnostic and treatment tools will help make diagnosing and treating Parkinson’s disease easier and more effective for patients suffering from this neurodegenerative disease.
If you or a loved one has Parkinson’s disease and you have not yet done Incapacity Planning, Estate Planning, or Long-Term Care Planning, please call us at one of the numbers below to make an appointment for an initial consultation:
Northern Virginia Parkinson’s Planning: 703-691-1888
Fredericksburg, VA Parkinson’s Planning: 540-479-1435
Rockville, MD Parkinson’s Planning: 301-519-8041
Annapolis, MD Parkinson’s Planning: 410-216-0703
Washington, DC Parkinson’s Planning: 202-587-2797
About Evan H Farr, CELA, CAP
