Battling the complexities of diagnosing Parkinson’s Disease
Parkinson’s is a significant global problem, affecting 10 million people worldwide. In Australia, 1 in every 308 people suffer from it, with 37 cases diagnosed every day.
But current methods of diagnosis only identify it at an advanced stage when treatment can only target symptoms and not stop its advancement. Concerningly, it’s estimated that Parkinson’s is misdiagnosed in more than 20% of cases using the current criteria.
A large multi-disciplinary and cross-institutional team led by Associate Professor Lyndsey Collins-Praino of the Adelaide Medical School, at the University of Adelaide, is investigating a multi-pronged approach to diagnosing Parkinson’s at an early stage, so that treatment can change its progression.
Associate Professor Collins-Praino says they are combining the latest techniques from neuroimaging, biomarker analysis and genomics, along with behavioural tasks custom-designed to assess cognitive and motor function.
“We are then able to probe this multifaceted dataset using the latest in machine learning techniques,” she says, “with the hopes that we might be able to predict who is at risk for the development of Parkinson’s.”
The research team is applying these cutting-edge techniques to multiple groups of people, including those who already have Parkinson’s and those who are identified as being at higher risk for developing the disease, as well as neurologically healthy control participants.
Those identified as being at higher risk of Parkinson’s can include those that have a constellation of symptoms (called prodromal symptoms), such as loss of sense of smell, REM sleep behaviour disorder and constipation.
Importantly, the work is also analysing people with a history of traumatic brain injury (TBI). Those with a previous history of TBI have a heightened risk of developing Parkinson’s. Even a mild brain injury increases your risk of developing Parkinson’s by 56%, while moderate to severe injuries increase that risk by 83%.
There are currently major gaps in the diagnosis of Parkinson’s, leading individuals to be identified too late, or indeed even misidentified.
“This severely limits therapeutic benefit,” says Associate Professor Collins-Praino, “but our work may change the way that Parkinson’s Disease is diagnosed in clinical practice.” This may lead to earlier identification, which could allow individuals to be placed into targeted interventions that have a better chance of success if started early.
The team is also aiming to provide critical guidance on the long-term management of individuals following a TBI, in the hopes of reducing their risk of developing Parkinson’s. This may have knock-on effects for other neurodegenerative diseases as well, including dementia. Currently, experts estimate that 5-15% of all dementia cases worldwide are due to a previous traumatic brain injury.
Associate Professor Lyndsey Collins-Praino
Adelaide Medical School
Faculty of Health and Medical Sciences