Detecting Parkinson’s before it breaks out?

A new test is designed to diagnose Parkinson’s before visible signs of the disease appear. Neurologists are hoping for a boost to therapy research.

In most cases, Parkinson’s is only diagnosed when characteristic symptoms such as tremors set in.

The treatment of any disease begins with the diagnosis – and the earlier the diagnosis can be made, the sooner and usually more effectively the disease can be treated. This is the hope for many diseases. And a new test that is supposed to diagnose Parkinson’s at a particularly early stage is currently being celebrated by experts. What does it mean for patients?

Difficult to diagnose Parkinson’s disease at an early stage

Parkinson’s disease is the second most common brain disease after dementia such as Alzheimer’s disease, which is associated with the loss of nerve cells. Although the life expectancy of those affected is hardly restricted by the disease, in most cases they will eventually be in need of care. The disease usually begins after the age of 50, and the risk of developing the disease increases with age. In most cases, general early symptoms occur first.

They can range from depressed mood to sleep disorders, constipation and even a loss of the sense of smell. At this stage, however, Parkinson’s is difficult to diagnose. In most cases, the diagnosis is only made when the characteristic losses in the area of movement begin – with slowed movements, stiffness and resting tremors. "By then, many nerve cells have already perished and the disease process has been going on for several years.

New test to enable earlier detection

The new test is intended to enable diagnosis before this point in time. It detects an incorrectly folded form of the protein alpha-synuclein. Alpha-synuclein is thought to be involved in the release of messenger substances. If the protein folds incorrectly and clumps together, it is deposited on the nerve cells and can impair their function to such an extent that the cells eventually perish. It is believed that the protein deposits play a central role in the development of Parkinson’s disease.

For the test, which was developed by an international research team with funding from the Michael J. Fox Foundation, cerebrospinal fluid is examined. It can be taken with a so-called lumbar puncture, in which a sample of cerebrospinal fluid is obtained from the spinal canal with a special hollow needle in the lower part of the back.

A total of 1123 people took part in the study, which was published in the May issue of the journal Lancet Neurology. Some of them were already suffering from Parkinson’s disease, others had a genetic risk of developing the disease; a third group had general complaints that could be early symptoms, some of whom were later diagnosed with Parkinson’s disease.

Healthy people were also among the participants. In fact, the test also found the misfolded alpha-synuclein in 88 percent of all people who had Parkinson’s disease. Of those people who had an impaired sense of smell in addition to Parkinson’s disease, as many as 99 percent had the protein. Of those who had sleep disorders typical of Parkinson’s disease – called REM dream sleep disorder – it was still 63 percent. Even in the risk groups – such as those who had early symptoms but had not yet been diagnosed – the protein was found in 86 percent of cases.



4th Professional Medical Student. Karachi Medical and Dental College.

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