Can we predict who is at risk of facing cognitive issues in PD and address them earlier? These are the questions being pursued by Dr. Goldman of the PDF Research Center at Rush University Medical Center.
PDF Grant Programs
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Results: Advancing Parkinson's Therapies
Accelerating Research from ďBench to BedsideĒ
Each year, PDF’s Advancing Parkinson’s Treatments (APT) Innovations Grant is awarded to novel programs that attempt to remove the barriers that prevent treatments from reaching people with Parkinson’s. In the current fiscal year, PDF is supporting this initiative with nearly $500,000.
Uric Acid and the Progression of Parkinson’s Disease
Uric acid, the chemical that at high levels can cause gout and kidney stones, may turn out to be a “marker” for the progression of Parkinson’s. With funding in part from PDF, investigators led by Alberto Ascherio, M.D., Dr.P.H., and Michael Schwarzschild, M.D., Ph.D., at Harvard University analyzed samples of blood and cerebrospinal fluid (the body fluid that bathes the brain) that had been collected from nearly 800 people with early-stage Parkinson’s in the 1980s as part of another clinical trial.
The investigators observed that people with PD who had high to normal levels of uric acid had a slightly reduced risk of needing to take levodopa for their Parkinson’s than those individuals with lower uric acid levels, suggesting that they may have a slower rate of Parkinson’s progression. The relationship between uric acid and Parkinson’s progression is not yet fully understood. Many researchers believe that oxidative stress plays a role in Parkinson’s and uric acid is a natural antioxidant found in the body. Researchers suspect that uric acid could not only be a specific marker for the progression of Parkinson’s but may also alter the course of the disease. These hypotheses need further exploration.
A clinical trial is now underway to examine the safety of inosine, a dietary supplement which the body converts into urate, and its ability to elevate urate levels in the blood.
Finding a Biomarker for Parkinson's Disease
Doctors do not currently have the tools either to definitively establish a Parkinson’s diagnosis or to measure the pace at which Parkinson’s develops. These challenges prompted the creation of the Longitudinal and Biomarker Study in PD (LABS-PD). The goals of this study, under the auspices of the Parkinson Study Group and supported by PDF, are to better understand the natural course of Parkinson’s motor and nonmotor symptoms and to provide a database for the development of biomarkers — that is, chemical tests and imaging technologies that track not only the progression of the disease but may also predict the risk for developing it.
LABS-PD has nearly 600 participants — all of whom have previously participated in a clinical trial —and is designed to enroll future participants from other completed trials and studies. Scientists hope that this data will yield insight into progression of Parkinson’s symptoms, rate of progression and connection between symptoms. More importantly, researchers will compare these findings to the biological samples they collect, tracking over time how any change in the body (as shown by the samples) relates to changes in a person’s symptoms. By doing so, they hope to identify biomarkers, which could lead to better individualized treatment of people living with Parkinson’s.
Parkinson’s Database Efficiencies
Through the APT grant, PDF has helped improve efficiency Parkinson’s database management by funding the inventory, assessment and integration of PD study databases among all the research projects that are managed by the Parkinson Study Group. The focus of this integration has been to take the databases of PSG studies that were sponsored by the NIH and other organizations over the last 20 years and put them into a format that is usable for retrospective analyses. These retrospective analyses or “data mining” efforts allow the matchless resource that is represented by a large clinical trial database to be used for secondary analyses that go far beyond the purpose of the original trials.
PDF has taken the lead in funding another data-building initiative by supporting a PSG project known as FOUND (Follow-up of Persons with Neurologic Diseases) that is run by Dr. Caroline Tanner at The Parkinson’s Institute in Sunnyvale, CA . The primary objective of this study is to gather long-term data on Parkinson’s disease progression, treatment response, complications and outcomes.
The FOUND study acquires this information by following-up with clinical trial participants after the end of a trial through questionnaires that are mailed three times a year. This type of project is especially important in chronic diseases such as Parkinson’s, as the data can help provide scientists with a more complete picture of the disease and how it develops over time. Studies such as this can also help clinical investigators gather information about nonmotor symptoms of PD, which are often the most troublesome to people living with Parkinson’s.
In the same spirit of encouraging young investigators to pursue careers in Parkinson’s, PDF has provided resources to PSG for training new investigators who may not yet have had experience in developing and managing clinical trials.
This training focuses on such areas as good clinical practices and ethics in research; standardized training on the Unified Parkinson’s Disease Rating Scale; standardized training on nonmotor aspects of Parkinson’s, including those involving mood and cognition; and use of electronic data capture systems. The main objective is to train and increase the number of researchers who are able to conduct clinical trials, with the intent of widening the pool of qualified Parkinson’s investigators — thereby accelerating the pace of clinical studies and the development of new treatments.