Around one million people in the United States and millions around the world, including celebrities like the late Muhammad Ali and Michael J. Fox, suffer from Parkinson's Disease (PD). According to the Parkinson's Foundation, PD is the second-most common neurodegenerative disorder behind Alzheimer's disease, with men about 1.5 times more likely to develop PD than women. As the population grows and ages, the number of people who will develop and live with PD will also increase, and with medical costs rising, this places a burden on families, the medical system, and society at large.
Parkinson's occurs because of a specific disruption or death in neurons that produce dopamine, which leads to a number of motor and non-motor symptoms. 1, 2 As a progressive disease, symptoms at the beginning of disease manifestation can be mild, but may include tremors that intensify with time, stiff or altered movements, and some speech issues as well according to the Mayo Clinic. At this time, there is no cure for PD, but there are medications and surgical interventions available to help manage the symptoms, as well as physical therapy. Unfortunately, just as with other neurological disorders including Alzheimer's and multiple sclerosis, the best available treatment is to just help patients feel as comfortable as possible as they continue living with their disease.
Some diagnostic biomarkers include the tremors and possible changes in mood or ability to make everyday movements easily. Imaging systems, including positron emission tomography (PET) and magnetic resonance imaging (MRI) can detect changes in dopamine production and uptake or physical changes in the abundance of certain types of neurons. 1, 2 On the biochemical side, it may be possible to detect changes in abundance for certain microRNA sequences or protein markers. One of the most common proteins studied in PD is alpha-synuclein (SNCA), which is produced in various parts of the brain and can form protein aggregates found in Lewy bodies that are characteristic in a large proportion of PD patients. 2 Another potential biomarker is the neurofilament light chain, particularly if found in the serum, could serve as a predictive biomarker in PD in conjunction with SNCA found in CSF. 4 Since, like other neurodegenerative disorders, the onset of PD is associated with neuroinflammation, measuring pro-inflammatory cytokines such as TNF-alpha and IL-10 could be instructive as well. 1
One of the most common drugs used in PD is called levodopa, which serves as a metabolic precursor of natural dopamine and is directly converted into dopamine by the patient's own neurons. 2 Levodopa is used in combination with carbidopa, which is a dopamine decarboxylase inhibitor that prolongs the life of dopamine in the system. There are also drugs that mimic the effects of dopamine and also inhibit monoamine oxidases to disrupt their ability to metabolize dopamine and reduce reactive oxygen species generation and protect neurons from oxidative damage. 2 In the future, some potential PD medicines may include inducers of autophagy in order to clear the SCNA and other protein aggregates to prevent apoptosis of affected neurons. 2 Perhaps even further in the future, a cure may be developed using gene therapy to introduce dopamine or help manage movement-related symptoms, but we aren't there yet.
For example, the Michael J. Fox Foundation highlights several fundraising opportunities, including charity concerts and walk/run events to drum up donations. There are events to educate PD patients and their families about research advances and accessibility to resources, as well as opportunities for PD patients to join studies and trials to help research along as direct participants. The Parkinson's Foundation has an event called #Take6forPD that provides many educational talks and also to register patients to participate in a global genetics study and other studies. As with all things, nothing is impossible when we all work together towards a brighter future.
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