Parkinson’s. It’s time to get personal
Understanding why people with Parkinson’s differ has the potential to transform the way we treat the condition now and accelerate future developments.
“Science has been a bit slow in catching up on the concept that Parkinson’s is probably not simply one condition, but instead an umbrella term for many different types of condition.” — Martin Taylor
This incredible diversity presents major challenges but research is closing in on the answers.
The concept of ‘personalised medicine’ is simple but hugely powerful.
If we can understand how and why people with Parkinson’s differ, we can start to sort out which people will benefit from different treatments and therapies. This has the potential not only to transform the way we care for people with the condition now but also how we develop and test future treatments.
The era of personalised medicine is already well underway, and one of the fields it is most evident in is cancer. Rather than treating tumours based on where they grow in the body, when treating certain types of cancer doctors can now choose the correct treatment based on the genetic fingerprint of the cells inside the tumour.
This has revolutionised the treatment of many cancers and led to much more targeted treatments that not only improve survival rates but also come with fewer side effects than traditional chemotherapy.
If we can identify different ‘types’ of Parkinson’s, the same approach could help us give the right treatment, care and support to each individual based on their particular symptoms and how their condition is likely to develop.
Sounds good, but where do we start?
The first step towards delivering truly personalised treatments for Parkinson’s is to work out what different types of the condition there are, and how they present and progress.
With a complex condition like Parkinson’s, this means you need a huge amount of carefully collected data. And that’s exactly what we’re gathering through 2 major studies which are both closely monitoring people who have recently been diagnosed and collecting information about every aspect of the condition as it develops over time.
Tracking Parkinson’s — the largest, in-depth study of the condition ever attempted. The project has now been running for 5 years and has involved 2,600 participants (people with Parkinson’s and their siblings) across 70 hospitals in the UK.
The Oxford Parkinson’s Disease Centre — over 1500 subjects to the cohort, including over 1000 people with Parkinson’s, plus 300 without the condition and 180 individuals thought to be ‘at-risk’ of developing it in future.
Together, these and other studies are gathering a detailed and comprehensive picture of Parkinson’s through detailed clinical assessments, gene tests, brain scans and analysing proteins in the blood.
The breadth and depth of the data being collected will allow researchers to spot patterns in the illness that have never been seen before.
Progress so far…
The Oxford Parkinson’s Disease Centre team have found that the people with Parkinson’s in their study fall into 5 broad categories based on their symptoms:
- mild movement and non-movement symptoms (25%)
- changes in posture, memory and thinking (23%)
- severe tremor (21%)
- poor psychological well-being, and sleep problems (19%)
- severe movement and non-movement symptoms, poor psychological well-being (12%)
You can read more about this in the paper they published in the Journal of Parkinson’s Disease.
This research is still at an early stage and the team are now continuing to study how these groups develop to see if early symptoms might predict how the condition progresses over time. They also want to compare their findings to those seen in Tracking Parkinson’s to see if the same patterns emerge in a different group of people.
And, more recently, data from the Tracking Parkinson’s study has highlighted a possible connection between cardiovascular health and Parkinson’s symptoms such as walking and memory.
Better clinical trials, new treatments faster
Perhaps the most exciting prospect for this area of research is the promise it hold for transforming the development and testing of new treatments in clinical trials.
On their own the data studies like Tracking Parkinson’s are gathering is powerful, but what if you could bring the data from all the major studies together in one place?
That is exactly what is happening now through a global consortium called the Critical Path for Parkinson’s.
The data being gathered in these long-term, painstaking studies is being harmonised and combined to create a much larger and more powerful database.
It will be carefully analysed by experts at the Critical Path Institute, based in Arizona in the US, to build tools that help researchers test the right treatments in the right patients at the right time.
The ultimate goal is to deliver new and better treatments in years, not decades by making clinical trials for Parkinson’s faster, cheaper and more likely to succeed.