One of the things that makes developing effective treatments for Parkinson’s disease so challenging is its complexity. While some forms are caused by genetics, others have environmental factors, and patients can show a wide range of symptoms of varying severity. Diagnosis of Parkinson’s is also currently made very late, after the disease may have been in the brain for a decade or more.
In a paper published in The Lancet Neurology, a group of scientists argue that this complexity demands a new way of classifying the disease for research purposes, one based not on clinical diagnosis but biology. The authors have called their biological model “SynNeurGe”.
The “Syn” stands for alpha-synuclein, a protein that in most Parkinson’s patients causes abnormal deposits called Lewy bodies. “Neur” stands for neurodegeneration. The “Ge” stands for genetics.
The authors argue that for research purposes, patients should be classified by the presence or absence of these three factors. This would allow the identification of Parkinson’s patients before symptoms appear, and aid the development of treatments tailored to patients’ unique biology. Right now, patients are diagnosed based on symptoms and signs, even though the disease may have been present in their brain for many years . By shifting classification criteria, researchers can identify disease earlier (even before people may experience symptoms), and target specific patient groups that have more in common with each other biologically, giving drug development a higher chance of success.
Although this is still for research purposes, this is a major shift in thinking. If you think of it, it’s quite unusual that we’ve had to wait until Parkinson’s patients have important symptoms before we could make a diagnosis. We don’t wait for someone to feel pain from cancer before we diagnose it.Instead, we detect and diagnose it, hopefully before someone is aware of any symptoms. This research classification is a critical step towards bringing our thinking about Parkinson’s into the 21st century.Dr. Ron Postuma, a clinician-scientist at The Neuro (Montreal Neurological Institute-Hospital) of McGill University and one of the study’s authors.
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