Investigator:
Stephan Grimaldi, MD, PhD
Name of Institution:
Massachusetts General Hospital, Boston, MA
Project Title:
Longitudinal Changes of Brainstem-based Biomarkers of Prodromal Parkinson’s Disease with Ultra-high Field MRI
Investigator Bio:
Stephan Grimaldi is a neurologist specializing in Movement disorders at the University Hospital La Timone in Marseille, France. In parallel to his clinical and teaching activities at Aix-Marseille University, he works in collaboration with the Center for Magnetic Resonance in Biology and Medicine of Aix-Marseille University on early biomarkers of neurodegeneration in Parkinson’s disease (PD) using ultra high field brain MRI (7 Tesla). He is currently a post-doctoral fellow in the laboratory of Dr. Marta Bianciardi at Massachusetts General Hospital.
Objective:
To evaluate long term changes of brain biomarkers of neurodegeneration in the prodromal phase of Parkinson’s disease (patients with Rapid eye movement (REM) sleep behavior disorder) using the cutting-edge technology of a 7 Tesla MRI scanner.
Background:
There is a huge need to establish robust biomarkers of early neurodegeneration in order to diagnose the condition early and include such patients in therapeutic trials. People with Rapid eye movement (REM) behavior sleep disorder (RBD) are active while they dream, shouting and moving, instead of being paralyzed while they dream which is the normal state. RBD often precedes the diagnosis of Parkinson’s disease (PD) and people with RBD are therefore suspected of early neurodegeneration. We aim to assess these patients over the long term both clinically and with detailed imaging studies. Using this imaging information, the project aims to identify changes in brainstem nuclei or brainstem pathways that can be used to detect early neurodegeneration and that can monitor disease progression.
Methods/Design:
We will look for longitudinal changes in clinical and imaging data at baseline and at three years in at least eight subjects in people with RBD vs healthy controls. The clinical data to be collected consists of a battery of tests such as the Movement Disorder Society-Unified PD Rating Scale (MDS-UPDRS), the Non-Motor Symptom Scale, the Montreal Cognitive Assessment, the SCOPA-SLEEP and autonomic questionnaires, and the RBD Screening Questionnaire. The imaging data will be collected using a 7 Tesla MRI scanner to evaluate microstructural damage in the brainstem, especially in nuclei suspected to be affected early in the neurodegeneration of PD. Also, we will evaluate network dysfunction by computing the structural and functional connectomes of these brainstem nuclei.
Then, we will search for correlations between the clinical data that captures disease progression and the MRI results.
Relevance to Diagnosis/Treatment of Parkinson’s Disease:
This project aims to identify early biomarkers of neurodegeneration with the goal of making early diagnosis a reality. Those who are diagnosed early can be included in clinical trials of potential neuroprotective agents. The same early biomarkers of neurodegeneration can then be used to monitor the response to the therapeutic intervention, thereby accelerating the development of therapeutics.