THE RISE OF BIOMARKER TECHNOLOGY IN PARKINSON’S DISEASE
A biomarker is a clue inside the body that indicates that disease is present. A biomarker can be an imaging test, a biopsy, or a test on a body fluid such as blood or cerebral spinal fluid. Recently, there has been an abundance of news about biomarkers and possible new ways of testing for Parkinson’s disease (PD). This is an exciting time for the PD community as these biomarkers are already changing how PD clinical trials are conducted — and in the near future, could revolutionize how PD is diagnosed, treated, and monitored over time.
A biomarker is a clue inside the body that indicates that disease is present.
For a long time, there were no reliable biomarkers for PD. This was challenging for researchers as they were not sure whether everyone in a clinical trial truly had PD or whether their disease changed with therapy.
Dr. David Standaert — a professor and Chair of the UAB Department of Neurology, senior member of the faculty of the Division of Movement Disorders, and chairman of APDA’s Scientific Advisory Board — spoke with us in a recent webinar about PD biomarkers. He discussed an imaging biomarker called a DaTscan which detects the loss of dopamine nerve projections that occurs in PD. It is used when the diagnosis of PD is uncertain (such as when there are very mild symptoms), there is an uncertain response to levodopa, or there are other unusual clinical features.
“Not only are we looking for a treatment for Parkinson’s, but we’re also starting to talk
about prevention.” — Dr. Standaert
Alpha-synuclein is a protein that is normally found in cells in the brain and throughout the body. In PD, for reasons that are not yet known, alpha-synuclein aggregates into abnormal forms. Dr. Standaert discussed two recently developed biomarker tests that detect this abnormal alpha-synuclein. One is a skin biopsy that is stained to see whether the abnormal alpha-synuclein is present in nerve cells within the skin biopsy. The other test, on cerebral spinal fluid, takes advantage of the “seeding properties” of abnormal alpha-synuclein. If normally shaped alpha-synuclein molecules are mixed with abnormally shaped molecules, the normal molecules will take on the abnormal shape. This grows the amount of abnormally shaped alpha-synuclein which can then be detected in a lab test. Research is underway to use the seeding assay to detect abnormal alpha-synuclein in blood, a more easily accessible body fluid for testing.
Of particular interest is the fact that abnormal alpha-synuclein can be detected in people with non-motor symptoms of PD such as loss of smell and REM behavior sleep disorder, who do not yet show motor signs of PD such as slowness, stiffness, or tremor. This means that biomarkers could potentially change when a diagnosis of PD is made. By moving up the diagnosis to when there is less disease present, researchers hope that interventions will have a better chance of preventing the progression of PD.
Watch the full webinar and learn more about the importance of biomarkers in PD!