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New research suggests that Parkinson’s disease is not one but two diseases, beginning in the brain or in the intestines. Which explains why Parkinson’s patients describe very different symptoms. The findings point towards personalized medicine as the way forward for people with Parkinson’s disease.
This is the conclusion of a study that has just been published in the leading journal of neurology. Brain.
The researchers behind the study are Professor Per Borghammer and physician Jacob Horsager from the Department of Clinical Medicine at Aarhus University and Aarhus University Hospital, Denmark.
“With the help of advanced screening techniques, we have shown that Parkinson’s disease can be divided into two variants, beginning in different places in the body. For some patients, the disease begins in the intestines and spreads from there to the brain to through neural connections. For others, the disease begins in the brain and spreads to the intestines and other organs such as the heart, “explains Per Borghammer.
He also notes that the discovery could be highly significant for the treatment of Parkinson’s disease in the future, as this should be based on the individual patient’s disease pattern.
Parkinson’s disease is characterized by slow deterioration of the brain due to accumulation of alpha-synuclein, a protein that damages nerve cells. This leads to slow, stiff movements that many people associate with the disease.
In the study, researchers have used advanced PET and MRI imaging techniques to examine people with Parkinson’s disease. Also included in the study are people who have not yet been diagnosed but who are at high risk of developing the disease. People diagnosed with REM sleep behavior syndrome are at increased risk of developing Parkinson’s disease.
The study showed that some patients had damage to the brain’s dopamine system before damage to the intestines and heart occurred. In other patients, scans revealed damage to the nervous system of the intestines and the heart before damage to the brain’s dopamine system was visible.
This knowledge is important and challenges the understanding of Parkinson’s disease that has prevailed until now, says Per Borghammer.
“Until now, many people have seen the disease as relatively homogeneous and have defined it on the basis of classic movement disorders. But at the same time, we have been puzzled why there was such a big difference between the symptoms of patients. With this new knowledge, the different symptoms make more sense and this is also the perspective in which future research should be seen, ”he says.
Researchers refer to the two types of Parkinson’s disease as the body first and the brain first. In the case of body-first, it can be particularly interesting to study the composition of the bacteria in the intestines known as the microbiota.
“Parkinson’s patients have long been shown to have a different microbiome in their gut than healthy people, without really understanding the importance of this. Now that we can identify the two types of Parkinson’s disease, we can examine the risk factors and possible genetic factors that may be different for the two types. The next step is to examine whether, for example, Parkinson’s disease that affects the body can first be treated by treating the intestines with a stool transplant or in other ways that affect to the microbiome. ” says Per Borghammer.
“Discovering Parkinson’s disease in the brain is a major challenge. This variant of the disease is likely to be relatively symptom-free until movement disorder symptoms appear and the patient is diagnosed with Parkinson’s. By then, the patient is already it has lost more than half of the dopamine system and therefore it will be more difficult to find patients early enough to be able to stop the disease, “says Per Borghammer.
The Aarhus University study is longitudinal, meaning participants are called back after three and six years so that all examinations and scans can be repeated. According to Per Borghammer, this makes the study the most comprehensive ever conducted and provides researchers with valuable insights and insight into Parkinson’s disease or diseases.
“Previous studies have indicated that there could be more than one type of Parkinson’s, but this has not been clearly demonstrated until this study, which was specifically designed to clarify this question. We now have insights that offer hope for better and more targeted treatment of people who will be affected by Parkinson’s disease in the future, “says Per Borghammer.
According to the Danish Parkinson’s Disease Association, there are 8,000 people with Parkinson’s disease in Denmark and up to eight million patients diagnosed worldwide.
This number is expected to rise to 15 million by 2050 due to the aging of the population, as the risk of contracting Parkinson’s disease increases dramatically as the population ages.
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This article has been republished from materials provided by Aarhus University. Note: the material may have been edited for its length and content. For more information, contact the cited source.
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