This week is Parkinson's Awareness Week, highlighting the importance of finding better treatments for this common neurodegenerative condition. Last month I wrote about areas of progress in Alzheimer's disease, and having just attended the 13th International Conference on Alzheimer's and Parkinson's diseases in Vienna, it is clear how work from these two fields can complement each other.
There is a desire to develop treatments not only to alleviate the symptoms of Parkinson's and Alzheimer's, but also to slow the progression of these conditions. Disease modifying treatments may be best applied early on in the condition, so as to preserve a good quality of life. For this reason, there is great interest in being able to identify a ‘prodromal’ phase in both diseases – one that occurs before all the typical symptoms and signs (such as slowness of movement, tremor and rigidity in Parkinson's) are present.
Much research is going on to identify the features of this phase, with the Movement Disorders Society and other groups working on a set of criteria. These may range in prevalence, type and manifestation. For example, all of the following are strongly associated with risk of developing Parkinson's disease:
As in Alzheimer's disease, great efforts are being made to identify biomarkers for Parkinson's disease. These could help with early diagnosis and would be tracked during clinical trials. An important protein involved in the pathology of the disease – which in future will become easier to track – is alpha-synuclein.
Alpha-synuclein is the main component of the so-called ‘lewy bodies’, which accumulate in the brain of someone suffering from Parkinson's disease. Work is being undertaken to validate tests which would reveal the make-up of certain forms of alpha-synuclein in the cerebrospinal fluid – although this does require a lumbar puncture to be performed.
As such, I was particularly excited by a report presented by AC Immune at the conference in Vienna. Working in collaboration with Biogen, this Swiss company is developing a tracer that can image alpha-synuclein in the brain, even at the early stages of Parkinson's disease. This is a promising tool for early diagnosis and the tracking of treatments modifying the disease.
Research on Alzheimer's and Parkinson's has many parallels; in Vienna, we were reminded that cognitive problems and dementia are common complications of Parkinson's disease. As such, collaboration between these two fields of research is of great importance. It is clear that we are entering an exciting era, where effective treatments for neurological conditions will become available along with the methods to test them effectively.
Julian is an independent advisor on CNS development, designing and overseeing the conduct of clinical trials of several novel agents – including vaccines against amyloid and tau proteins, and compounds in rare diseases. He has developed successful electronic books and tools and courses on Global Medicines Development. For further information, please contact the author.
Julian Gray studied medicine in Oxford and London UK and subsequently completed a DPhil (PhD) in neuropharmacology in Oxford under an MRC Training Fellowship at the Department of Clinical Pharmacology in Oxford. He entered the pharmaceutical industry as a medical expert at Sandoz in Basel in 1988 where he conducted the first clinical trials of Exelon in Alzheimer's disease. He left to become head of the Alzheimer area at Roche, where he did pioneering studies in the 1990s on agents modifying disease progression. Following this, he tested an early amyloid modulating compound at Praecis, a biotech company in Cambridge Massachusetts. He later returned to Europe to become head of CNS at Eisai´s European office in London.