Recognize signs of Parkinson's in the scalp
Pathological changes associated with the disability of Parkinson's patients are already recognized in signals from the scalp without the skull having to be opened. Scientists from the University Medical Center Leipzig and the Max Planck Institute for Human Cognitive and Brain Sciences have recently published these new findings in the journal Brain.
How does the characteristic slowing down of movements come about in patients with Parkinson's? Electrical oscillations of nerve cells in the depths of the brain and the cerebral cortex are pathologically coupled with one another. Researchers know this from recordings made during an operation on the brains of Parkinson's patients if they were given a brain pacemaker.
But can this coupling also be recognized if the electrical nerve activity is only derived from the patient's scalp by an EEG? Doctoral student Ruxue Gong and a team of scientists led by Prof. Dr. Joseph Claßen, Director of the Clinic and Polyclinic for Neurology at Leipzig University Hospital and Prof. Dr. Thomas Knösche, MPI for Human Cognitive and Brain Sciences.
In the only five-minute EEG measurements, the researchers actually found such couplings in Parkinson's patients, which, compared to healthy test persons, are stronger in brain regions that serve to control movement. Breaking the link between vibrations at different locations could be particularly important for treating Parkinson’s symptoms. "We hope that in the future the coupled electrical oscillations in Parkinson's patients can be corrected with external electrical or magnetic stimulation without the need for an operation," says Claßen. "With our mathematical model calculations, we would like to recognize which characteristics such innovative therapies must have in order to be successful. The new findings could have provided an important building block for this," explains Knösche.
Pathological couplings were also found in a single area of the frontal cortex that is only marginally involved in motor control. "Perhaps the cognitive disorders that exist in some Parkinson's patients have a common cause with the motor disorders," says Claßen. This thesis will be further investigated in future studies.
News from Parkinson's research
According to figures from the German Center for Neurodegenerative Diseases (DZNE), diagnoses of Parkinson's disease have risen sharply in recent decades and, according to forecasts, will triple by 2040, especially in western countries to grow. Parkinson's is caused by the misfolding of the protein alpha-synuclein, as a result of which the protein is deposited in the brain and irreversible damage occurs. The consequences are tremors, gait and speech disorders or memory loss.
By the time these symptoms show up, the disease is well advanced. It is all the more important to find ways of making an early diagnosis of the disease possible in a simple way. And also to find really effective therapies for Parkinson's disease through drugs or vaccines that can delay or even stop the course of the disease.
Parkinson's research has made great strides in recent years, especially in early diagnosis. At the Highlights Digital event in March 2021, the German Society for Parkinson's Disorders and Movement Disorders (DPG) was delighted with the first promising research results from clinical studies.
Symptoms such as constipation, REM sleep behavior disorders (or: dream sleep disorders), olfactory perception and depression can be the first signs of later Parkinson's disease, as they are signs of typical nerve cell damage. A publication by neurologist Daniela Berg from the University of Kiel, published in April 2021, shows that 80 percent of the REM sleep behavior disorder in people over 50 after excluding other causes indicates Parkinson's disease and the patients in the next Parkinson's disease for 15 to 20 years. The sleep disorder manifests itself as lively muscle tone during sleep and terrifying dreams. Early diagnosis can reduce the risk of developing Parkinson's later by changing lifestyle. But studies on new Parkinson's therapies can also benefit from the participation of people with REM sleep behavior disorder.
Scientists from the Universities of Würzburg and Marburg show in a new study that the α-synuclein protein is also deposited in the skin and can thus be used as a biomarker. The researchers examined patients with REM sleep behavior disorder using a minimally invasive skin biopsy and were able to show that Parkinson's disease can be detected years before the first visible symptoms.
Digital technologies are being used more and more in medicine, why not also against Parkinson's? What is possible in this area is being researched as part of the Validating DIGItal biomarkers for better personalized treatment of Parkinson's Disease (DIGIPD) project at Fraunhofer SCAI. Changes in language, facial expressions or motor skills are recorded using small sensor devices and compared with sensor data (digital biomarkers) from other studies. In this way, it was possible to make predictions about the course of the disease. DIGIPD started in May 2021 and will collect important data over the next three years.
There are also very promising studies in the treatment of Parkinson's disease. The best candidate is antibody therapy and it works like a vaccine. After the Parkinson's patients were given tailor-made antibodies by infusion, there was a reduction in the protein α-synuclein in the nervous system, which is responsible for protein deposits in the brain. With PASADENA and SPARK, two further antibody studies with around 600 patients have started, the results of which are expected in two years. There the antibodies are first tested on patients without symptoms, later the tests are to be extended to people who are already sick.
The most rapidly increasing neurological disease
The disease used to be called "paralysis" because tremors are its most prominent feature. But the tremor "is just one of many symptoms that Parkinson's patients can suffer from," emphasizes Prof. Dr. med. Dr. phil. Alain Kaelin, neurologist and President of the Swiss Movement Disorders Society (SMDS), in a statement on Friday.
Parkinson's is "a misunderstood disease with many faces", which among other things affects the mind considerably. Alarm signs that occur before the disease manifests itself in motor skills are, for example, a decrease in the sense of smell, daytime sleepiness, drop in blood pressure when standing, muscle cramps in the neck and shoulder area. However, only specialists can clarify whether Parkinson's is actually present.
Because the diverse appearance makes early detection difficult and more people will get it in the future, "increased social awareness of the disease is important," writes the SMDS. Reason to explain the insidious disease, the cause of which is still unknown, on the occasion of the global day of action.
In addition to tremor, the most common motor symptoms of Parkinson's include slowness of movement, balance disorder, stiffness, back and shoulder pain and reduced facial expressions (hypomimia). In many Parkinson's patients, the disease also manifests itself through non-motor symptoms such as sleep disorders and depression.
According to the World Health Organization (WHO), Parkinson's is the world's most rapidly increasing neurological disease. The reason for this is the increasing aging of the population. In Parkinson's disease, among other things, the nerve cells in the brain that produce the messenger substance dopamine are slowly and progressively damaged for reasons that are currently still unexplained.
The dopamine deficiency leads to motor and non-motor dysfunction in the body. "Although a cure is currently not possible, the symptoms can be effectively alleviated with interprofessional treatment by neurologists together with other health professionals such as physiotherapists and nurses," says the SMDS report.
"Most patients can benefit from the best possible quality of life due to the generally very slow progression of Parkinson's disease into old age. Prerequisites for this are timely diagnosis, individually tailored therapy and certain lifestyle adjustments."
What Parkinson's early on?
Parkinson's associate many with slow movements and trembling hands. But these are not the first symptoms of the disease, explains Prof. Rüdiger Hilker-Roggendorf of the German Society for Parkinson's in the "Neue Apotheken Illustrierte".
Possible first signs of Parkinson's are therefore sleep disorders, problems with smelling and mood swings. Patients should go to the doctor if these symptoms are more frequent and there is no obvious explanation for smoking as the cause of the olfactory disorder. This is especially true for those who have close relatives with Parkinson's.
Parkinson is not curable. The sooner the disease is recognized, the better doctors can counteract and get the symptoms as long as possible, explains the neurologist. Here, drugs are used, but also other forms of treatment such as physiotherapy and occupational therapy.
Parkinson's is a nerve-related motor disorder that primarily affects older people. The cause of the disease called shaking palsy is the dying of nerve cells in the brain. They no longer produce dopamine, which helps the body to control movements. Numerous disorders are the result: shaking, tense muscles and gait and balance disorders. Add to that a quiet and monotonous language as well as a rigid facial expression. Additional symptoms may include sleep disorders, depression and mental retardation, including dementia.
Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease. In the Federal Republic according to health insurance data currently about 400,000 people are suffering from the incurable disease, writes the German Parkinson Society. On average, the patients are 60 years old at diagnosis. Men are affected more frequently than women.