Parkinson's Disease: Detecting Parkinson’s disease when it might still be curable
A patient with Parkinson’s disease (PD) has to lose 60-70% of the nerve cells in a particular area of the brain before the physical symptoms of PD appear. This means that curative treatment can only be instituted after the horse has already bolted, when the disease process is too far down the track to be reversed. Accordingly, current treatments only reduce the symptoms; they do not and cannot stop the inevitable, on-going nerve cell degeneration. Future therapeutic strategies must target patients in the earliest stages of their disease before the nerve cell loss has gone too far. There is an urgent need to identify the condition before it causes disability. Although typically known for its physical symptoms (e.g. tremor and slowness), PD has lots of other symptoms including memory loss, mood disturbance and sleep disturbance. Importantly, a number of these manifest before the physical symptoms appear, allowing the potential for early disease detection.
Addressing the pre-symptomatic diagnosis of Parkinson’s disease, we will study the sleep disturbance that occurs in this disease. The development of sleep disorder characterised by dream enactment behaviour after the age of 50 years carries an estimated five-year risk of up to 45% for the development of Parkinson’s disease. Its recognition may therefore represent an ideal candidate biomarker for predicting the emergence of PD and other similar diseases. We will use clinical, behavioural assessment, sleep studies and functional imaging using magnetic resonance imaging to determine those at risk of conversion to PD.
Parkinson’s disease affects one to two percent of the population aged over 65 years, costing the Australian nation in excess of six billion dollars per annum. We are unaware of any other research group in the world who have the capacity to undertake prospective circadian assessments and functional neuroimaging in combination with behavioural testing as proposed in this project. This project offers real hope for the treatment of this frightening disease that affects so many people.