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Research to Customise Parkinson’s Treatment

Parkinson’s WA has awarded Parkinson’s Centre (ParkC) scientists a $70k Zrinski Research Grant to identify subtypes of Parkinson’s in a first-of-its-kind study to help improve quality of life.

Using sophisticated analysis of data collected over a number of years, researchers will identify groups of people based on the pattern of their thinking skills.

Research Director, Dr Andrea Loftus, said the team would examine how participants differ in terms of their quality of life, sleep, and mood.

“Using this information, we will conduct research into how the different subtypes respond to interventions such as non-invasive brain stimulation and cognitive training,” Dr Loftus said.

“It may be that a particular group, for example, those who have difficulties with planning, respond better to cognitive training or brain stimulation than others.

“Parkinson’s is an umbrella term which we think encompasses a range of different symptom groups. It is clear that no one person’s Parkinson’s is the same as another’s, but there are some characteristics which some people have in common.

“We think it is important that these subtypes are identified so we can develop the most effective, customised (to the subtype) intervention.”

Dr Loftus said determining the subtypes and identifying subsequent symptom progression would have major, tangible benefits for people with Parkinson’s in terms of diagnosis, prognosis and treatment.

“We hope this research will also offer another future avenue for interventions to improve cognition and quality of life with Parkinson’s,” she said.

“The end goal is to identify and optimise methods of managing and slowing the progression of Parkinson’s, as well as improving the symptoms and individual experiences.”

Dr Loftus said a study using such a large number of participants and unique style of analysis had not been performed before.

“Also, no study has yet examined subtypes in Parkinson’s over time. This will be an invaluable contribution to the scientific understanding of the progression of Parkinson’s,” she said.

Brains Behind Best Parkinson’s Treatment

A team of neuroscientists have been awarded $200K from the Parkinson’s WA Zrinski Research Grant to find the best surgical technique to treat the main motor symptoms of Parkinson’s.
Led by UWA’s School of Psychiatry and Neurosciences, Professor Sergio Starkstein, and School of Surgery, Professor Christopher Lind, the study will focus on understanding the regions of the brain associated with severe tremor and motor fluctuations, as well as the best technique to treat these symptoms in people with Parkinson’s.
Professors’ Lind and Starkstein’s team seek to improve an existing technique, known as Deep Brain Stimulation, to reduce motor symptoms, by targeting a new region of the brain to achieve better results.
“So far, Deep Brain Stimulation of the subthalamic nucleus, is one of the most effective treatments for patients with Parkinson’s who have marked ON-OFF fluctuations, severe tremor or dyskinesia (involuntary movement) resulting from long-term use of medication,” Professor Starkstein said.
“However, the experience collected during the past 10 years shows that some patients may develop emotional and behavioural side-effects after the surgery, such as apathy and depression, as well as cognitive deficits, such as decline in memory and word fluency.
“Therefore, one of the most interesting challenges in Deep Brain Stimulation for people with Parkinson’s is to find brain sites that provide the best motor improvement with the least side effects.”
Professor Starkstein said his group had been studying a new target for Deep Brain Stimulation, known as the posterior subthalamic area, which promised to deliver similar or even better motor responses upon stimulation, with less emotional and cognitive side effects.
“We completed a pilot study of nine patients with Parkinson’s using the new technique, which showed significant motor improvement in the absence of cognitive deficits or psychiatric changes,” he said.
“We have since started a more ambitious study to determine the site within the new target that delivers the best motor response, while providing the greatest safety in terms of cognitive or psychiatric complications.”
Professor Starkstein said 15 patients had already had surgery and been clinically assessed and the funds from the Zrinski Research Grant would allow the team to add an additional 25 patients to complete the study and clinical assessments.
“We are also acquiring sophisticated brain images which will be analysed with state-of-the-art methods, and hopefully identify those individuals who will obtain the greatest benefit from subthalamic area Deep Brain Stimulation,” he said.
Professor Starkstein said it was the first study to carry out sophisticated brain imaging analysis to identify brain structural and metabolic markers that predict the best motor response.