Parkinson’s Disease May Damage the Brain Long Before Symptoms Appear; 2 Tests Could Detect It Early

Parkinson’s Disease May Damage the Brain Long Before Symptoms Appear; 2 Tests Could Detect It Early
(Gorodenkoff/Shutterstock)
George Citroner
5/23/2023
Updated:
5/23/2023
0:00
A recent study found the annual incidence of Parkinson’s disease, a progressive and degenerative neurological condition, among older adults is 50 percent higher than the current estimate of 60,000 diagnoses annually, affecting approximately 90,000 people each year in the United States alone. This may soon change. 

Early detection and accurate diagnosis of Parkinson’s disease are critical for effectively treating and managing the condition. However, the early symptoms of the disease often resemble those of less severe conditions, leading to a delayed confirmation of Parkinson’s until the later stages when significant brain impairment has occurred.

A new lab test may now enable the detection of Parkinson’s in its earliest stages, potentially leading to more substantial benefits from treatment.

The Absence of Early Diagnosis Has Hindered the Search for Treatments

Parkinson’s disease is currently diagnosed by observing various physical symptoms, including tremors, stooping posture, small handwriting, and sleep issues.
However, even before these symptoms manifest, the brain undergoes gradual damage. The disease causes the death of nerve cells responsible for producing dopamine, a chemical messenger crucial for coordination and movement. By the time patients seek medical help for symptoms, they have already lost 60 to 80 percent of these dopamine-making cells.

In addition, Parkinson’s also damages nerve endings that produce norepinephrine, a neurotransmitter essential for regulating blood pressure and other automatic bodily functions. This may explain certain nonmovement symptoms of Parkinson’s, like fatigue and blood pressure abnormalities.

The absence of a lab test or any biomarker capable of detecting Parkinson’s in the earliest stages has hindered progress in finding new treatments. Including individuals with similar movement symptoms but who don’t have the disease in research studies may confuse the findings.

However, promising developments in diagnostic tests capable of detecting the disease in its early stages offer hope for breakthroughs in treatment, potentially leading to a future cure.

2 Tests Accurately Detect a Marker of Parkinson’s

New tests have been developed to detect early signs of a specific protein called alpha-synuclein, which affects certain brain areas. Alpha-synuclein, which is genetically linked to Parkinson’s disease, has been found to play a role in either the development or progression of the condition.
The two tests, SYNTap and Syn-One, are the only two biomarker tests—supported by relevant scientific research—for identifying evidence of Parkinson’s disease, according to their manufacturers.

SYNTap

SYNTap examines the patient’s spinal fluid collected through a spinal tap to identify signs of the misfolded alpha-synuclein protein. “Validation of this biomarker launches a new, biological era in Parkinson’s research,” Dr. Kenneth Marek, president and senior scientist at the Institute for Neurodegenerative Disorders, said in a statement.
A study published in The Lancet Neurology demonstrated that the SYNTap test successfully detected alpha-synuclein in the spinal fluid of early-stage and at-risk patients. The test showed a diagnostic accuracy of nearly 88 percent in detecting Parkinson’s in individuals with the condition while also achieving an approximately 96 percent accuracy in ruling it out.
The SYNTap test, which must be ordered by a doctor, was approved by the Food and Drug Administration in January 2022 to test for Lewy body dementia, the symptoms of which may often overlap with Parkinson’s.

Syn-One

The other test, which has been used since 2019, is called Syn-One. It offers the advantage of being less invasive. The test detects traces of the alpha-synuclein protein in the skin using a skin punch biopsy, which involves obtaining a small sample from a skin lesion. A clinical trial from 2022 revealed that Syn-One was able to detect the alpha-synuclein protein characteristic of Parkinson’s and other conditions in almost all patients.

The skin biopsy procedure is straightforward, resembling a routine visit to a dermatologist’s office.

“A neurologist, physician’s assistant, or nurse practitioner collects three skin ‘punches,’ or very small biopsies—one at the back of the neck, one above the knee, and one above the ankle—using a local anesthetic like lidocaine,” Dr. Christopher Gibbons, senior scientific advisor to CND Life Sciences and the study’s lead author, told The Epoch Times. “The skin biopsies are about one-quarter the size of a pencil eraser and do not require any stitches, just a Band-Aid,” he added.

“The whole process takes about 10 to 15 minutes, and then the skin biopsies are sent to a lab for analysis.”

However, a positive result from either test does not necessarily indicate Parkinson’s disease but rather a group of disorders associated with abnormal alpha-synuclein clumping. These disorders include Lewy body dementia and multiple system atrophy (MSA), a rare disorder that causes damage to areas of the brain that control body functions and motor control and shares similar signs and symptoms with Parkinson’s.

Direct comparisons between the Syn-One test and spinal fluid tests have not been done, according to Gibbons. However, results are similar, he added, “with the Syn-One test reporting slightly higher sensitivity and specificity according to the NIH-funded study.”

However, independent European studies published in NPJ Parkinson’s Disease and the journal Neurology demonstrated that skin immunofluorescence, similar to the technology used in the Syn-One test, outperformed spinal fluid tests. Immunofluorescence showed moderate agreement with cerebrospinal fluid tests, suggesting its potential to reveal a pathological form of the alpha-synuclein protein.

Tests Significantly Impact Treatment and Prognosis

Timely intervention and early treatment initiation can greatly benefit Parkinson’s patients. Early intervention has the potential to slow disease progression and improve a patient’s overall quality of life.

The diagnostic uncertainty patients and caregivers face is incredibly frustrating, Gibbons said. “Many of the treatments for Parkinson’s disease and other synucleinopathies carry side effects, so it is important to avoid treatments that won’t provide any clinical benefit.” He further emphasized that an earlier and more accurate diagnosis provides patients and caregivers with the tools to prepare for the significant life changes that lie ahead.

Roger Miller, a patient who underwent the noninvasive Syn-One test, attests to the difference it made in his life. “It helped to know what I had,“ he said. ”I had so many MRIs on my brain. I was being treated for all sorts of things before this test,” he added. “It makes a lot of difference because now my neurologist can treat me for Parkinson’s properly.”

George Citroner reports on health and medicine, covering topics that include cancer, infectious diseases, and neurodegenerative conditions. He was awarded the Media Orthopaedic Reporting Excellence (MORE) award in 2020 for a story on osteoporosis risk in men.
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