What’s New in Parkinson’s: November 2022

The adenosine and dopamine push-pull dynamic. Aggression toward care partners. “Juvenile” Parkinson’s. Large-scale data on the gut and Parkinson’s. A celebration of adaptive clothing. Here’s what’s new in the world of Parkinson’s this month.

PARKINSON’S ARTICLES

• Findings from a large-scale study involving 490 people with Parkinson’s and 234 control participants showed that more than 30% of species, genes, and pathways tested had “altered abundances” in Parkinson’s, showing multiple associations between the gut microbiome and Parkinson’s.
• Also adding support to the gut-brain-Parkinson’s connection, a poster presented at the Society for Neuroscience’s 2022 conference highlighted new findings between the gut microbiome and Parkinson’s, obesity, and pesticides. “The neuroscience research presented…illustrates that, when it comes to metabolic and neurological disorders, we cannot target only the brain. Everything that happens in the gut has an impact on the brain,” an assistant professor of neurosurgery at Houston Methodist Research Institute said of the findings.
• Results from a new study about the impacts of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) suggest that for people who are pre-disposed to neurological conditions (including Parkinson’s or Alzheimer’s), having COVID further exacerbates the process of neurodegeneration. The research was conducted by scientists at the University of Queensland and published in Molecular Psychiatry.
• A group of conservation and public health organizations recently called on the California Department of Pesticide Regulation to reevaluate its approval of paraquat (an herbicide that has been linked to Parkinson’s) and ban its use in the state. Jonathan Evans, the environmental health legal director at the Center for Biological Diversity, said, “We can’t keep ignoring paraquat’s proven role in causing needless deaths and its links to devastating health conditions like cancer and Parkinson’s.”
• Kyowa Kirin, the Davis Phinney Foundation, and PMD Alliance recently published findings from 2022 Parkinson’s Care Partner Survey and accompanying whitepaper, which reinforce the critical role of care partners in supporting healthcare needs (and beyond) and highlight the emotional impact of caregiving.
• In other care partner news, a professor of neurology at the University of Colorado School of Medicine is using his findings from a study on aggression toward Parkinson’s care partners to develop an intervention to address the common problem. His research showed that people with Parkinson’s often show aggressive behaviors toward their care partners, which in turn increases care partner stress and mental health and negatively affects relationships between the person with Parkinson’s and their care partner.
• A study published in Cell found that a specific mutation in the LRRK2 gene (the G2019S mutation) alters the shape and function of mitochondria and triggers a type of “cell death” that elicits hyperinflammation in response to infection. The findings support the potential of using LRRK2 inhibitors to treat Parkinson’s and similar conditions.
• Scientists at the University of Copenhagen found that people with Parkinson’s often receive “irregular” dental care while also requiring more dental treatments than people without Parkinson’s. The research, published in the journal Community Dentistry and Oral Epidemiology, highlights the effects Parkinson’s can have on oral health and the need for proper oral hygiene and regular dental exams for members of the Parkinson’s community.
• Scripps Research Institute researchers have developed a tool that analyzes genetics, brain scans, and physical examinations to predict how quickly a person’s Parkinson’s may progress over the course of a year. The team believes the tool will help researchers determine and select the most at-risk people with Parkinson’s and design shorter, more impactful trials to investigate Parkinson’s therapies.
• The US Food and Drug Administration (FDA) has granted 510(k) marketing clearance to the digital health start-up H2o therapeutics for its prescription mobile app, Parky. The Parky app monitors Parkinson’s symptoms, such as tremors and dyskinesia, in real time via the use of an Apple Watch.
• Researchers at the University College London published findings in JAMA Neurology that validate known Parkinson’s risk factors and confirm some more controversial associations, such as with sleep apnea, restless legs syndrome, epilepsy, and hearing loss. In their analysis of health insurance data, the researchers found associations between Parkinson’s and early symptoms, including sensory skin changes, diabetes (type 1 and 2), inflammatory conditions, and tremor.
• A study published in Biomedicine and Pharmacotherapy explains the association between a mutation of the adenosine type 1 receptor gene and “juvenile Parkinson’s,” or Parkinson’s that affects people younger than 40. The study included research teams from the Autonomous University of Barcelona, the Luxembourg Institute of Health, and the National Institutes of Health (NIH) in Baltimore.
• Researchers at the Göttingen Max PIanck Institute (MPI) for Multidisciplinary Sciences have shown for the first time how lipids (organic compounds that are insoluble in water) bind to fibril surfaces and impact the arrangement of the synuclein proteins within those fibrils (small filaments or fibers that are part of a cell or larger structure, and that have been implicated in neurodegenerative conditions including Alzheimer’s and Parkinson’s). The study was published in Nature Communications.
• A collaboration between Metabolon and Tracking Parkinson’s (a UK-based longitudinal study of Parkinson’s funded by Parkinson’s UK) will help researchers identify new metabolomic biomarkers and track biological changes over time to better understand the pathogenesis of Parkinson’s.
• In a review of decades’ worth of data on more than 5,000 women, researchers at the Mayo Clinic found that women who had both ovaries removed before age 43 were five times more likely to eventually be diagnosed with Parkinson’s, compared to women their age who did not have this procedure. The findings, published in JAMA Network Open, support the theory that premature estrogen loss might contribute to Parkinson’s in some women.
• Having acquired an exclusive worldwide license of intellectual property from the KU Center for Technology Commercialization, DiagnaMed Holdings will develop a virtual reality and artificial intelligence tool designed to diagnose neurodegenerative conditions, including Parkinson’s.
•  A study published in npj Parkinson’s Disease suggests that levels of neurofilament light chain (NfL) protein may serve as a non-invasive biomarker of cognitive progression in Parkinson’s.
• Researchers at the University of Cambridge explain how a thin “shell of water” plays a key role in how proteins (including alpha-synuclein) begin to aggregate and form the toxic clusters that eventually lead to neuron death in conditions like Parkinson’s.
• In Nutrients, researchers discuss the link between iron supplements and Parkinson’s, including how excessive iron intake may increase the risk of developing Parkinson’s.
• Researchers at ETH Zurich have discovered that a certain set of proteins have different shapes in the spinal fluid of people with Parkinson’s and people without Parkinson’s. In the study, published in Nature Structural and Molecular Biology, the researchers highlight 76 proteins that might serve as biomarkers for the detection of Parkinson’s.
• In a study published in Brain, researchers from Northwestern Medicine share findings that reveal how novel short tandem repeat sequences influence a person’s risk of Parkinson’s and “chip away at understanding all the complex genetic factors” behind Parkinson’s.
• A scoping review of research published in Neurology found that people with neurological conditions, including Parkinson’s, may experience worsening symptoms due to climate change.

PARKINSON’S treatments and THERAPIES

• A special issue of the journal Brain Plasticity explains the latest research on exercise’s ability to enhance brain function and delay (and perhaps even prevent) the development of neurodegenerative conditions such as Alzheimer’s and Parkinson’s.
• The Washington Post also shared an in-depth look at exercise’s proven effects on Parkinson’s symptoms.
• Researchers at Oregon Health & Science University have, for the first time, clearly and definitively demonstrated that adenosine, a neurotransmitter, effectively “acts as a brake to dopamine” in a unique push-pull system. The findings, published in Nature, may lead to new Parkinson’s medications.
• Results from a Phase 3 clinical trial suggest that AbbVie’s ABBV-951, a continuous infusion formulation of carbidopa/levodopa, can help control motor symptoms and reduce motor fluctuations in people with advanced Parkinson’s. The findings were published in The Lancet Neurology.
• Findings from a recent study published in Science Signaling suggest that itanapraced, a drug candidate for Alzheimer’s, may be effective in treating LRRK2-related Parkinson’s.
• A researcher at the University of Toronto is combining artificial intelligence and microelectronics to create neural implants that can modulate the brain’s activity to help treat neurological conditions like Parkinson’s.
• The FDA has accepted for review the New Drug Application for Amneal Pharmaceuticals’ IPX203, a novel, oral formulation of carbidopa/levodopa extended-release capsules. Data from the company’s Phase 3 RISE-PD study suggests that IPX203 can provide a longer duration of symptom control with the added benefit of fewer doses.
• Data from a Phase 2 trial showed that treatment with simvastatin, a cholesterol-lowering medication, did not slow the progression of Parkinson’s over a two-year period. The findings were published in JAMA Neurology. 
• The FDA has placed a clinical hold on Inhibikase Therapeutics’ midstage Parkinson’s drug candidate IkT-148009, which was undergoing a Phase 2 trial for Parkinson’s. Inhibikase President and Chief Executive Officer Milton H. Werner, PhD, said that “given the safety, tolerability and pharmacokinetics data observed in clinical trials with IkT-148009 to date, we are actively working with the FDA to understand the agency’s concerns and to resolve them as soon as possible.”
• SynAgile Corporation recently shared positive results from its Phase 2 clinical trial of continuous carbidopa/levodopa administration via the DopaFuse delivery system, demonstrating that it has the potential to be a safe, non-invasive treatment for Parkinson’s motor symptoms. SynAgile is now preparing for a double-blind Phase 3 clinical trial of the DopaFuse system.
• In Science, researchers from University College London Queen Square Institute of Neurology explain how a gene therapy they developed alters only overactive cells (and not cells that are functioning normally) in a way that can successfully suppress seizures. The researchers believe the findings suggest that the therapy may also be able to treat other conditions, like Parkinson’s, where only certain brain cells are overactive.
• Biopharmaceutical company Athira Pharma recently shared data that highlights the potential therapeutic benefits of fosgonimeton for promoting neuroprotection, reducing alpha-synuclein aggregation, and improving motor function in animal models of Parkinson’s. The findings were presented at the Society for Neuroscience’s 2022 conference.
• Short-term findings published in the Annals of Internal Medicine suggest that the experimental drug ENT-01 may help minimize constipation in people with Parkinson’s. In a trial involving 150 people with Parkinson’s who experience chronic constipation, participants who were given ENT-01 for a few weeks had much more regular bowel movements than participants who did not take the drug.
• InMed Pharmaceuticals has launched a program (the INM-900 series) to investigate the effects of cannabinoid analogs in neurological conditions such as Alzheimer’s, Huntington’s, and Parkinson’s. The company has identified two cannabinoid analogs (compounds that have been modified and carry a different molecular makeup than natural cannabinoids from the cannabis plant) that have shown promise in treating neurodegenerative conditions. InMed will now conduct studies using in vivo models in neurodegenerative conditions to select the most appropriate candidate for clinical studies.

PARKINSON’S LIVING WELL STORIES

• A fashion show hosted by Parkinson’s Resources of Oregon showcased adaptable clothing, shoes, and accessories designed for people living with Parkinson’s.
• Guy Deacon, a retired army general who was diagnosed with Parkinson’s 11 years ago, recently completed a solo journey through Africa to raise Parkinson’s awareness.
• The Athletic highlights the work former NFL player Akbar Gbaja-Biamila has done to educate the Black community about Parkinson’s, the lack of diversity in research, and the importance of getting involved.

PARKINSON’S SURVEYS, CLINICAL TRIALS, and volunteer opportunities

• YOPD Survey – A doctoral student in occupational therapy at Russell Sage College is conducting a research study to determine the impact of Young Onset Parkinson’s Disease on cognition, quality of life, and life roles. If you received a Parkinson’s diagnosis before age 60, you can learn more and complete the survey here.
• Phoenix-Area Residents – Deep Brain Stimulation (DBS) and Exercise Study at Barrow Neurological Institute – This study aims to help researchers learn more about how aerobic exercise affects symptoms of Parkinson’s and quality of life in people who have DBS. They will also look at brain wave activity using the Medtronic Percept DBS device in order to better understand what changes in the brain might be caused by exercise and how that affects Parkinson’s symptoms. Reach out to Markey if interested.
• Colorado Oral Strengthening Device – The University of Colorado is looking for adults with Parkinson’s to participate in a research study exploring how a novel low-technology device can achieve an increase in tongue strength comparable to standard-of-care exercise using tongue depressors but with the kinematics and simple biofeedback of existing high-cost devices. Research has shown that tongue resistance exercises paired with biofeedback have resulted in improved tongue strength to support chewing, control of food and liquid in the mouth, and propulsion of material for a swallow. Learn more and enroll here.
• Do you have early-stage Parkinson’s? The Orchestra Study is a clinical research study to evaluate the use of an investigational medication called UCB0599 in men and women with early-stage Parkinson’s. You can learn more and see if you qualify here.
• PD GENEration – The Parkinson’s Foundation has announced a major expansion of its national study to make genetic testing and counseling more available for people with Parkinson’s. The study (NCT04057794) hopes to enroll 15,000 people in all 50 US states, Puerto Rico, and the Dominican Republic. Details are available here. For questions about enrollment, email [email protected].
• Parkinson’s Progression Markers Initiative – In an expanded study, the Parkinson’s Progression Markers Initiative (PPMI) is currently working to enroll up to 100,000 people with and without Parkinson’s. The study team is especially seeking to enroll people diagnosed with Parkinson’s in the past two years and who are not yet on treatment, as well as people 60 and older who aren’t living with Parkinson’s but have a risk factor for it (such as a close relative with Parkinson’s, a known Parkinson’s-associated mutation, and/or REM sleep behavior disorder). The observational study is also enrolling people with no known connection to Parkinson’s to serve as a control group. Learn more here.
• TOPAZ (Trial of Parkinson’s and Zoledronic Acid) – Caroline Tanner, MD, PhD, is recruiting participants for a new remote clinical trial led by a team of Parkinson’s experts at UCSF in partnership with researchers from across the country. The study aims to help people with Parkinson’s or parkinsonism maintain their independence by reducing the risk of hip fractures. The study will test if zoledronate, an FDA-approved medication for osteoporosis, can prevent fractures in people with Parkinson’s, whether or not they have osteoporosis. To learn more, visit the study website at TOPAZstudy.org, email [email protected], or call (415) 317-5748.
• Join Google and LSVT in Project Euphonia – LSVT Global has partnered with Google on an exciting research project called Project Euphonia to help improve automatic speech recognition software for people with speech disorders. These disorders may make using devices like Google Home, The Nest, and other Smart devices, Siri, Alexa, or speech-to-text frustrating. To do this, LSVT Global needs samples of disordered speech to train the system. You are encouraged to enroll if you’ve been diagnosed with Parkinson’s, PSP, MSA, or CBD with mild, moderate, or severe speech disorders. Participation is easy, can be done from your own home, and can earn you a $60 gift card! Learn more here.
• G2019S LRRK2 Parkinson’s: Increasing Awareness and Genetic Testing Program – This program aims to support the development of precision medicine intended to treat people with genetic forms of Parkinson’s. Up to 15% of cases of Parkinson’s disease have an underlying genetic cause, yet many people have never had genetic testing. This research program will be very important in supporting the future development of a new oral precision medicine treatment for one of the most common genetic forms of Parkinson’s, aimed at slowing its progression. To learn more, visit geneticpd.com.
• A PD Avengers research group is undertaking a new project called Sparks of Experience, designed to be more systematic about collecting and considering the experiences and ideas that come from the curious minds of people living with Parkinson’s. “In the past, these sometimes quirky ideas inspired by lived experience have turned into significant new directions for research. It could be said we are trying to capture serendipity,” the team says. To learn more and get involved, see the flyer here. 
• Game-based Exercise Project – Researchers at the University of Auckland are investigating how games can be used as potential rehabilitation systems. This project aims to develop suitable game-based exercise experiences to help people living with Parkinson’s. If you are 45 or older, living with a chronic condition such as Parkinson’s, and/or are experiencing age-related health conditions, you are invited to participate in a survey that will help the researchers to understand the community’s interests in games and gameplay in the context of exercise and rehabilitation. To learn more and take the 15-minute survey, see the flyer here. 
• SPARX3 – A Phase 3 Clinical Trial about Exercise and Parkinson’s – This research team is currently seeking volunteers to participate in a clinical trial about the effects of aerobic exercise on people with Parkinson’s. Learn more and see if you qualify here. For more details, contact Katherine Balfany at [email protected].
• PAIRing Up – If you are a person with Parkinson’s or a care partner to someone with Parkinson’s, you are invited to participate in an online survey to address neuropsychiatric (cognition, depression, anxiety) concerns in Parkinson’s. The survey aims to learn about the needs and priorities for clinical care, education, support, and research related to neuropsychiatric symptoms. To learn more and participate, click here to download the flyer. 
• A multidisciplinary research team in the UK is investigating how to best use music to help people with Parkinson’s manage symptoms related to movement and mood. This includes research about music for dancing and is the first study to incorporate the new Dance Sophistication Index for people with Parkinson’s. To learn more and take a 30-minute survey, click here.
• The University of Oulu and collaborators from Aalborg University, Fraunhofer University, the University of Manchester, the University of Glasgow, the University of Lisbon, and the University of Melbourne, are conducting a survey for people with Parkinson’s and Parkinson’s care partners about self-care. Complete the survey here to share your self-care strategies and techniques. You can also review ideas submitted by others and add them to your own self-care toolbox.
• Home-based Exercise and Cognitive Behavior Therapy – University of Alabama in Huntsville
• Speech and Telemedicine Study – The Purdue Motor Speech Lab
• Parkinson’s and Service Dogs – University of Groningen, Netherlands
• Neurology Study Interest Registry – University of Rochester
• Park Test – University of Rochester

For more of what’s new in Parkinson’s news, check out our full series here. 

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