Healthbeat Report: Predicting Parkinson's

May 24, 2012 (CHICAGO)

Richard Fiske Bailey says even he had a hard time realizing something was happening with his body. It was the way he was driving his sports car that caught the attention of friends.

"When I went to shift gears I would reach down with my left hand and shift I would shift with my left hand instead of my right hand, I never noticed it. And people would start to say, what is wrong," Fiske said.

It took a long time but eventually he had a diagnosis: Parkinson's disease.

"I was formally diagnosed in 2003 by my fifth neurologist," Fiske said.

A slight tremor in a hand, tense muscles and slow movements are some of the more distinctive signs suggesting Parkinson's disease. But even these can be confused with other conditions. That means thousands of cases are not diagnosed until a lot of brain cells are gone.

Parkinson's disease occurs when the nerve cells in the brain that make a chemical called dopamine are slowly destroyed. No one is sure why that happens.

Now researchers are turning to what would seem an unlikely source of a brain disorder: the gut.

"This area of research is really hot right now, and we think it's really important," said Dr. Kathleen Shannon, neurologist, Rush University Medical Center

There is growing evidence that Parkinson's disease may begin in the intestinal wall then spread to the brain.

"It's a game changer. First of all, it's a way to identify patients who have Parkinson's disease decades before they ever actually have the symptoms," said Jeffrey H. Kordower, Ph.D., neuroscientist, Rush University Medical Center.

In very small study, researchers at Rush University Medical Center examined tissue samples taken from patients during colonoscopies years before they showed any symptoms of Parkinson's. What the Rush scientists were looking for is something called alpha synuclein. It's a protein that accumulates in the brains of Parkinson's patients and is considered a pathologic hallmark of the disorder. It also seems to gather in the intestines.

"Even before the brain cells are infected the nerve cells in the wall of the intestines are affected with the same protein," said Dr. Shannon.

So how those proteins might get from the intestinal track to the brain is a mystery, but researchers suspect it's a very slow process, possibly taking years. Picking up signs of the protein through colonoscopy or sigmoidoscopy might one day be used to predict who's at risk for the disease, long before there is any damage in the brain.

Richard Fiske Bailey has been proactive, taking medications and participating in clinical research programs.

"I might be receiving benefit from the trials and two, I'm advancing the case for everybody," he said.

"That is the thing we are most excited about it the possibility we could intervene in the disease earlier, diagnose the disease earlier and have treatments that really make a difference," said Dr. Shannon.

While research might eventually lead to the use of colonoscopy to diagnose Parkinson's disease, scientists stress the need for more studies. The Michael J. Fox Foundation will be funding the next phase of this research at Rush.

For more information, call 312-563-2900 Extension 4 or visit http://www.rush.edu/rumc/page-1099611538174.html

The Michael J. Fox Foundation for Parkinson's Research
www.michaeljfox.org

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