Gait instability and falls are among the most debilitating and frustrating symptoms for those with Parkinson’s disease (PD). Unfortunately, they are also often resistant to or only partially responsive to current therapies that work to increase the dopamine lacking in Parkinson’s. Researchers have therefore been considering the role other brain chemicals, including acetylcholine, play in ambulation issues.

Changes in the acetylcholine system have been implicated in Parkinson’s-associated cognitive dysfunction but might also be blamed for imbalance and falls. In a prior study funded by The Michael J. Fox Foundation, brain imaging showed loss of acetylcholine communication between a cluster of cells in the brainstem and other brain regions involved in coordinating movement and maintaining attention. In people with PD, this deficiency was correlated with increased falls and gait slowing. Another study also suggested that a drug that elevates acetylcholine levels may reduce falls.

To further explore the relationship between acetylcholine and movement problems, the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health (NIH), has awarded researchers at the University of Michigan an $11.5 million grant to launch a five-year study.

Scientists will focus their efforts on understanding the acetylcholine system in more detail, parsing out its effect on falls and assessing its responsiveness to a drug ­— Varenicline (Chantix) ­— that targets acetylcholine receptors. This medication is currently available by prescription to aid smoking cessation.

Investigators are hopeful that by delving into an area of Parkinson’s disease research not yet fully explored they will find more effective therapies specifically targeting gait dysfunction and falls.

Register with Fox Trial Finder to see if you're eligible to participate in this study, which is now recruiting.