Characterizing Impairment Trajectories in People with Parkinson’s Disease

Study Rationale: 
Little is known about what causes individuals with Parkinson’s disease (PD) to develop symptoms, much less the genetic and non-genetic factors that influence these changes. In most cases, it seems as if people with PD accrue motor and non-motor impairments unpredictably and with varying severity, which presents a challenges for both research and care. Pinpointing impairment endpoints — and identifying the factors that influence these endpoints — will significantly advance our understanding of the biological processes that precipitate the complications associated with PD, a necessary step for slowing and stopping PD progression.

Hypothesis:
We hypothesize that there exist naturally occurring clusters of people with PD that, over time, experience similar patterns of changes in mobility and pain. We further hypothesize that genetic variation contributes to this observable variation in mobility and pain in people with PD.

Study Design:
Using machine learning algorithms and patient-reported outcomes, we will identify distinct subgroups of people with PD who display similar impairment patterns in mobility and pain. Once we have ascertained these distinct subgroups, we will isolate genetic and non-genetic factors that contribute to these subgroup assignments (for example, to a more severe versus a less severe impairment pattern).

Impact on Diagnosis/Treatment of Parkinson’s Disease:
This project has the potential to significantly advance clinical trials and other research by uncovering unique impairment patterns in mobility and pain. It will also contribute to efforts for predicting long-term outcomes and could uncover novel biological processes that will aide in developing new therapies.

Next Steps for Development:
Our impairment models could provide a predictive tool that will help clinicians and people with PD map out the potential trajectories of disease progression, improving both PD care and self-management. The findings from the genetic studies could provide novel targets for the development of new drugs for PD.