An objective and valid trait and state biomarker of Parkinson’s disease will help therapeutic development by providing a measure to help confirm diagnosis (trait), and track disease progression (state). The purpose of this project is to further develop diffusion tensor imaging as a non-invasive trait biomarker for Parkinson’s disease.
The scientific plan is to test the global hypothesis that selected measures derived from diffusion tensor imaging provide a highly sensitive and specific, non-invasive trait biomarker of Parkinson’s disease. We will perform high-resolution diffusion tensor imaging on patients with atypical Parkinsonism and patients with moderate Parkinson’s disease. Specifically, patients diagnosed with progressive supranuclear palsy, multiple systems atrophy, and essential tremor will be studied. Blinded assessment of the diffusion tensor imaging data will be performed in the basal ganglia, thalamus, and cerebellum.
Relevance to Diagnosis/Treatment of Parkinson’s Disease:
Parkinson’s disease can be misdiagnosed with several forms of atypical Parkinsonism. This can occur even more frequently when a general neurologist makes the diagnosis, and still occurs when the most specialized movement disorders neurologist makes the diagnosis. Incorrect diagnoses haunt clinical medicine and clinical trials where new therapeutic targets are developed. This is because a drug posited to affect Parkinson’s disease should only be tested on this patient group, rather than on a patient misdiagnosed as having Parkinson’s disease.
We will deliver a solid assessment of whether diffusion tensor imaging identifies brain patterns that differentiate patients diagnosed with tremor and atypical Parkinsonism from patients diagnosed with Parkinson’s disease. If successful, we will deliver a technique that has the potential to be used widely because the machinery needed is a standard 3 Tesla General Electric scanner and the analysis software is available already. As such, it will be noninvasive, highly sensitive and specific, with the potential for direct utilization in hospitals and universities with standard 3 Tesla scanners.
The purpose of this project is to further develop diffusion tensor imaging as a non-invasive biomarker for Parkinson’s disease (PD). The current study will use brain imaging scans to target areas of the basal ganglia, cerebellum, and cortex to determine if diffusion tensor imaging can differentiate PD from Parkinson’s plus syndromes and from essential tremor. We will perform high-resolution DTI on 15 patients with essential tremor, 15 patients with progressive supranuclear palsy, 15 patients with the parkinsonian variant of multiple system atrophy, and 15 patients with PD. Several diseases such as progressive supranuclear palsy, multiple system atrophy, and essential tremor are frequently misdiagnosed as PD. Incorrect diagnoses haunt clinical medicine and clinical trials where new therapeutic targets are developed. Providing a noninvasive DTI biomarker that identifies PD and discriminates PD from other tremor and Parkinson plus syndromes will both facilitate early diagnosis and potentially provide a measure that can be used in clinical trial studies to aid therapeutic development.