The Future of Parkinson's - A Glimpse into Tomorrow

Are you curious about the latest advancements in Parkinson's research? In this episode of Live Parkinson's - Live an Exceptional Life, we delve into the exciting future of Parkinson's disease.

Key topics covered:

• Understanding Parkinson's: A brief overview of the disease and its current state of research.
• Promising Avenues of Research: Explore the potential of stem cell therapy, gene therapy, drug discovery, and brain-computer interfaces.
• The Future of Parkinson's Care: Discuss the impact of personalized medicine, telehealth, and community support.
• A Glimpse into Tomorrow: Gain insights into the future of Parkinson's treatment and the hope it brings.

Tune in to discover the latest breakthroughs and learn how these advancements may shape the future of Parkinson's care.

 #ParkinsonsDisease #ParkinsonsResearch #ParkinsonsAwareness #Neurology #Science #Healthcare #FutureofMedicine #Hope #Inspiration #LiveParkinsons #LiveAnExceptionalLife

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References:

1. Assessment of heterogeneity among participants in the Parkinson's Progression Markers Initiative cohort using α-synuclein seed amplification: a cross-sectional study
2. Siderowf, Andrew et al.
3. The Lancet Neurology, Volume 22, Issue 5, 407 - 417

Parkinson's Disease Challenges, Progress, and Promise - National Institute of Neurological Disorders and Stroke

Stem Cell Therapy For Parkinson's Disease Shows Promise in Early Studies - UCI Health

From Lab to Bench To Hope: A Review of Gene Therapies in Clinical Trials for Parkinson's Disease and Challenges - Springer.com

Chapters

• 0:10 The Future of Parkinson's Research
• 12:38 Advancements in Parkinson's Disease Treatment
• 21:50 Empowering Future of Parkinson's Care

Transcript

Speaker 1: 0:10

Hello and welcome to Live Parkinson's Live an Exceptional Life. I'm your host, chris Kustenbader, and I've been living an exceptional life with Parkinson's for the past 14 years. The mission of this podcast is to help as many people as possible living with Parkinson's to lead a great quality of life. Today's topic is the future of Parkinson's a glimpse into tomorrow. Imagine a world where people with Parkinson's can live their lives without tremors, stiffness and slowness that define the disease, a world where they can walk freely, speak clearly and enjoy life to the fullest. This isn't just a dream. It's the goal of countless scientists and researchers around the globe. With the holidays upon us and a season of hope and new beginnings as we are approaching another new year, I wanted to provide some hope for people living with Parkinson's by looking at current research and promising therapies on the horizon. Today, we're diving deep into the exciting world of Parkinson's research. We'll explore the latest breakthroughs, promising new therapies and areas of research, and the hope that lies ahead for millions of people affected by the disease. Why is this so important? Parkinson's is the second fastest growing neurodegenerative disease behind alzheimer's disease. A 2022 parkinson's foundation back study reveals that nearly 90 000 people are diagnosed with parkinson's disease every year in the us. This is a 50 increase from the previous estimates of 60 000 diagnoses annually. The study also estimates that people living with Parkinson's will increase to 1.2 million by the year 2030. Those are some pretty sobering statistics, so that's why I wanted to share some hope and shine the light on these promising new therapies. While there are no guarantees, researchers are working hard to find a cure for this debilitating disease.

Speaker 1: 2:04

So let's provide a roadmap for what we'll be covering in this episode. First, we'll start with understanding the current state of research. I'll provide a quick overview of major milestones and breakthroughs, then discuss the current landscape and challenges in Parkinson's research, and then we'll take a look at some obstacles researchers face in finding a cure or effective treatment for Parkinson's. Then we'll transition into the next segment, looking at the promising avenues of research, including stem cell therapy, gene therapy, drug discovery and brain-computer interfaces. Then, in part three, we'll examine the future of Parkinson's care. We'll look at personalized medicine, telehealth and remote monitoring. In addition, we'll talk about support groups and advocacy, and then public policy, and then we'll tie it all together at the end. So if you're ready to join me, let's pull back the curtain and glimpse into the tomorrow for Parkinson's research, to understand where we're going. I think it's important to understand where we've been.

Speaker 1: 3:06

Parkinson's disease was named after the 19th century English physician, james Parkinson. It's a progressive neurodegenerative disorder that affects the nervous system. It's characterized by the loss of dopamine-producing cells and the substantia nigra in the brain. Dopamine is important in movement and motor control. Now, while the exact cause of Parkinson's remains unknown, researchers have identified several risk factors, including genetics, environmental toxins and aging. So let's take a look at the current landscape of research for Parkinson's and look at some key points from 2023 and 2024 in Parkinson's research. Now, the information that I'm going to be providing is from a number of different reputable and respected journals and foundation articles that I was able to do as part of the research. So here are some of the key points from the 2023-2024 Parkinson's research.

Speaker 1: 4:05

One of the things that researchers are working on is early detection and biomarkers. Studies are exploring blood tests to identify molecular changes associated with Parkinson's, potentially allowing for earlier diagnosis and monitoring of disease progression. Another key area that's being studied is gut-brain connection. Researchers are investigating the link between your gut microbiome alterations and Parkinson's disease, potentially offering new avenues for diagnosis and treatment. Another key area is alpha-synuclein targeting therapies. Scientists are investigating the use of antibodies designed to target and clear alpha-synuclein, which is a protein that aggregates, which is a key pathological feature of Parkinson's. In addition, they're using AI-assisted diagnostics. Artificial intelligence is being explored to analyze data like breathing patterns to potentially detect Parkinson's earlier. Another key area of study is non-motor symptoms. There's been increased attention is being paid to the non-motor symptoms of Parkinson's, which can be just as devastating on someone's quality of life as the motor symptoms. So areas that they're looking into are constipation, sleep disturbances and cognitive issues.

Speaker 1: 5:31

Okay, now let's look at some of the important research areas in 2023 and 2024. Genetics and risk factors identifying genetic mutations associated with increased Parkinson's risk, and also exploring environmental factors that may contribute to disease development. Another area that is a focus is disease modifying therapies developing treatments that can slow or halt the progression of Parkinson's disease. Beyond symptom management, personalized medicine, which we'll talk a little bit about later on, is tailoring treatment strategies on individual patient characteristics and genetic profiles. One of the most exciting pieces of current research benefiting the Parkinson's community was published in April of 2023 in the Lancet Neurology Journal by the leaders of the Parkinson's Progression Markers Initiative, or PPMI, funded by the Michael J Fox Foundation, the researchers were able to develop a biological test for Parkinson's disease that demonstrates high diagnostic accuracy, and it differentiates molecular subtypes and detects disease in individuals before cardinal movement symptoms arise. According to the Michael J Fox Foundation, this new test, known as alpha-synuclein seed amplification assay, has the revolutionary ability for researchers to define Parkinson's biologically and offers a critical tool for clinical trial design and assessment of treatment effects and for early detection of the disease. The assay accurately diagnosed disease in 99% or 274 of 279 people with smell loss and sporadic Parkinson's without a known casual genetic mutation. All right, so that's the current state of Parkinson's research and some of the major milestones and current breakthroughs.

Speaker 1: 7:26

Now let's look at some of the current challenges and obstacles in Parkinson's research that researchers face in finding a cure or effective treatment. So here are some of the key obstacles. Number one is the complexity of the disease. Parkinson's is a highly complex disease with symptoms and progression varying widely among individuals. This is why it's sometimes called a boutique disease, because while there are similar symptoms, many people experience them differently and at different rates. So, while two people may have Parkinson's, one may have tremors, the other may not, and or experience certain non-motor symptoms that someone else doesn't. So because of this, it's difficult to have a one-size-fits-all treatment for helping to either slow or halt the progression of Parkinson's.

Speaker 1: 8:14

Another challenge or barrier that researchers face is the lack of biomarkers. While there's been some great progress, there's a need for reliable biomarkers to diagnose Parkinson's early and track progression. Now, according to the article Parkinson's Disease Challenges Progress and Promise published by the National Institutes of Neurological Disorders and Stroke, they stated that there is no single definition or definitive test for diagnosing PD in a living person and there is no way to track disease progression on a biological level. So they further go on to say aside from finding a cure, the Holy Grail PD research is the discovery of biomarkers, detectable and measurable changes in the body that can be used to predict disease and monitor disease activity and progression. Biomarkers can be identified through a number of different methods, including imaging scans like an MRI or CT, biological samples like spinal fluid and plasma, and also through genetic studies.

Speaker 1: 9:19

A third challenge or obstacle is clinical trial design. Designing effective clinical trials for Parkinson's is challenging due to the variability in the disease progression and the need for long-term studies to assess the impact of treatments. According to the article Demystifying Parkinson's that was published in the Harvard Gazette. Number four is understanding disease mechanisms. While the loss of dopamine-producing neurons is a hallmark of Parkinson's, the underlying mechanisms are not fully understood. More research is needed to uncover the molecular and genetic factors involved in Parkinson's. Number five in terms of challenges is access to care. Many patients have challenges finding access to specialized care, including neurologists and movement disorder specialists. This can delay diagnosis and treatment, impacting the effectiveness of interventions. And then number six is comorbidities. Parkinson's patients often have other health conditions, such as depression and sleep disorders, which can complicate treatment and research effects.

Speaker 1: 10:23

All right, now that we have a good understanding of the current state of Parkinson's research and some of the challenges that researchers face, let's turn our attention now to the promising avenues of research in the Parkinson's arena, and let's lead it off with stem cell therapy. Now, before we dive into stem cell therapy for Parkinson's, I think it's important to discuss what stem cells are, because there's been a lot of discussion in the news about stem cells and should they be used or shouldn't they be used. Well, if you're like me, you may be scratching your head and asking well, what exactly are stem cells? Well, here's the short, simple explanation. There are unique cells with a remarkable ability to develop into many different cell types in the body during early life and growth. There are actually three types of stem cells Embryonic stem cells, and they're derived from embryos, specifically from a stage called the bladocyst. These cells are pluripotent, which means that they can turn into almost any cell type in the body, so these are often the ones that their use is considered controversial. Next is adult stem cells. These are found in tissues of fully developed organisms. They are multipotent, meaning that they can develop into a limited range of all cell types typically related to the tissue they are found in, like blood cells, bone, cartilage and fat cells. And then the third type is induced pluripotent stem cells, and they're created by reprogramming adult stem cells to revert themselves to a pluripotent state. These cells behave like embryonic stem cells and can develop into any cell type. So, for instance, they can develop into a brain cell or a red blood cell or a bone cell. And then so some of the functions and uses of stem cells. Number one is development and growth. They help with repair and regeneration of damaged tissues and research and medicine used in research to understand diseases. They can test new drugs and develop treatments for various conditions, including Parkinson's.

Speaker 1: 12:38

Okay, now that we know a little bit more about stem cells and the three types of stem cells, let's look at some current stem cell research for Parkinson's. The first stem cell therapy that I wanted to discuss is BEMDANE-PROSEL. According to the article, stem Cell Therapy for Parkinson's Disease Shows Promise in Early Study published in UCI Health. The article states that the results of first in human trial of a stem cell derived therapy for Parkinson's show signs of promise. Scientists reported at the International Congress of Parkinson's Disease and Movement Disorder meeting safe, well-tolerated and showed evidence of clinical improvement in a small study of 12 participants, said Dr Claire Henshcliffe, a leading Parkinson's disease expert and principal investigator of the clinical trial at the UCI Alpha Clinic. The therapy developed by Blue Rock Therapeutics said planning is underway for a phase two clinical trial in early 2024. The therapy involves injecting dopamine-producing neurons derived from human embryonic stem cells into the brain, aiming to restore dopamine production and alleviate symptoms. According to the article, next up in stem cell research is induced pluripotent stem cells, or IPSCs. Researchers are also exploring the use of IPSCs, which are adult cells reprogrammed to behave like embryonic cells. These cells can potentially be used to generate dopamine-producing neurons and replace damaged dopamine-producing cells.

Speaker 1: 14:22

The next promising avenue of research is gene therapy. Gene therapy for Parkinson's aims to target specific genes involved in the disease progression, and let's look at some of the key approaches and focus areas of gene therapy. First off is targeting alpha-synuclein. Researchers are developing gene therapies to reduce the production of alpha-synuclein, a protein that forms toxic clumps in the brain of people with Parkinson's. According to the article exploring the potential of gene and cell-based therapies in Parkinson's by the Parkinson's Foundation, by decreasing its production or preventing its aggregation, these therapies aim to slow disease progression. So if they can slow the aggregation of alpha-synuclein and prevent its aggregation, then hopefully that can lead to slowing or coming up with a cure for Parkinson's.

Speaker 1: 15:15

Second is dopamine production. Gene therapy can introduce genes that encode enzymes involved in dopamine synthesis or production, and this helps restore dopamine levels in the brain, which are significantly reduced in Parkinson's patients, according to the article From Lab Bench to Hope a Review of Gene Therapies and Clinical Trials for Parkinson's Disease and Challenges at Springercom. The third is neurotropic factors. Some gene therapies deliver genes that produce neurotropic factors, which are proteins that support growth and survival of dopamine-producing neurons. This can help protect the existing neurons and promote the growth of new ones. According to the article I just referenced, a review of gene therapy and clinical trials for Parkinson's disease. Another type of gene therapy is targeted brain circuits. Researchers have developed gene therapies that specifically target certain brain circuits affected by Parkinson's. For example, a study used an adeno-associated virus to target dopamine producing neurons in the substantia nigra, resulting in improved motor symptoms in primate models. According to the article in naturecom entitled Gene Therapy Zeros in on Parkinson's Disease Brain Circuits. And then another area that they're looking into with gene therapy is combination therapies. Gene therapy is often combined with other treatments, such as medications or deep brain stimulation, to enhance overall effectiveness. According to the Parkinson's Foundation, these approaches are still in the experimental stage, but they hold promise for improving the quality of life for people with Parkinson's.

Speaker 1: 17:01

All right, now let's look at the latest advancements in drug development, including new medications and drug delivery methods. In terms of new medications, the first one is VyaLev V-Y-A-L-E-V. This medication was approved by the FDA in 2023 to treat motor fluctuations in people with Parkinson's disease. It's a combination of levodopa, carbidopa and a new drug called embresia. Now, I actually participated in the embresia clinical studies and I still use it today. Next up is Crexent, and it's a reformulated, longer-acting version of carbidopa levodopa approved by the FDA in 2024. Its aim is to provide better symptom control with fewer doses. So that's Crexant C-R-E-X-O-N-T. So they're the two new medications out in the market, vialev and Crexin.

Speaker 1: 18:02

Now let's talk about drug delivery methods. The first one I want to discuss is continuous subcutaneous apomorphine infusion. This method involves a pump that's going to deliver a continuous supply of apomorphine, a dopamine agonist, directly under the skin, and this can help smooth out symptom fluctuations and reduce off times. Another one is injectable therapies. Researchers are exploring injectable therapies that can deliver drugs directly to the brain, bypassing the blood-brain barrier. This could potentially provide more targeted and effective treatments.

Speaker 1: 18:40

And then, finally, let's dive into brain-computer interfaces, which hold significant promise in improving the lives of people with Parkinson's. By directly connecting the brain to external devices, brain-computer interfaces can help restore lost motor function and alleviate symptoms. So let's explore some of these brain-computer interfaces. First up is real-time symptom detection and response, and let's take a look at tremor detection. Brain-computer interfaces can detect the onset of tremors by monitoring brain activity patterns associated with these involuntary movements, according to the study Tremor Suppression Orthosis for Upper Limbs published in Springercom. Adaptive stimulation Once a tremor is detected. Bci brain-computer interface can trigger targeted stimulation to counteract the tremor, potentially reducing its severity or duration. According to the study, brain-computer interfaces for treatment of neurological disorders Number two.

Speaker 1: 19:41

Next up is enhanced deep brain stimulation Personalized stimulation Brain-computer interfaces can optimize the parameters of DBS, tailoring the stimulation to the individual's specific needs and minimizing side effects. They also have closed-loop systems. By continually monitoring brain activity, brain computer interfaces can adjust the stimulation in real time, providing more precise and effective control over symptoms. And that comes from the article why Closed-Loop Cortec, thinking Ahead. Next up is neurorehabilitation motor function restoration. Bcis or brain computer interfaces can be used to train the brain to relearn motor skills such as walking or reaching, by providing real-time feedback and reinforcement and that comes from brain-computer interface in healthcare emerging markets. And then, in terms of neuro feedback, by providing visual or auditory feedback on brain activity, brain-computer interfaces can help individuals with Parkinson's develop better control over their movement.

Speaker 1: 20:46

Okay, now we've explored some promising avenues of research. Now let's turn our attention to the future of Parkinson's care, and let's lead it off with personalized medicine. And what do we mean by that? Well, personalized medicine is an approach to medical treatment that tailors therapies to individual patients based on their genetic makeup, lifestyle and environmental factors. It aims to maximize treatment efficiency while minimizing side effects. So, in terms of Parkinson's, personalized medicine can be based on genetic profiling to identify disease risk, predict how the disease may progress and in helping select optimal medications. It can also be used for biomarker analysis to monitor disease progression and early detection. Imagery studies can assess brain changes, and it can be used to tailor personalized exercise and diet plans. Other areas to briefly include are telehealth and remote monitoring, support groups, community advocacy and policy.

Speaker 1: 21:50

Now there's still much to learn about Parkinson's disease and the future is filled with hope. With ongoing research, innovative treatments and supportive communities, we can work toward a future where Parkinson's is no longer a debilitating disease. So thank you for joining me today. Please visit my website, libparkinsonscom, and subscribe to the free monthly newsletter, and there's also free resources to help you live your best life with Parkinson's, as well as articles to keep you up to date. And if you want to support this podcast, visit my Ko-fi page, ko-ficom. Slash live Parkinson's and buy me a cup of coffee. Thanks again for listening. Until next time, stay positive, stay healthy, stay strong and live your best life with Parkinson's. You.