By Karyn Odway

From predicting cognitive impairment to deep brain stimulation, advances in predicting disease course and in therapy technologies are resulting in better outcomes for Parkinson’s disease (PD) patients.

Katerina Markopoulou, MD, PhD, Neurological Institute, says new PD-focused research and advancements are showing promise in both diagnosing and treating this progressive and often disabling neurological disorder.

Cognitive Impairment Predictor

When it comes to cognitive impairment in people with PD, recent research is providing some insights into the disease course. It speaks to a newly identified Parkinson’s biomarker that may predict the development of cognitive impairment during the disease course.

“A rather routine clinical test, such as an electroencephalogram (EEG), can serve as a biomarker and assist in the management of the PD symptoms,” notes Dr. Markopoulou, who authored the study published in the Frontiers of Aging Neuroscience and presented it the American Academy of Neurology’s annual meeting last month. “It may help determine whether the disease course will be more severe, as cognitive impairment that may develop later in the course of the disease makes the clinical management more difficult.”

This PD biomarker also could lead to more targeted treatments. “The current treatment options for cognitive impairment are limited, however a biomarker such as the one we described may assist in selection of patients for clinical trials that aim to identify appropriate new therapies for cognitive impairment,” Dr. Markopoulou adds.

Currently, there is no way to slow the progression of PD, but as Dr. Markopoulou explains: “The better the characterization of the disease features, the better the chance of developing targeted therapies.”

Deep Brain Stimulation

One of those advanced therapies that evolved over the past 20 years is deep brain stimulation (DBS). In the appropriately selected PD patients DBS can significantly improve symptom control and make a difference in the quality of life of patients with PD.

“Considering the DBS option earlier in the disease process and not as a ‘last resort’ has improved clinical outcomes,” Dr. Markopoulou says.

The DBS treatment involves the insertion of electrodes in specific areas of the brain that control movement. These electrodes are connected to a battery implanted in the patient’s chest through which the neurologist  can adjust the electrical current that stimulates these specific brain areas to achieve symptom control by  improving tremor, slowness and stiffness that are associated with PD.

The technology has advanced significantly, according to Dr. Markopoulou. “The development of new stimulation electrodes has provided the neurologist with the ability to direct the stimulating current to achieve a better ”therapeutic window” with fewer side effects. In addition, the new batteries are able to sense the abnormal activity in these brain areas that underlies the parkinsonian symptoms, thus assisting in clinical management.

Dr. Markopoulou says the benefit of the DBS therapy is better and more long-lasting than medication alone. However, it is important to keep in mind that DBS, like the medications currently available to treat PD, are symptomatic therapies and they do not slow disease progression or cure the disease.

The patient that best qualifies for DBS treatment is one who has the disease for at least four years and has developed complications from the standard of care PD therapy known as levodopa.

Dr. Markopoulou now leads a global consortium,  the Genetic Epidemiology of Parkinson’s Disease Consortium(GEoPD) that isdedicated to promoting scientific research and education in the field of genetics of PD. Ongoing research efforts within the consortium are focused at how the genetic makeup of a PD patient may impact the selection of a PD patient for DBS, as well as the short and long term outcome of DBS surgery. Ultimately it is hoped that these research efforts will help improve treatments and the quality of life of PD patients.

Learn more about NorthShore’s Neurological Institute here; and its research & clinical trials here.