Prescott Family Initiative with the Arizona Parkinson's Disease Center:
Predictors of Parkinson’s Disease and Parkinson’s Disease-Associated Dementia
Charles H. Adler, MD, PhD and Thomas G. Beach, MD, PhD (Sun Health Research Institute)
Parkinson’s disease (PD) is currently diagnosed clinically by finding slowness of movement along with either rest tremor or rigidity. However, the only way to definitively diagnose PD is by autopsy. In addition to being a disorder of movement, 30-75% of patients with PD develop dementia which can be very disabling. While there are treatments (medications and surgical procedures) that improve the motor symptoms, there are no treatments that slow or halt disease progression or prevent dementia in PD. Unfortunately, the underlying cause of PD and of dementia in PD is unknown.
Since 1986 the Brain and Body Donation program at Sun Health Research Institute has been enrolling healthy elderly individuals and people with Parkinson’s disease, Alzheimer’s disease, and other neurologic disorders willing to donate their brain and other organs for research purposes. Currently there are ~800 living subjects enrolled and over 950 brains have been collected. Participants are evaluated annually by a movement disorders specialist, a behavioral neurologist and a neuropsychologist looking for signs of PD and dementia. The major goal is to find the earliest clinical markers for the onset of PD and for the onset of dementia in people with PD so that studies of treatments to slow or stop these disorders can be started earlier. One of the critical features of the program is the confirmation of the clinical diagnosis by autopsy.
The Prescott Initiative study has three Cores: Clinical, Neuropathology, and Bioinformatics. The Clinical Core is responsible for assessments of motor and cognitive function as well as smell and autonomic problems in those living individuals enrolled. The major goal will be to develop predictive models of risk for the development of PD and risk of onset of dementia in PD, by studying populations of individuals that do not have these disorders. The Neuropathology Core performs all of the autopsies and is undertaking studies of pathological markers of PD in both the peripheral nervous system and the central nervous system. These studies could lead to an earlier diagnosis of PD using laboratory methods. The Bioinformatics Core will refine the database that houses all the information that is gathered and develop a system that will eventually enable external researchers to access critical parts of the information.
The Arizona Parkinson Disease Consortium is a consortium of investigators at multiple institutions throughout Arizona: Mayo Clinic Scottsdale, Sun Health Research Institute, Barrow Neurologic Institute, Banner Good Samaritan Medical Center, Arizona State University, and the Translational Genomics Research Institute. The APDC focuses research on investigation into the causes and diagnosis of PD and dementia in PD, as well as formulation of cures and new treatments, including drug discovery and development that may ultimately lead to prevention, better treatments and a cure for the disease.