June 26, 2017Neurology
Currently available Parkinson's disease (PD) medications are only effective in improving motor deficits caused by the disease. However, the loss of cognitive abilities severely affects the individual's quality of life and independence. One barrier to developing treatments for the cognitive effects of PD is the considerable variability among patients. As a result, a study must enroll several hundred patients when designing clinical trials to test treatments. Although PD is commonly thought of as a movement disorder, but after years of living with the disease, approximately 25% of patients also experience deficits in cognition that impair function.
According to an article published online in Lancet Neurology (16 June 2017), a newly developed research tool may help predict a patient's risk for developing dementia and could enable clinical trials aimed at finding treatments to prevent the cognitive effects of the disease. The study combined data from 3,200 people with PD, representing more than 25,000 individual clinical assessments and evaluated seven known clinical and genetic risk factors associated with developing dementia. From this information, a computer-based risk calculator was built that may predict the chance that an individual with PD will develop cognitive deficits. Interestingly, a patient's education appeared to have a powerful impact on the risk of memory loss. The more years of formal education patients in the study had, the greater was their protection against cognitive decline.
Moving forward, the authors plan to further improve the cognitive risk score calculator. The team is scanning the genome of patients to hunt for new progression genes. Ultimately, it is their hope that the tool can be used in the clinic in addition to helping with clinical trial design. However, considerable research remains to be done before that will be possible. One complication for the use of this calculator in the clinic is the lack of available treatments for PD-related cognitive deficits. Clinicians face ethical issues concerning whether patients should be informed of their risk when there is little available to help them. It is hoped that by improving clinical trial design, the risk calculator can first aid in the discovery of new treatments and determine which patients would benefit most from the new treatments.