You can find out more about NPF's National Medical Director, Dr. Michael S. Okun, by also visiting the NPF Center of Excellence, University of Florida Center for Movement Disorders & Neurorestoration.

Patients and family members have been waiting for news about the possibility of a blood test to detect Parkinson’s disease.   In November, a small article was published in the FASEB journal where Foulds and colleagues reported the results of a pilot study that examined phosphorylated alpha-synuclein as a potential candidate for use as a blood test in detection of Parkinson’s disease.  In this month’s What’s Hot column we will examine this recent paper, discuss the current state of the field, and discuss how the development of a blood test could affect those at risk, and those suffering from Parkinson’s disease.

The investigation focused on a protein called alpha-synuclein which is thought to be important to the cause of Parkinson’s disease, and is a critical component in the deposits that accumulate in the Parkinson brain.  The authors measured alpha-synulcein in both Parkinson’s disease and in control patients.  They reported that Parkinson’s disease patients had an abnormal phosphorylated form of alpha-synuclein.  The changes in the blood were sampled over a three-month period, and were found to be stable in 30 patients; and they were in general, not present in control subjects.

There were, however, several issues with this study.  First, the sample size was too small to conclude that this test will prove viable in a much larger population of Parkinson’s disease patients.  Second, the authors provided little information on the actual patients they studied. Parkinson’s disease is not one disease, and as groups develop blood tests, they will need to carefully characterize and report the clinical symptoms of the patients studied.  Additionally, groups will need to be cautious in understanding which types of patients will reveal blood changes, and more importantly, which groups will not.  Finally, changes in phosphorylated alpha-synuclein could possibly occur in other Parkinsonian syndromes, other neurological diseases, and other systemic diseases.  These other diseases must be carefully investigated.  Though there were important methodological issues with this study, it is still likely we will see Parkinson’s disease blood tests and biomarkers in the near future.

If successfully developed how would a blood test for Parkinson’s disease be used?  There are several potential options for this emerging technology.  First, if a disease modifying therapy can be developed, then identifying at risk patients for early intervention could be critical.  A blood test could potentially identify those at risk, and help to facilitate early intervention.  Another important use for a blood test could be in monitoring the symptomatic treatment of current Parkinson’s disease sufferers, especially in those enrolled in drug trials.  The test would however, need to reflect changes in biological activity over time, and would also need to closely correlate to changes in disease state (e.g. progression of symptoms). 

A blood test for Parkinson’s disease would also introduce important ethical considerations, especially for asymptomatic individuals.  Though the test may not reflect genetic status, it may unmask a Parkinson’s disease diagnosis.  Revealing a potential risk to develop Parkinson’s disease could profoundly change a person’s life.  Studies of genetic counseling have revealed that once patients understand the implications of a blood/genetic test, they will often decline it.  Additionally, for currently symptomatic individuals, close monitoring of disease status could result in stress, anxiety, and worry that may translate into a worsened overall quality of life.

It is important to understand that many groups around the world are attempting to develop blood tests and biomarkers for Parkinson’s disease.  It is likely that many of the methodological limitations limiting blood tests will soon wane, and that successful approaches will emerge.  As we move forward it will be important for the field to clearly define the potential uses of a blood test, and especially to protect patients and also to protect families.  It is also important that patients understand that there will likely be more than one blood test in the future, and that close communication with their doctors will be critical in deciding which test, or which battery of tests would be appropriate to check. In summary, the development of blood tests and biomarkers has the potential to improve the lives of many Parkinson’s disease patients, and also to push the research horizon in a positive direction.  These tests must be pursued cautiously and with an open mind as to how they will affect both the population at risk, and the people currently living with Parkinson’s disease.

Selected Reference
Foulds, P. G., Mitchell, J. D., Parker, A., Turner, R., Green, G., Diggle, P., Hasegawa, M., Taylor, M., Mann, D., Allsop, D. Phosphorylated alpha-synuclein can be detected in blood plasma and is potentially a useful biomarker for Parkinson’s disease. FASEB J. 25, 4127–4137 (2011). www.fasebj.org

Posted: 1/3/2012 8:14:06 AM by Cathy Whitlock


Browse current and archived What's Hot in PD? articles, the National Parkinson Foundation's monthly blog for people with Parkinson's written by our National Medical Director, Dr. Michael S. Okun. 

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February 2014
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January 2014
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December 2013
Could Fungus and Mold be an Important Contributor to Parkinson’s Disease?

November 2013
Pimavanserin and the Hope for a Better Drug for Hallucinations and Psychosis in Parkinson’s Disease

October 2013
Halting of the Creatine Study

September 2013
The Importance of Identifying and Treating Caregiver Strain

August 2013
Putting Parkinson’s Disease Information into the Palm of Your Hand: Parkinson’s Enters the Smartphon

July 2013
What Parkinson’s Disease Patients Need to Know about H. Pylori Gastrointestinal Infections

June 2013
A2A Receptor Antagonists and Parkinson’s Disease Treatment

May 2013
Another Setback for Trophic Factor Treatment in Parkinson's Disease

April 2013
IPX066 and What Patients Really Want in New Carbidopa/Levodopa (Sinemet) Formulations

March 2013
The Weather Forecast for Parkinson’s Disease Calls for Worldwide Economic Storm

February 2013
Defeating the Barriers to Implementing Exercise Regimens in Parkinson’s Disease Patients

January 2013
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December 2012
Neurologist Care Reduces Hospitalizations in Parkinson's Disease

November 2012
A Victory in Court for Parkinson's Disease Patients who Require Ongoing Rehabilitative Therapies

October 2012
Given the recent FDA announcement about Mirapex (pramipexole), should I be worried about dopamine agonists?

September 2012
What about the new Parkinson’s Disease Vaccine? What should I know?

August 2012
Caffeine as a Potential Treatment for Parkinson’s Disease

July 2012
Time to Consider GPi DBS for Parkinson’s Disease: A Shift in the Practice of Patient Selection for DBS

June 2012
A New Treatment for Parkinson’s Disease-Related Constipation

May 2012
Too Many Pills: Improving Delivery Systems for Parkinson’s Disease Drugs

April 2012
Measuring Quality and Assessing Depression in Parkinson's Disease

March 2012
Watch out for Unexpected Obstacles if You Use a Cueing Strategy to Break Freezing of Gait in Parkinson’s Disease

February 2012
Pill Color, Generic Medications and Insurance Issues: Important Medication-Related Tips for the Parkinson’s Disease Patient

January 2012
Are Blood Tests for Parkinson’s Disease on the Horizon?

December 2011
Placing Stem Cells in Animal Models of Parkinson’s Disease: Another Important Step

November 2011
Important News for the Parkinson’s Disease Community: More Evidence that Sinemet and Madopar are Not Toxic and do Not Accelerate Disease Progression

October 2011
The Case for All Parkinson’s Disease Patients to be Co-managed by a Primary Care-Neurologist Team

September 2011
Scientists say Research on Brain Proteins Involved in Parkinson’s Disease is “Shaping” Up

August 2011
Who Actually Takes Care of Most of the Parkinson’s Patients Worldwide: The Need for Education and the Parkinson’s Toolkit

July 2011
If you are Dizzy or Passing Out, it could be Your Parkinson’s Disease or Parkinson’s Disease Medications

June 2011
How Will Group Visits for Parkinson’s Disease Fit into the Future of Parkinson’s Disease Care?

May 2011
Why Patients Should be Wary of Chelation Therapy for Parkinson’s Disease

April 2011
Opening the Door to Gene Therapy in Parkinson’s Disease: The Need for Refinement of the Technology and Approach

March 2011
Does it Matter if I Can’t Get Brand Sinemet?

February 2011
Should I get a DaTscan or PET scan to confirm my diagnosis of Parkinson’s disease?

January 2011
A Critical Reappraisal of the Worst Drugs in Parkinson’s Disease

December 2010
Environmental Risks for PD: Manganese, Welding, Mining, and Parkinsonism

November 2010
Calling for the FDA to Revise the Eight Sinemet a Day Rule

October 2010
Dry Cleaning Solvents and Potential Environmental Risks for Developing Parkinson’s Disease

September 2010
Maintaining the Balance: Why Parkinson’s Disease Patients Need to Understand Drug Recalls, Withdrawals, and Safety Alerts

August 2010
Shining a Light on Parkinson’s Disease: Optogenetics Has a Bright Future in Research

July 2010
Poor Medication Management of Parkinson's Disease During Hospital Admissions: Patients and Families Can Improve Their Hospital-Based Management

June 2010
Why Are Patches and Continuous Release Technology a Big Deal to Parkinson's?

May 2010
Is the PD SURG Trial Another Surge Forward for DBS Therapy?

April 2010
Cycling in PD in Those Who Can’t Walk: Is it Possible?

March 2010
New iPS Stem Cells for PD: What Does it Mean?

February 2010
Time for Comprehensive Care Networks for PD

January 2010
Is Parkinson's Disease a Prion Disease?

December 2009
Parkinson's Disease Linked to Gaucher's Disease

November 2009
Brain Cells Keep Time Stamps: Implications for Parkinson's Disease Therapies

October 2009
Is it Safe to Have an MRI with a DBS in Place?

September 2009
Take Care of Your Bones as They Are Affected in Parkinson's Disease (Even in Men)

August 2009
Is it Time to Start Paying Attention to Pain Symptoms in Parkinson's Disease Patients?

July 2009
Glutathione Fails to Demonstrate Significant Improvement in PD Symptoms

June 2009
Keeping an Eye on Trials Important to the Parkinson's Disease Patient

May 2009
Increased Risk of Melanoma in Parkinson's Disease

April 2009
Finally a DBS Expert Consensus Statement Aimed at Their True Customers: The Patients

March 2009
Pesticides and Environmental Exposure in Parkinson's disease: Should We Stay Away From the Stink Truck?

February 2009
Is Exercise Effective Treatment and Protection Against PD?

January 2009
Why are Transplant Trials Struggling to Succeed in the Treatment of PD?

December 2008
Are Monoamine Oxidase Inhibitors Disease Modifying or Neuroprotective in PD?

November 2008
Update on Gene Therapy for Parkinson's Disease

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Each month, we will feature a new column by NPF's National Medical Director, Dr. Michael Okun, on the latest developments in Parkinson's disease research. Read the latest "What's Hot in PD?" below.

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