Podcast Episode 59: Understanding Biomarkers to Deliver Precise Treatments

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While Parkinson’s disease (PD) is a broad category that includes similar symptoms, each person’s disease may have different features, rate of progression, needs and treatments connected to the specific underlying cause of that person’s disease. As we move towards “personalized” or “precision medicine,” which strives to treat each person’s condition according to their unique disease, research in neurology needs the tools to be able to define differences that can allow a truly personalized approach to treatment. Measuring biomarkers, measurable features that are characteristic of a disease, is one of these tools that provides a better understanding of the disease’s underlying biology and causes. They could be imaging such as MRI, chemicals in the blood or brain, brain wave patterns, or even specific signs and symptoms.

Knowing the underlying causes of the disease can help to design and test therapies that could slow down or stop PD. Using biomarkers would be especially helpful for the design of clinical trials for several reasons. It would allow researchers to segment testing of medications by individuals with similar underlying biology in order to understand if it works for all or just some types of Parkinson’s. It would also help us better monitor if and how a drug is working. Neurologist Dr. Alberto Espay of the University of Cincinnati proposes that Parkinson’s research requires a new way of thinking based on biomarkers to know precisely what kind of disease one is dealing with, especially when participating in clinical trials. Drugs that work for one form of PD may not work for another. Dr. Espay compares the precision of treating Parkinson’s today to where the cancer field was 30 years ago.

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About This Episode

Released: July 16, 2019

Alberto J. Espay, MD, MSc, FAAN, FANA 

Dr. Alberto Espay is professor and endowed chair of the University of Cincinnati James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders. He trained in neurology at Indiana University as well as in clinical and electrophysiology of movement disorders at the University of Toronto, where he obtained a master’s degree in clinical epidemiology and healthcare research.

Dr. Espay served as chair of the Movement Disorders Section of the American Academy of Neurology; associate editor of Movement Disorders, the official journal of the International Parkinson and Movement Disorder Society (MDS); and in the executive committee of the Parkinson Study Group. He currently serves as chair of the MDS Task Force on Technology and as secretary-elect of the MDS Pan-American Section. Dr. Espay is also an honorary member of the Mexican Academy of Neurology and has received numerous awards, including the Cincinnati Business Courier’s Health Care Hero award, the Patients’ Choice award, the Compassionate Doctor award, and the Spanish Society of Neurology’s Cotzias award.

Dr. Espay has published more than 200 peer-reviewed research articles, 25 book chapters and five books. His research efforts have focused on the measurement of motor and behavioral phenomena in—and clinical trials for—Parkinson’s disease as well as in the understanding and management of functional movement disorders. With his colleagues at the Gardner Center, he recently launched a novel biomarker development program for neurodegenerative diseases with the aim of identifying small but biologically suitable subgroups most likely to respond to therapies already available for repurposing.

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For all of our Substantial Matters podcast episodes, visit parkinson.org/podcast

For more insights on this topic, listen to our podcast episodes “What is a Disease Modifying Therapy in PD?” and "The Skinny on Clinical Trials in PD."

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