As researchers advance treatments for Parkinson’s disease (PD), there is a critical need to engage with the Parkinson’s community early and often during the research process. Populations of focus — including Black and African Americans, hispanics/latinos, women and others — are often underrepresented in, and historically excluded from, research. Engaging these communities in the development of drugs and the design of clinical trials creates an opportunity for greater representation in research. The Parkinson’s Foundation is committed to making research inclusive and creating a systemic change in the PD research space.

In September 2023, the Parkinson’s Foundation hosted a new, tailored version of its Learning Institute, which trains people with Parkinson’s and care partners in research and advocacy to work alongside scientists and government agencies in the drug development process.

Held in Atlanta, GA, in collaboration with Morehouse School of Medicine, the new training sought to engage the Black and African American Parkinson’s community (people with Parkinson’s, care partners, neurologists and professionals). During a three-day training, participants found community, learned how to confidently work alongside researchers and use their voice to advocate for changes in research.

“As a Foundation, we are actively creating programs and developing partnerships that will advance health equity for populations of focus,” said Evelyn Stevens, senior director of community engagement at the Parkinson’s Foundation. “We designed this educational and interactive training to deepen our understanding of the current needs of Black and African American people living with Parkinson's, and their care partners.”

The training included exclusive insight into the Foundation’s global genetics initiative, PD GENEration: Mapping the Future of Parkinson’s, and the opportunity to enroll and receive on-site genetic testing as part of the study. Before the training, 29% of attendees had reported participating in a research study. By the end of the Learning Institute, 100% of participants with Parkinson's had completed their first research study, PD GENEration. 

“Being part of the faculty for the Learning Institute to advance health equity in Parkinson’s care for the African American community was remarkable.”

- Reversa Joseph, MD, movement disorders specialist at Chalmers P. Wylie Veterans Outpatient Clinic

“I was honored to present on ethics in research as it was vital to empower participants with an understanding of the research process, enabling them to make informed decisions about clinical trial participation,” said Dr. Joseph. 

Ensuring diversity and inclusivity in Parkinson’s research is critical to accelerating breakthroughs toward a cure, which is why PD GENEration is designed to increase racial diversity among participants. In 2023, it announced Morehouse School of Medicine as the first historically Black institution of medicine to become a PD GENEration research site (read the article).

As of January 2024, 14.9% of PD GENEration participants are racially diverse. For perspective, U.S. clinical trials generally achieve less than 2% of diversity among participants.

“PD GENEration has established a strong relationship with the community through engagement and programs,” said Amasi Kumeh, director of research partnerships at the Parkinson’s Foundation. “We have become a gateway to research, helping recruit diverse participants for clinical trials and providing information about the process.”

The Learning Institute also emphasized community. The YMCA of Metro Atlanta, The Center for Movement Challenges, and a physical therapist from Emory University hosted a movement break for attendees, as exercise is proven to help people with PD manage symptoms. On the final afternoon, community members of Atlanta were invited to learn more about PD, get resources and meet the graduates of new class of 2023 Research Advocates.

No Topic Off-Limits

Black and African Americans experience health disparities when navigating Parkinson’s from day one — and are more likely to be diagnosed later in the disease stage than white people. Knowing this, the event was designed to welcome open conversation. “We wanted to provide a safe space for everyone to share their experiences and learn from one another,” Evelyn said.

For the first time, roundtable discussions were hosted. Every table was assigned a PD expert, neurologist or Parkinson’s Foundation staff member to lead a PD topic — from symptom management to best ways to reach the Black and African American community and how to connect people to PD resources.

“The moment that I stepped into the conference room for my first day of training, I knew this would be a life-changing experience.”

- Vanessa Russell Palmer, a person with Parkinson’s and Learning Institute attendee

“Interacting with other African Americans with Parkinson's, neurologists that look like me and sharing our daily challenges was empowering," said Vanessa. Becoming a Parkinson's Foundation Research Advocate has provided me with a new village of support, and I feel empowered to fight this disease every day and to work to bring more information about Parkinson's research and access to care to the African American community.”

Discussing the ethics of research was central to the training, directly addressing medical mistrust and the historical mistreatment the community has experienced in research and care. “Understanding past mistakes is crucial to preventing their recurrence, and it was rewarding to highlight the oversight that is now in place to ensure ethical research practices. Discussing the root causes of medical mistrust is necessary for acknowledgment and progress, fostering a path towards informed and empowered healthcare decisions,” said Dr. Joseph.

Through this training and other initiatives, the Foundation aims to continue addressing the ethical barriers associated with research in its effort to help all people live better with Parkinson’s.

Diversifying Research

Diversity in research accelerates the rate that researchers can better understand PD and drives better outcomes for the entire PD community. Research advocates return to their communities, activated and inspired to raise awareness and educate their community about the importance of taking part in clinical trials. “Diversifying research gets us one step closer in our efforts to advance treatments and find a cure for Parkinson’s disease.” said Evelyn.

Next, the Parkinson’s Foundation is working to tailor more trainings and local educational events to populations of focus. As with every Foundation event, the focus remains to ensure all people with PD and their families have what they need to manage this disease and live better with Parkinson’s.

Help spread Parkinson's awareness and register to attend a local event today. 

A new study indicates that tiny particles of polystyrene can promote the clumping of a protein involved in Parkinson’s.

Plastic waste is a growing problem, and as plastics break down the pieces can be problematic. A new study in Science Advances suggests that tiny plastic particles may be the latest environmental contributor to Parkinson’s disease (PD).

Microplastics are defined as particles smaller than 5 millimeters in diameter — for comparison, a grain of rice is 6 millimeters— and can also include nanoplastics (less than 1 micrometer). According to past research, it is common for blood samples to contain polystyrene nanoparticles, which come from pieces of foam packing materials, cups and cutlery. Research has also shown that unlike other kinds of plastic, polystyrene nanoparticles can enter the brain.

Parkinson’s disease is diagnosed when a protein, called alpha-synuclein, begins to clump in vulnerable neurons in the brain. The clumping ultimately affects dopamine, the neurotransmitter that gets progressively lost in PD, leading to early signs of the disease. This new study shows that polystyrene nanoparticles can interact with alpha-synuclein and promote its clumping in test tubes, in brain cells grown in a petri dish, and in mice.

About the Study & Results

Nanoplastic contaminants promote alpha-synuclein clumping.

Researchers mixed alpha-synuclein “seeds” with nanoplastics in test tubes to see if the presence of nanoplastics triggered the clumping of alpha-synuclein. After three days, they observed that, when combined with alpha-synuclein seeds, the nanoplastics promoted the acceleration of alpha-synuclein clumping formations.

Nanoplastic contaminants interact with alpha-synuclein at very specific regions of the protein.

Using computer modeling, the research team predicted a strong interaction between polystyrene nanoparticles and a region of alpha-synuclein. To validate this prediction, the team created a shortened version of alpha-synuclein that lacked the region the nanoparticles were predicted to interact with. Without that part of alpha-synuclein, the nanoparticles did not stick to the protein in lab experiments, indicating that the computer model was accurate.

Nanoplastic contaminants accelerate alpha synuclein clumping in neurons.

In mouse neurons grown in a petri dish, the researchers observed that nanoplastics were internalized into a specific compartment within the cell, called the lysosome, where alpha-synuclein tends to clump. They found that the nanoplastics accelerated the accumulation of pathogenic alpha-synuclein in these cells.

Nanoplastic contaminants accelerate alpha synuclein clumping in the mouse brain.

The researchers injected alpha-synuclein seeds and nanoplastics into the brains of live mice and found that about 20% of dopaminergic neurons — those thought to be crucial in the development of Parkinson’s — internalized both. Injecting the combination into mice led to an increase in alpha-synuclein clumps in dopaminergic neurons and an increase in alpha-synuclein pathology (as measured by molecular markers) compared to injecting the seeds alone. In 3 of 10 mice injected, nanoplastics alone led to alpha-synuclein pathology.

Traces of polystyrene can be found in human brain tissues. Finally, in brain tissue samples obtained from people with Lewy body dementia, a condition characterized by the presence of alpha-synuclein aggregates, the research team identified traces of polystyrene. This discovery suggests the potential presence of plastic nanoparticles in the human brain.

Highlights

•  Alpha-synuclein clumping was triggered and/or accelerated by nanoplastics in three different models — test tubes, brain cells grown in a petri dish and in mice brains.
• The interaction between polystyrene nanoparticles and alpha-synuclein occurs at a specific region in the alpha-synuclein protein.
• In brain tissue samples from people with Lewy body dementia, traces of polystyrene can be detected, suggesting that plastic nanoparticles may be present in human brains.

What does this mean?

Plastic waste may be contributing to Parkinson’s as an environmental factor. However, we do not yet know how such interactions might be happening in humans and whether the type of plastic might play a role.

What do these findings mean to the people with PD right now?

People are exposed to and consume microplastics every day, through breathing, eating foods and drinking liquids — whether they are packaged in plastic or not. Studies like this one are integral to disentangling how the effects of environmental toxicants contribute to the development of PD — we now know that polystyrene nanoparticles can make their way into the brain. Explore the environmental risk factors connected to Parkinson’s.

People who are concerned that they may be experiencing Parkinson’s symptoms should talk to a healthcare provider.

Learn More

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and the topics in this article through our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.

• Environmental Factors
• PD & Pollution: Something in the Air
• Top Parkinson’s Science News Articles of 2023