Science News

New Study Finds Blood Test Can Help Track Parkinson’s Symptoms and Progression

Parkinson's Foundation Science News blogs

Researchers found changes in molecules in the brain and blood that are associated with Parkinson’s, they also found changes linked to certain symptoms

Two of the most widely recognized hallmarks of Parkinson’s disease (PD) are tremors and slowed movement. However, when these symptoms appear, it means that people with PD have already lost up to 60% of their dopamine neurons. Neurons are nerve cells in the brain that are crucial for maintaining a balanced and functioning nervous system.

Diagnosing and treating Parkinson’s early can fend off severe symptoms for years. Inversely, when a diagnosis is delayed, rapid decline can be more likely to occur. Unfortunately, there are no tools, besides assessing symptoms, to diagnose Parkinson’s or predict the course of the disease. However, a new study in Nature Communications has found evidence of molecular changes in the brain and blood of people with Parkinson’s who experience cognitive and movement complications of PD.

Finding molecular changes in the blood that mirror changes in the brain is essential for developing new minimally invasive tests that can diagnose Parkinson’s, be able to track the course of the disease, and monitor how it is responding to treatment.

Parkinson’s symptoms are primarily caused by the death of dopamine neurons in the brain. Dopamine allows us to regulate motivation, memory, cognitive functions, and motor skills. One critical region in the brain that relies on dopamine for these functions is the striatum, which has two regions that behave differently in Parkinson's:

Illustration of a female brains anatomy-the caudate nucleus
  • The caudate: When dopamine levels drop in this area, it leads to cognitive impairment.
  • The putamen: When dopamine levels drop in this area, motor control is impacted.

Both regions are densely populated with the same kinds of neurons. While we know how these areas impact movement and cognition, we still do not understand the molecular mechanisms underlying these distinct responses in the human brain.

To learn more about changes in these brain regions, which are difficult to study as they are deep in the brain, researchers used brain samples from 35 people who died with Parkinson’s and 40 people who died without neurological issues. They looked for changes in RNA (a molecule essential for various biological processes) and identified thousands of RNAs that were different in those with Parkinson’s compared to those who did not have the disease.

Study Findings

  1. RNA changes in the brain: Many of these RNA changes were linked to the function of the synapse, the special connection between nerve cells that allow them to communicate with each other. Researchers found decreases in RNAs involved in dopamine neuron dysfunction and death; an increase in RNAs involved in inflammation and immune hyperactivation; and an increase in RNAs involved in stress response.

  2. Mirroring patterns in the blood: To compare whether the changes they observed in the brain were mirrored in blood samples, the researchers accessed samples from the Parkinson’s Progression Markers Initiative (PPMI), which has collected blood from people who do and do not have Parkinson’s. They found that the RNA levels in the brain were altered in the same direction in the blood.

  3. Changes associated with cognitive impairment: The researchers found 57 RNAs in the caudate that were significantly altered in donors that had been diagnosed with Parkinson’s disease dementia. When researchers looked at the differences in RNAs in the blood of people with PD vs. healthy controls, they found a few RNAs that were altered in people with PD.
  4. Changes associated with movement symptoms: The researchers found 18 RNAs in the putamen that were significantly altered in donors who experienced levodopa-induced dyskinesia. When researchers looked at differences in RNAs in the blood of people with PD vs. healthy controls, they found no significant differences.
  5. Differential patterns depending on age at PD onset: The researchers also found differences between the brains of people who were diagnosed with Parkinson’s before and after the age of 55 — those who were diagnosed earlier showed fewer molecular changes than those who were diagnosed later. Similar results were found in blood.

Study Highlights

  • People with Parkinson’s have unique changes in RNA molecules in brain regions that rely on dopamine for regulating motivation, memory, cognitive functions, and motor skills.
  • Similar RNA changes were also observed in blood samples of people living with Parkinson’s.
  • Patterns of RNA changes were associated with certain symptoms (e.g., cognitive decline, motor complications) or disease features (e.g., early vs. late onset).

What does this mean?

Today, only invasive tests can track molecular changes in the brains of people with Parkinson’s. This study has found that molecular changes that happen in the brain can also be found in the blood. In the near future, this information can be leveraged to develop minimally invasive blood tests that could be used to help confirm a Parkinson’s diagnosis, track disease progression, and evaluate how the disease is responding to treatment. However, more studies are needed before these findings can be used as a clinical tool.

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

People with Parkinson’s symptoms should talk to their doctor about screening.

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.

Advancing Research

Neuro Talk: Accelerating Drug Discovery Through the Parkinson’s Virtual Biotech

Launching a new Parkinson’s disease (PD) drug can take years and cost upwards of one billion dollars. In our latest Neuro Talk, John L. Lehr, president and CEO of the Parkinson's Foundation, and Arthur Roach, director of the Parkinson’s Virtual Biotech at Parkinson’s UK, discuss how the Parkinson’s Virtual Biotech is accelerating PD drug discovery and development. John and Arthur share how this international collaboration will help find the next life-saving Parkinson’s drug in years, not decades.

Learn more about the Parkinson’s Virtual Biotech.

Videos & Webinars

Expert Briefing: Parkinson's and the Gut-Brain Connection

October 11, 2023

We know the brain and gut are connected. While stomach or intestinal distress can lead to anxiety or depression, gut-brain connections go much further — new research strongly suggests a link between the gut (the gastrointestinal system) and Parkinson’s disease. Learn more about the gut’s potential impact on symptoms and progression.

Download Slides - Introduction and Closing Remarks

Download Slides - Dr. Rusch's Presentation

Presenter

Carley Rusch, PhD, RDN, LDN, Medical Science Liaison
Abbott Nutrition

Videos & Webinars

Neuro Talk: Accelerating Drug Discovery Through the Parkinson’s Virtual Biotech

Launching a new Parkinson’s disease (PD) drug can take years and cost upwards of one billion dollars.

In our latest Neuro Talk, John L. Lehr, president and CEO of the Parkinson's Foundation, and Arthur Roach, director of the Parkinson’s Virtual Biotech at Parkinson’s UK, discuss how the Parkinson’s Virtual Biotech is accelerating PD drug discovery and development. This international collaboration will help find the next life-saving Parkinson’s drug in years, not decades.

Advancing Research

Meet the Researcher Working to Evolve Parkinson’s Therapies Through the Blood-Brain Barrier

Aurélie de Rus Jacquet headshot

The blood-brain barrier, a network of blood vessels that act as a security system to protect cells in the brain, is an understudied but vital area in Parkinson’s disease (PD) research. This barrier allows essential nutrients to enter the brain and keeps unwanted substances out, but the barrier deteriorates in people with PD. Aurélie de Rus Jacquet, PhD, is working to understand how inflammation can affect the permeability of the blood-brain barrier and identify potential therapies to address the problem.

“The blood-brain barrier is sort of the filter that allows good molecules to enter the brain, but prevents others from entering, therefore keeping them in the blood,” said Dr. de Rus Jacquet. “If that barrier stops working properly, a number of molecules that should stay in the blood may actually enter the brain and could end up triggering inflammation, neurodegeneration and all kinds of features that are really detrimental to the brain and are features of Parkinson’s disease.”                

Using a 3-D cellular model of the blood-brain barrier, Dr. de Rus Jacquet studied brain cells called astrocytes, which typically regulate the blood-brain barrier, from both people with and without the PD-related LRRK2 G2019S mutation. She found that the Parkinson’s astrocytes secrete harmful molecules and impair the filter function of the blood-brain barrier.

Now, she will study how astrocytes communicate with the immune system and look to identify the molecules that sneak through the blood-brain barrier and trigger neurodegeneration.

While a lot of existing and developing pharmacological therapies are focused around dopamine replacement, Dr. de Rus Jacquet’s research is looking to tackle Parkinson’s from a different angle.

“A lot of effort over the past decades has been focused on trying to find a therapy for dopaminergic neurons,” she said. “But maybe the question is, do we need to find a therapy that addresses dopaminergic neurons and other brain cells as well? One of the goals of this research is to find a way to target the potentially toxic molecules entering the brain from the blood early in Parkinson’s disease, before the neurons die. If we can identify and target those molecules before they enter the brain, it will facilitate drug discovery and success for future therapies.”

Dr. de Rus Jacquet started this important research during her Parkinson’s Foundation Postdoctoral Fellowship at Université Laval, Québec, Canada. Afterward, she went on to receive a Parkinson’s Foundation Launch Award to continue this research and has successfully transitioned to her own independent faculty position at Université Laval, where she now operates her own research lab. She recently published a paper on her research in Nature Communications.

“The support of the Parkinson’s Foundation has made a profound impact on my research and my career,” Dr. de Rus Jacquet said. “This work is very complicated and expensive, and the Foundation’s continued support allowed me to smoothly transition everything from my postdoctoral research into my own lab without any gap in timing.”

Dr. de Rus Jacquet is excited to continue to learn more about the blood-brain barrier and how better understanding of how it functions in people with PD can lead to new treatment options.

“Innovative research is what is necessary to make a difference in PD,” said James Beck, PhD, Parkinson’s Foundation chief scientific officer. “But innovation is not something you buy in a store — it takes people. This is why the Parkinson’s Foundation invests in scientists like Dr. de Rus Jacquet who have the insight, creativity and dedication to find new strategies to halt or prevent neurodegeneration in people with PD.” 

Now that she is running her own research lab, Dr. de Rus Jacquet is excited to work with students who are interested in PD research and is working to promote diversity in the patient population involved in research studies.

“I have moved on to a new stage where I can continue doing this promising research but also be impactful in other ways,” she said. “I can train the next generation of scientists and get them excited about this work. I can serve on committees working to reach out to a more diverse Parkinson’s population, which is so important to better understanding this disease. None of this work would be possible without the support I’ve received from the Parkinson’s Foundation and the donors who believe in this cause and this research. I’m deeply touched, and I am so grateful.”

For more information on our research grants, visit Parkinson.org/Grants.

My PD Story

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Researchers

Hong-Yuan Chu, PhD

2023 Impact Award  

Exploring New Types of Parkinson's-affected Neurons to Expand Treatment Opportunities

In Parkinson’s disease (PD), dopamine-releasing neurons in the brain region called the substantia nigra break down over time. These neurons play important roles in regulating the activity of other neurons in the motor region of the cerebral cortex, so their progressive loss leads to the movement symptoms seen in the disease. While a great deal of PD research has looked into the disease’s impact on the basal ganglia, less is known about the cellular changes that happen to the motor cortex. To better understand these downstream neurological effects and how to better treat or prevent them clinically, Hong-yuan Chu, PhD, recipient of a Parkinson’s Foundation 2023 Bill and Amy Gurley Impact Award, will be doing a deep-dive into the chemical and functional changes that occur in motor cortex neurons after substantia nigra dopamine neurons are lost.

From his lab at the Van Andel Research Institute in Grand Rapids, Michigan, Dr. Chu has identified a specific type of neuron in the motor cortex called parvalbumin-expression interneurons (PV-INs) that seem to become more sensitive and overreactive after PD-like dopamine neuron loss. Using mouse models, Dr. Chu and his team will use sophisticated electrophysiology recording techniques to measure how differently PV-INs act in PD and non-PD contexts.

With a better understanding of how PV-INs change during PD progression, Dr. Chu will next test how well those neurons interact with other neurons with and without dopamine neurons present. PV-INs primarily communicate with pyramidal tract neurons (PTNs), which relay signals to the spinal cord that get forwarded to muscles for movement. With powerful microscopes, Dr. Chu will be able to see how PV-INs organize themselves around PTNs to help facilitate motor signaling, comparing their effectiveness in mice with and without PD-like dopamine neuron loss.

Completing this research will provide exciting new data on a relatively understudied type of neuron in the context of PD. Through these experiments, Dr. Chu hopes to find new targets for treatment in the brain, opening up additional therapeutic options in the future. After learning that he had received this award, Dr. Chu said: “I am grateful for the support of the Parkinson’s Foundation, which will help my lab pursue new ideas and accelerate expansion of our research program. This work has great potential to provide new insights into how Parkinson’s affects brain function, which can help us design better treatments in the future.”

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

My PD Story

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Researchers

Jane Aldrich, PhD

2023 Impact Award  

Utilizing a Molecular Switch to Correct Disruptive Parkinson's Disease Protein Clumps

Research has shown that a protein called alpha-synuclein is likely a key driver of Parkinson’s disease (PD) progression. If the regulation of alpha-synuclein is out of balance in the brain, it can cause major stress to neurons and lead to their breakdown, a hallmark sign of PD. While most studies have focused on how alpha-synuclein goes haywire in PD, Jane Aldrich, PhD, recipient of a Parkinson’s Foundation 2023 Bill and Amy Gurley Impact Award, is taking a different approach: she will be investigating how to improve the neurons’ ability to regulate alpha-synuclein and thereby stop cellular damage.

Proteins are used to perform the tasks and processes that keep everything running smoothly inside cells. Some proteins, like alpha-synuclein, are chemically modified in the cell by attaching a small group at specific locations which can change their behavior. In PD, when alpha-synuclein is modified it forms toxic threads in neurons, which eventually form clumps. There is a separate protein, called PP2A, whose job is to take the chemical group off alpha-synuclein. However, in many PD cases, this protein doesn’t work properly, potentially leading to the accumulation of clumped, chemically modified alpha-synuclein protein.

In her lab at the University of Florida, Dr. Aldrich has identified a small molecule that can repair PP2A in cells. A functioning PP2A can restore the regulation of alpha-synuclein, preventing PD-associated damage. In collaboration with Dr. Paramita Chakrabarty, Dr. Aldrich will use a mouse model of alpha-synuclein dysregulation and inject the mice with this small molecule that can potentially restore the function of PP2A. After treating mice for up to two months, they will look at brain tissue samples under a microscope to see if this molecule was able to prevent alpha-synuclein from clumping inside neurons.

Next, Dr. Aldrich will test variations of the PP2A repair molecule, looking for versions that might work better than the original. As with all new drugs or treatments, even slight molecular changes can lead to improved function and outcomes. By doing these experiments, Dr. Aldrich hopes to find better PP2A repair molecules and advance these compounds for potential future therapeutic use.

When asked about what this award and support means to her, Dr. Aldrich replied, “I am very excited that research from my lab could possibly help identify disease-modifying therapies for Parkinson’s disease. I have a long-standing interest in exploring compounds that are active in the brain, and this will be the first opportunity for my lab to expand our research to target a neurodegenerative disease. The proposed research will provide proof of concept that compounds we synthesize can modulate the state of alpha-synuclein in PD models and have potential application as treatments for the disease.”

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

My PD Story

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Researchers

Kaitlin Lansford, PhD

2023 Impact Award  

Overcoming Communication Barriers and Improving Well-being with Listener Training

Most people know about the movement symptoms of Parkinson’s disease (PD), but they do not usually think about how the disease impacts communication. Research shows that up to 90% of people with PD may develop hypokinetic dysarthria, a disorder that affects a person’s physical speaking ability. This disorder contributes to decreased intelligibility of those affected, greatly impacting their ability to communicate with others. Common interventions focus solely on the patient (speaker) to improve their speech. Kaitlin Lansford, PhD, recipient of a Parkinson’s Foundation 2023 Bill and Amy Gurley Impact Award, seeks to improve the social well-being of those with PD experiencing this speech disorder by investigating whether listening training for their care partners can help overcome these communication barriers.

The two main speech consequences of hypokinetic dysarthria are reduced volume and imprecise articulation. Therefore, speech therapy for those with hypokinetic dysarthria is often focused on having the person speak louder and more clearly. Such speaker-targeted interventions can improve intelligibility, but its effectiveness is limited, especially when related physical and cognitive symptoms are more severe. Dr. Lansford, director of the Motor Speech Disorders lab at Florida State University, in collaboration with her research partner, Dr. Stephanie Borrie from Utah State University, has demonstrated that listeners can be trained to better understand dysarthric speech. Such listener-based interventions have the potential to improve communication without increasing the communicative burden of the person with PD. With care partners often wanting to have a more active role in the rehabilitation of their loved ones, listening training has great potential for improving the social lives of those with PD.

To better understand how listening training can be used to complement commonly used speaker interventions for those with PD-associated hypokinetic dysarthria, Dr. Lansford will conduct a study in which 20 speakers with PD and hypokinetic dysarthria and 600 listeners will be recruited to participate in a series of speaking and sensory tasks. The speakers will provide speech samples and will be cued to speak, louder, more clearly or in their normal speaking voice. The speech samples will be used to generate perceptual experiments. The recruited listeners will be randomly assigned to one of the speaker training conditions and half (300) will engage in listening training, in which they will benefit from a familiarization experience with feedback. The other half of listeners (300) will not receive listening training. All listeners will transcribe the speech samples and these transcriptions across the different speaker and listener training conditions will be scored for intelligibility, after which the impact of combined training can be properly assessed.

“Receiving the Parkinson's Foundation Impact Award to support this research project is a true honor,” said Dr. Lansford. “Given that most daily communication for people over 65 years occurs with family and friends, a dual [speaker and listener] treatment approach has the potential to significantly and positively impact the lives of people with PD and their key communication partners. [This award] will greatly enhance the visibility and impact of our findings, opening doors to future collaborations, grants, and opportunities to support this line of research, thereby advancing therapeutic interventions and enhancing patient care in PD.”

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

My PD Story

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Researchers

Raymond Norton, PhD

2023 Impact Award  

Controlling Brain Inflammation to Reduce Collateral Damage in Parkinson's Disease

Inflammation is the body’s way of dealing with injury or foreign organisms, such as bacteria or viruses. While effective, the inflammatory process can cause collateral damage to cells and tissues if not managed appropriately. As the body ages, the risk of chronic inflammation — when the inflammatory alarm stays on even when is no threat — increases. Chronic inflammation in the brain has been observed in Parkinson’s disease (PD), and the associated damage likely contributes to the progressive loss of dopamine neurons that characterize the disease. Ray Norton, PhD, recipient of a Parkinson’s Foundation 2023 Bill and Amy Gurley Impact Award, believes that PD-induced inflammation involves brain cells called microglia, and he has a plan for how to inhibit those brain cells to reduce inflammation and potentially slow down disease progression.

In healthy brains, microglia release chemical signals —called cytokines— that turn on the inflammation alarm when facing a threat. This recruits immune cells to deal with the threat, after which the microglia stop releasing inflammation cytokines and the alarm turns off. In PD, microglia can malfunction in ways that make them release those cytokines inappropriately and in greater amounts, triggering inflammatory responses that can damage and ultimately break down sensitive neurons. Prof. Norton, from his lab at Monash University in Melbourne, Australia, has developed a peptide that binds to a specific protein on the microglia, which is over-active in PD, leading to cytokine release and neuron death. The peptide developed by Prof. Norton has the ability to bind to this protein and inhibit (i.e., block) its function, thus preventing the release of those inflammatory cytokines and subsequent neuron damage that occurs in PD.

Prof. Norton, together with his collaborators Joe Nicolazzo and Dorothy Wai at Monash, David Finkelstein at the Florey Institute of Neuroscience and Mental Health and Gyorgy Panyi at the University of Debrecen, will first be looking at how the levels of the microglial protein change in two different mice models of PD, helping them understand how those changes may contribute to increased brain inflammation. Next, he will use neurons in Petri dishes from PD and non-PD donors to assess how well his inhibitor molecule prevents the release of inflammatory cytokines in healthy and disease contexts. This will show if this inhibitor works with human microglia and could be biologically effective in the brains of those with PD. Finally, Prof. Norton will modify the design of his inhibitor molecule to make it better at crossing the body’s blood-brain barrier, a system built to protect the brain from invaders, but which can also block drugs from passing through. All these experiments will help develop this microglia inhibitor into a strong candidate for new PD therapies that reduce brain inflammation to limit and prevent neuron damage from the disease.

Prof. Norton is thrilled to have received this award to continue his work, and is excited about its potential to help those with PD: “Successful completion of this project will underpin the development of a potent and target-specific drug lead with the potential for rapid clinical translation for the treatment of Parkinson’s disease. It would be personally very rewarding to see the peptide inhibitor I developed become a clinical candidate for Parkinson’s disease.”

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

My PD Story

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Researchers

Scott Waldman, MD, PhD

2023 Impact Award  

Testing a New Way to Protect Neurons by Empowering their Mitochondria

Mitochondria are the small oxygen-consuming and energy-producing powerhouses inside cells. Evidence has shown that in Parkinson’s disease (PD), mitochondria are impaired in key groups of dopamine neurons in the brain. This impairment may contribute to the neurons’ progressive breakdown, hallmark to the disease and cause of the gradual onset of movement symptoms. Scott Waldman, MD, PhD, recipient of a Parkinson’s Foundation 2023 Bill and Amy Gurley Impact Award, has found a receptor on the surfaces of those PD-associated dopamine neurons that may provide therapeutic ways to protect the mitochondria and prevent the progression of the disease.

The receptor —called GUCY2C— was first discovered on the surfaces of cells in the intestine; there, specific hormones bind to the GUCY2C receptors and induce intestinal secretion. Drugs that mimic those hormones have been developed as treatments for constipation. GUCY2C has only recently been discovered to be on the surface of PD-relevant dopamine neurons as well, where their role seems to be linked to keeping neuronal mitochondria healthy.

Dr. Waldman, with the help of his coinvestigator Dr. Richard Smeyne at Thomas Jefferson University in Philadelphia, Pennsylvania, has already shown that genetically removing GUCY2C from dopamine neurons causes them to have smaller and less effective mitochondria, making the neurons more likely to break down. This discovery was their first clue that GUCY2C may be a useful clinical target for new PD therapies.

For his first experiment supported by this award, Dr. Waldman will take dopamine neurons from mice with and without GUCY2C receptors and treat them with a hormone-mimicking drug that activates the receptors. From this, he will be able to confidently determine if GUCY2C activation improves mitochondrial health through biochemical measurements and comparisons across the tested groups.

Next, Dr. Waldman will add alpha-synuclein protein clumps, linked to PD development and progression, to those same mouse neurons and see if GUCY2C activation protects them from the disease-causing proteins. If his hypothesis proves correct, the GUCY2C-activated neurons should be protected from PD-associated damage due to their strengthened mitochondria, while the neurons lacking the receptor will be more vulnerable. Dr. Waldman will also recreate this alpha-synuclein stress test using living mice, ultimately looking at their brains under a microscope to see whether GUCY2C activation was able to protect against PD-like neuron degeneration.

Altogether, this work will shed light on a potential new avenue for PD therapies, combating the disease by strengthening the mitochondria in the vulnerable dopamine neurons. Asked about the significance of this research support, Dr. Waldman said that this Impact Award “underscores the significance of discovering a new molecular pathway that regulates the integrity of neurons in the substantia nigra and which can be co-opted to defend against toxic insults… it represents an essential source of support to continue studies that advance these novel molecular discoveries to translation into new approaches to prevent and treat Parkinson’s disease.”

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

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