Systematic screening for Parkinson’s disease is now possible

A new Israeli brain scanning technique could lead to systematic screening to diagnose cases of Parkinson’s disease before the first symptoms appear, say scientists.

In the coming years, pharmaceutical companies are expected to receive approvals for drugs to treat Parkinson’s disease. One of the main challenges for doctors is to quickly identify the people who develop the disease and, therefore, those who will need to receive these treatments.

Ordinary MRIs, the usual method of visualizing the structure of the brain, cannot detect the onset of Parkinson’s disease because they are not sensitive enough.

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The disease — which disproportionately affects Ashkenazi Jews — is normally diagnosed in clinical tests, in which doctors make an assessment based on symptoms rather than brain condition.

There is another method, which assesses the state of the brain, but it involves the injection of a radioactive substance, and is therefore only rarely used due to its invasiveness and high cost.

Professor Aviv Mezer said his team of researchers at the Hebrew University of Jerusalem have developed a scientifically objective and easy-to-implement diagnostic method, which evaluates brain scans based on measurements of deterioration in the brain and definitively confirms the presence of the disease.

The researchers validated the proof of concept and are working on the development of a tool that can be used in a hospital setting.

A woman undergoing an MRI. (Credit: Povozniuk via iStock by Getty Images)

“It’s very positive, because scientists prefer objective measurements like this to doctors’ assessment of symptoms, and it could very well advance the diagnosis,” Mezer said.

His team used a special type of brain scan called quantitative MRI or qMRI, which provides detailed measurements from scans. They then developed an algorithm to analyze these measurements.

Using this algorithm, they were able to obtain the detailed information that ordinary MRIs failed to provide for the diagnosis of Parkinson’s disease, namely information on microstructural changes in the striatum, a region of the forebrain essential for motor function.

Previous research has shown that the striatum deteriorates as Parkinson’s disease progresses. As this region is very important in allowing patients to control their muscles, it is thought to impair this ability.

While the most noticeable effects are tremors and a hunched posture, patients with Parkinson’s disease often lose primary and secondary motor control, experience vision, bladder and sleep problems, and may eventually lose memory and sink into dementia.

Mezer and his colleagues sought to find a method to use qMRI to detect this deterioration at its initial stage, and they succeeded. They reported their success in an article published Friday in the journal Science Advances.

“This discovery can be used to develop screening tools for Parkinson’s disease that could help detect the disease based on brain changes, not symptoms,” Mezer said. “Successful intervention must be early, so this could allow for more effective intervention. »

His lab is already working on such a tool, which he says could be validated for clinical use within three to five years.

“Until now, we didn’t have a quantitative MRI showing the extent of striatal damage that would confirm Parkinson’s, or a way to see it. Our research gave us both,” he said.

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