The Test Could Eventually Help Provide More Precise Diagnoses For People With Movement Disorders Such As Parkinsons Disease
Researchers at UCLA Health have developed a blood test that can distinguish between two very similar movement disorders, Parkinsons disease and multiple system atrophy . The test, which is currently for research use only, identifies the disease by analyzing the contents of tiny sacs called exosomes that are sent out by brain cells and wind up in the blood.
The researchers report their findings in this months Acta Neuropathologica.
Parkinsons disease can be difficult to distinguish from other neurodegenerative diseases, including MSA, due to similar symptoms such as muscle rigidity and tremors.;Patients who have been incorrectly diagnosed with one or the other disease may feel anxiety when unexpected symptoms occur,;or, in the case of a Parkinsons misdiagnosis, the disease progresses faster than predicted.
If they do have Parkinsons, there are a lot of treatments that can help with the symptoms for a long time, says Gal Bitan, professor of neurology at the David Geffen School of Medicine at UCLA. If they have MSA, which is a very aggressive disease that leads to rapid deterioration, they would want to prepare. They would want to talk with loved ones, and possibly take care of their estate.
Both Parkinsons and MSA patients had elevated alpha-synuclein, but in Parkinsons it mostly came from neurons, while in MSA it came from oligodendrocytes. The researchers could tell the two diseases apart with high accuracy.
Caroline Seydel is the author of this article.
Mri In Parkinson’s Testing
One of the more common tests done during a neurologic workup is an MRI scan and one may think that in the investigation of a disease that affects the brain such as Parkinsons, this imaging test would be a necessity. In the context of Parkinsons disease, however, an MRI is not particularly helpful. It looks at the structure of the brain which, for all intents and purposes, appears normal in this disease. An MRI may, however, be indicated when symptoms appear in younger people or if the clinical picture or the progression of symptoms is not typical for Parkinsons. In these situations, MRI can be used to rule out other disorders such as;stroke, tumors,;hydrocephalus;, and Wilsons Disease .
Further Testing In Parkinson’s
In other situations, where perhaps the diagnosis is not as clear, younger individuals are affected, or there are atypical symptoms such as tremor affecting both hands or perhaps no tremor at all, further testing may help. For example, imaging can play a role in differentiating between essential tremor and Parkinsons. It can also be important to confirm what is initially a clinical diagnosis of Parkinsons prior to an invasive treatment procedure such as surgical DBS
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Imaging And Lab Tests
Your doctor may order some imaging tests and laboratory tests. Imaging tests can include computed tomography scans and magnetic resonance imaging scans. Laboratory tests can include blood tests and urine tests.;
While these tests and scans will not help diagnose Parkinsons disease, they can help rule out other conditions that have similar symptoms.;
Your doctor may also suggest that you get a dopamine transporter scan . This scan requires a single-photon emission computed tomography scanner. It involves an injection of a small amount of a radioactive drug so that your doctor can study the dopamine systems in your brain .;
While a DaTscan cannot conclusively prove that you have Parkinsons, it can help confirm your doctors diagnosis and eliminate other conditions.;
Blood Test Would Detect Parkinsons In Early Stages
A group of researchers developed a blood test that would allow neurologists detect Parkinsons disease and track the illness as it progresses.
If successful, we expect our findings will translate into a valuable diagnostic tool for Parkinsons disease, said study co-author Judith Potashkin, professor of cellular and molecular pharmacology at Chicago Medical School, Rosalind Franklin University of Medicine and Science.
According to the Parkinsons Disease Foundation, it is estimated that 60,000 people in the United States are diagnosed with Parkinsons disease each year.; Data from 2013, by the University Center for Health Sciences at the University of Guadalajara, reported more than 500,000 cases of this neurodegenerative condition in Mexico. The same year, an economic model of Parkinsons disease forecasted that cases in the worlds population will double by 2040.
Now days, this disease is still incurable. It can cause tremors and severely hamper movement. Although medications allow controlling the condition, it gets worse over the years and medications do not stop its progression.
The traditional method to diagnose Parkinsons is by analyzing symptoms. Currently, brain scans are available, allowing the analysis of imaging studies to detect the disease; however, the information obtained from these devices may still be somewhat imprecise, Potashkin said.
The study was published in the Feb. 3 online issue of the Proceedings of the National Academy of Sciences.
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Can Parkinsons Disease Be Diagnosed By How You Smell
Theres evidence that people with Parkinsons disease may emit a specific type of scent, which is related to increased sebum production. However, doctors have not developed a way to use this odor to diagnose the disease. More research is being done to see how the finding can help with diagnosis and treatment.;
Could A Blood Test Detect Parkinsons In Advance
Parkinsons disease has an autoimmune origin, at least in part, and the signs of the onset of this disease could be found well in advance by looking for autoimmunity markers in the blood. This is according to researchers from La Jolla Institute for Immunology , who have published their results in the journal Nature Communications. If you are able to diagnose the disease as early as possible, it could make a huge difference , said Cecilia Lindestam Arlehamn, main author of the study.
We recall that Parkinsons is a neurodegenerative disease that results in the damaging of several areas of the brain, causing mobility disorders, which may be very serious, as well as cognitive disorders. A key role in the disease is attributed to alpha-synuclein, a protein that, in an altered form, accumulates in several areas of the brain , eventually destroying the neurons that produce dopamine, an essential neurotransmitter for muscle control.
Back in 2017 the researchers from La Jolla showed that alpha-synuclein can cause T lymphocytes to trigger auto-immune reactions. Basically, according to the researchers, when alpha-synuclein accumulates, it attracts T lymphocytes and makes them attack brain cells by mistake, thus contributing to the progression of Parkinsons. However, it is not clear if these auto-immune reactions are an initial cause of the disease, or only worsen the degeneration of the neurons already compromised by the accumulation of alpha-synuclein.
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Is Early Diagnosis Possible
Experts are becoming more aware of symptoms of Parkinsons that precede physical manifestations. Clues to the disease that sometimes show up before motor symptoms and before a formal diagnosis are called prodromal symptoms. These include the loss of sense of smell, a sleep disturbance called REM behavior disorder, ongoing constipation thats not otherwise explained and mood disorders, such as anxiety and depression.
Research into these and other early symptoms holds promise for even more sensitive testing and diagnosis.
For example, biomarker research is trying to answer the question of who gets Parkinsons disease. Researchers hope that once doctors can predict that a person with very early symptoms will eventually get Parkinsons disease, those patients can be appropriately treated. At the very least, these advances could greatly delay progression.
Parkinson’s Disease and Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
Early Signs Of Parkinson’s
Early physical signs include the common motor symptoms: tremor, muscle rigidity and slowness. They may also include the following:
- Symptoms starting on one side of the body
- Change in facial expression
- Failure to swing one arm when walking
- Stooped;posture;
- Loss of sense of smell
- Depression;or;anxiety
Some of these symptoms are quite common and by no means exclusive to Parkinsons, so if you have some of them, it does not mean you have Parkinsons.
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Blood Test May Help Differentiate Parkinsons From Similar Diseases
The American Academy of Neurology is the world’s largest association of neurologists and neuroscience professionals, with 36,000 members. The AAN is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer’s disease, stroke, migraine, multiple sclerosis, concussion, Parkinson’s disease and epilepsy.
How Parkinsons Disease Is Diagnosed
Diagnosing Parkinsons disease can be complicated because there isnt a specific blood test or screening test that can determine whether or not you have it.
Instead, Parkinsons is diagnosed clinically, which means a doctor will examine you, review your symptoms and medical history, and diagnose accordingly.;
Parkinsons disease is a neurological condition that can make movement difficult. If your general practitioner thinks you might have Parkinsons, they may refer you to a neurologist who specializes in movement disorders for a diagnosis.;
It can be challenging to catch Parkinsons in the early stages because the symptoms may be too mild to notice or meet the diagnostic criteria. Also, early Parkinsons symptoms are often mistaken for typical signs of aging.
The symptoms of Parkinsons disease are also similar to those of other health conditions, which may be misdiagnosed as Parkinsons at first. Your doctor may suggest specific tests and scans to help eliminate other conditions that can mimic the symptoms of Parkinsons disease.
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How A Diagnosis Is Made
The bedside examination by a neurologist remains the first and most important diagnostic tool for Parkinsons disease . Researchers are working to develop a standard biological marker such as a blood test or an imaging scan that is sensitive and specific for Parkinsons disease.
A neurologist will make the diagnosis based on:
- A detailed history of symptoms, medical problems, current and past medications. Certain medical conditions, as well as some medications, can cause symptoms similar to Parkinsons.
- A detailed neurological examination during which a neurologist will ask you to perform tasks to assess the agility of arms and legs, muscle tone, gait and balance, to see if:
- Expression and speech are animated.
- Tremor can be observed in your extremities at rest or in action.
- There is stiffness in extremities or neck.
- You can maintain your balance and examine your posture.
How The Levodopa Test Is Conducted
The levodopa test is given at least eight hours after the patients last dose of any medication to boost dopamine levels in the brain and usually takes place in the morning.;Motor functions are analyzed before the test and again 60 to 90 minutes after taking levodopa using part 3 of the unified Parkinsons disease rating;scale .
- Degree of difficulty while rising from a chair
- Gait;
- General posture
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How Parkinson’s Disease Is Diagnosed
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
There’s no “gold standard” test that will diagnose Parkinson’s disease . Instead, a physician relies on their own clinical observations and judgment, along with a patient’s description of possible signs and symptoms, to make the diagnosis. That, of course, makes a physical examination very important in this process. Much of your doctor’s exam will be aimed at assessing whether you have the so-called cardinal signs of Parkinson’s: resting tremor, rigidity , bradykinesia and postural instability .
How Is Parkinson’s Disease Diagnosed
Your doctor will ask questions about your symptoms and your past health and will do a neurological exam. This exam includes questions and tests that show how well your nerves are working. For example, your doctor will watch how you move. He or she will check your muscle strength and reflexes and will check your vision.
Your doctor also may check your sense of smell and ask you questions about your mood.
In some cases, your doctor will have you try a medicine for Parkinson’s disease. If that medicine helps your symptoms, it may help the doctor find out if you have the disease.
Tests
There are no lab or blood tests that can help your doctor know whether you have Parkinson’s. But you may have tests to help your doctor rule out other diseases that could be causing your symptoms. For example:
- An MRI or CT scan is used to look for signs of a stroke or brain tumor.
- Blood tests check for abnormal thyroid hormone levels or liver damage.
Another type of imaging test, called PET, sometimes may detect low levels of dopamine in the brain. These low levels are a key feature of Parkinson’s. But PET scanning isn’t commonly used to evaluate Parkinson’s. That’s because it’s very expensive, not available in many hospitals, and only used experimentally.
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Blood Test For Parkinson’s: Study Details
When brain cells die, Nagele says, they explode ”like a water balloon breaking.”
The contents of those dying cells spill partially back into the blood. “Their debris is released and your body will sense it and develop autoantibodies to clear that debris,” he says.
The new test looks for these autoantibodies in the blood specific to the disease. The researchers narrowed down a list of more than 100 of these autoantibodies to 10 that looked most promising. When these antibodies rise to a certain level, it signals disease, Nagele says.
To evaluate the Parkinson’s test, Nagele’s team looked at more than 150 blood samples, including:
- Twenty-nine from patients with confirmed Parkinson’s disease
- Fifty from Alzheimer’s disease patients
- Ten from multiple sclerosis patients
Referral To A Specialist
If your GP suspects Parkinson’s disease, you’ll be referred to a specialist.
This will usually be:
- a neurologist, a specialist in conditions affecting the brain and nervous system
- a geriatrician, a specialist in problems affecting elderly people
The specialist will most likely ask you to perform a number of physical exercises so they can assess whether you have any problems with movement.
A diagnosis of Parkinson’s disease is likely if you have at least 2 of the 3 following symptoms:
- shaking or tremor in a part of your body that usually only occurs at rest
- slowness of movement
- muscle stiffness
If your symptoms improve after taking a medication called levodopa, it’s more likely you have Parkinson’s disease.
Special brain scans, such as a;single photon emission computed tomography scan, may also be carried out in some cases;to try to;rule out;other causes of;your symptoms.
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New Blood Test For Parkinson’s Studied
Test Has High Degree of Accuracy; Parkinsonâs Experts Cautiously Optimistic
The test requires a single drop of blood, says Robert Nagele, PhD, a professor of medicine at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine.
It looks for specific proteins that are produced by the body in response to Parkinson’s disease, he tells WebMD.
Nagele is also the founder of Durin Technologies, the test developer. Another co-researcher is a paid consultant for the company.
No blood test is yet commercially available for Parkinson’s, which affects 5 million people worldwide. The study is published in PLoS One.
The news was met with cautious optimism by two experts.
Measuring A Particular Blood Protein Might Help Doctors Easily Distinguish Parkinson’s Disease From Some Similar Disorders A New Study Suggests
WEDNESDAY, Feb. 8, 2017 Measuring a particular blood protein might help doctors easily distinguish Parkinson’s disease from some similar disorders, a new study suggests.
The potential blood test is “not ready for prime time,” Parkinson’s disease experts said. But, it marks progress in the quest for an objective way to diagnose Parkinson’s and similar conditions known as atypical parkinsonian disorders, they noted.
Parkinson’s disease is a movement disorder that affects nearly 1 million people in the United States alone, according to the Parkinson’s Disease Foundation.
The root cause is unclear, but as the disease progresses, the brain loses cells that produce dopaminea chemical that regulates movement. As a result, people suffer symptoms such as tremors, stiff limbs, and balance and coordination problems that gradually worsen over time.
Right now, there is no blood test, brain scan or other objective measure that can definitively diagnose Parkinson’s, said James Beck, vice president of scientific affairs for the Parkinson’s Disease Foundation.
“In general, Parkinson’s disease is diagnosed with a clinical exam,” Beck explained.
The best person to make that call is a neurologist with expertise in movement disorders, according to Beck.
“But,” he said, “even highly trained doctors initially get it wrong about 10 percent of the time.”
There is no cure for Parkinson’s or APDs, or any way to halt their progression.
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