Advances in Parkinson's Disease Research
Story Landis, Ph.D., has been Director of the National Institute for Neurological Disorders and Stroke (NINDS) since 2003. Throughout her research career, Dr. Landis has made fundamental contributions to the understanding of nervous system development.
Neurological disorders—such as Parkinson's disease (PD)—strike an estimated 50 million Americans each year, exacting an incalculable personal toll and an annual economic cost of hundreds of billions of dollars in medical expenses and lost productivity. Dr. Landis recently provided NIH MedlinePlus magazine with answers to the following questions about Parkinson's disease research.
Why is this such an exciting time in brain research?
Mapping brain structures and functions is a vibrant field of science. The President's BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies) announced earlier this year is an extraordinary opportunity for the federal government and the private sector to work together to develop a comprehensive understanding of how the human brain works. It will create new tools, technologies, and research strategies for studying the brain. Scientists might gain a better understanding of mechanisms underlying Parkinson's disease, which could lead to new therapies to treat and, perhaps, cure neurological disorders, including PD.
What does brain research today tell us about what causes Parkinson's disease?
Scientists have known for nearly 50 years that specific brain cells die in PD, but we don't fully understand why this occurs. We know that certain genetic mutations increase a person's risk for developing PD, as can illness or environmental factors, such as exposure to certain toxins, pesticides, or chemicals. Other factors that may contribute to the disease process, or cause cell death, also are being investigated. We recently discovered a network of genes that may help dispose of damaged mitochondria—the cell's power plants—that could offer new targets for treating Parkinson's and other neurological diseases. Our long-term research and planning strategy led to the NINDS-hosted January 2014 conference, "Parkinson's Disease 2014: Advancing Research, Improving Lives," at which neuroscientists, physicians, public and private organization representatives, and people with Parkinson's disease discussed the highest research priorities, ranging from lab discoveries to developing new therapies for PD.
What drugs are presently used to treat PD?
Levodopa is the most commonly used drug to treat PD. It increases the level of the chemical messenger dopamine in the brain, which helps reduce many symptoms but does not stop the progression of the disease. Other types of drugs include those that mimic dopamine or those that block or reduce the activity of enzymes that break down dopamine. Doctors also may prescribe medications to treat the non-motor symptoms of PD, such as depression and anxiety, or the motor complications of PD, such as involuntary twisting or writhing.
How are the movement symptoms caused by PD minimized today?
In addition to drug therapy, deep brain stimulation—which uses an electrode that is surgically inserted into areas of the brain that are involved in Parkinson's disease—can stimulate the brain in a way that blocks signals that are involved with many of the movement symptoms of PD.
What research is under way to treat PD?
NINDS and other researchers hope to improve existing treatments and find new approaches to slowing disease progression. These efforts include better understanding the genetic risk factors involved in PD; studying the role mitochondria, oxidative stress, inflammation, and other cellular processes might play in disease progression or cause cell death in PD; gaining insight as to how altered protein shapes may influence neurological diseases; and identifying new targets to treat disease symptoms and complications. Researchers are also trying to find new ways of getting drugs across the brain's protective barrier.
What are some of the most promising research areas?
A major NINDS initiative is the Parkinson's Disease Biomarkers Program, aimed at discovering ways to identify individuals at risk for developing PD, track disease progression, and speed the development of new therapeutics for PD. Six projects are actively recruiting volunteers at sites across the U.S.
The NINDS also collaborates with the Michael J. Fox Foundation for Parkinson's Research on BioFIND, a project collecting biological samples and clinical data from healthy volunteers and those with PD. And the NINDS Morris K. Udall Centers of Excellence for Parkinson's Disease Research Program currently funds 10 centers across the country, where researchers are examining PD disease mechanisms, the genetic contributions to PD, and potential therapeutic targets and treatment strategies.
Also, scientists are using induced pluripotent stem cells—cells that can be made to turn into any cell type in the body—that have been taken from individuals with Parkinson's disease and coaxed into becoming dopamine neurons to test potential therapies. Of course, clinical trials involving people with Parkinson's disease are vital to the treatment and prevention of PD and make a difference in improving the quality of life for those with PD, now and in the future.