Study Rationale:
We currently do not understand why some people with Parkinson’s disease (PD) have particularly severe symptoms, or symptoms that progress rapidly, compared to those who do not. This variability makes it difficult to predict disease trajectory, provide adequate counseling to individuals with PD and to identify treatments that can potentially slow progression. Although genes and environmental factors, such as exposure to chemicals or head trauma, can influence the risk of developing PD, the role they play in shaping the course of the disease after it has developed is less clear.
Hypothesis:
We hypothesize that the environmental exposures and genetic variants that influence the risk of PD development may also help predict the severity of symptoms and how rapidly the disease progresses.
Study Design:
We will work with the Fox Insight database, a large cohort of people with PD and age-matched healthy volunteers. In addition to answering many surveys about the symptoms of PD, a subset of the participants in Fox Insight have answered questionnaires about environmental exposures and provided genetic information. We will examine the association between environmental exposure, genetic variants and the severity of motor and cognitive symptoms. We will determine whether these factors can predict how rapidly people progress to motor and cognitive impairment. Finally, we will explore how the environment and genes interact to influence both symptom severity and progression.
Impact on Diagnosis/Treatment of Parkinson’s Disease:
Improving our ability to predict disease trajectory could allow us to identify individuals who will benefit from clinical trials. Understanding environmental and genetic interactions could further help target prevention strategies to those most at risk, reducing the number of people with PD or limiting how disabling the condition can be.
Next Steps for Development:
The associations identified in this study will be confirmed in a group of people with PD followed over time, and then used to stratify individuals enrolled in clinical trials designed to test interventional treatment.