Researchers Target MRI as Diagnostic Biomarker

Lindsey Shapiro, PhD avatar

by Lindsey Shapiro, PhD |

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A research team in Canada is embarking on a project that will apply MRI to identify new biomarkers for diagnosing Parkinson’s disease and monitoring its progression over time.

The potential findings may speed Parkinson’s diagnoses and help patients receive treatment sooner.

Identifying easily recognizable MRI signatures of Parkinson’s could mean that family doctors are able to make the diagnosis without the need for patients to be referred to a specialist, which can be particularly impactful for patients living in more remote areas, according to the research team.

“Even though we can’t cure Parkinson’s, existing therapies can reduce symptoms, keeping patients in their jobs and in their lives,” Penny MacDonald, MD, PhD, said in a press release. MacDonald is an associate professor at Western university and one of the study’s lead investigators.

“A confirmatory test like an MRI could allow a general practitioner to order the radiological suite that will be distinct for Parkinson’s. They’ll be able to confirm if the patient has Parkinson’s and they’ll feel empowered to start the medication,” MacDonald added.

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MacDonald will team with other researchers at Western and McGill universities to move the project forward. The collaboration comes as part of the new McGill-Western Initiative for Translational Neuroscience (ITN), which is funded by the Canada First Research Excellence Fund.

Parkinson’s disease is a complex disorder accompanied by a range of motor symptoms — such as tremors, slow movements and muscle rigidity — as well as non-motor symptoms like cognitive problems, fatigue, and gastrointestinal problems.

These symptoms sometimes can be confused with other disorders, making an accurate diagnosis difficult.

“There are several other diseases like progressive supranuclear palsy and multi-system atrophy that can resemble Parkinson’s, and it’s important to make the correct diagnosis,” said Alain Dagher, MD, a professor at McGill, a neurologist at the Montreal Neurological Institute Hospital, and one of the study’s investigators.

An accurate diagnosis also usually requires a referral to a specialist, which can lead to a long wait before patients ultimately receive the right treatment.

“If a patient is waiting a year or more to see a neurologist or movement disorder neurologist, after their general practitioner has submitted a referral, that’s often time that they’re waiting to be treated. That wait is not trivial and huge changes happen during that time. People sell their homes, they leave their jobs, so a lot of that uncertainty could be dealt with sooner,”  MacDonald said.

The effects of this lengthy diagnostic process are highlighted in the story of Alice Jones, a Parkinson’s patient who struggled to find an accurate diagnosis. (Note: “Alice Jones” is a pseudonym used by Western University to protect the patient’s privacy.)

Jones first noticed difficulties in her everyday movements — such as wiggling her toes, moving her shoulder, or washing her hair — about five years ago.

“These difficulties seemed disconnected,” said Jones. “At that time, I thought they were annoying challenges and hoped to get help with each.”

She was diagnosed with a frozen shoulder and a pinched nerve. After weeks of physical therapy, her mobility did not improve. Eventually, two new physical therapists noticed her arms were not swinging naturally while walking, which can be a subtle sign of Parkinson’s.

“After diagnosis, I immediately started therapy to help with the symptoms and had significant, measurable progress in two weeks,” Jones said. “I became rejuvenated because, it turns out that the various challenges were all related and, as the neurotransmitters [brain chemicals] were strengthened and reestablished, my abilities and confidence in my body returned. Parkinson’s has motivated me to remain very active so I retain my motor skills.”

MacDonald and her team hope that the identification of new diagnostic biomarkers can prevent diagnostic delays like Jones’ in the future, and will “allow for equality of care across Canada,” ITN stated in the press release.

Work on the MRI biomarker project will begin this year. In the long-term, the team hopes to find solutions that can prevent Parkinson’s, rather than just treating its symptoms.

“The ultimate aim is for these biomarkers to help us to uncover therapies that either slow the progression of Parkinson’s, stop it or reverse it,” said MacDonald. “But even if we can’t come up with a cure or a treatment that’s going to change therapy, just having a biomarker translates into better care for patients right now.”