Mayo Clinic News Network
Newswise — SUN CITY WEST, Ariz., and SCOTTSDALE, Ariz. – Researchers at Banner Sun Health Research Institute and Mayo Clinic are continuing to study how to diagnose early Parkinson’s disease. The research team’s most recent article, “Peripheral Synucleinopathy in Early Parkinson’s Disease: Submandibular Gland Needle Biopsy Findings,” has been recognized by Movement Disorders, the official journal of the International Parkinson and Movement Disorders Society, as the “best original research article” of 2016.
Parkinson's disease is a progressive disorder of the nervous system that affects movement, as well as sleep, balance, blood pressure and smell. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. While tremor may be the best-known sign of Parkinson's, the disorder also commonly causes stiffness or slowing of movement. Diagnosis is made based on medical history, a review of signs and symptoms, a neurological examination, and by ruling out other conditions. Up to 55 percent of patients may be misdiagnosed early in the disease.
Although Parkinson's disease can't be cured, medications may markedly improve symptoms. And, while there is no diagnostic test for Parkinson’s disease, the researchers believe that a procedure termed transcutaneous submandibular gland biopsy may provide the needed accuracy. The test involves inserting a needle into the submandibular gland under the jaw that creates saliva and then withdrawing the needle to obtain the core of the gland tissue within. From this test, researchers can compare the tissue extracted from patients with Parkinson’s disease to patients who do not have Parkinson’s disease.
“This was the first study demonstrating the value of testing a portion of the submandibular gland to diagnose a living person with early Parkinson's disease. Making a diagnosis in living patients is a big step forward in our effort to understand and better treat patients," says study author Charles Adler, M.D., Ph.D., a Mayo Clinic neurologist.
As part of the study, 25 Mayo Clinic patients with Parkinson's disease and 10 people without it had the procedure done. Biopsies were taken from one submandibular gland ─ completed as an office procedure by Michael Hinni, M.D., and David Lott, M.D. ─ both Mayo Clinic otorhinolaryngologists. Then, the biopsied tissues were tested for evidence of the abnormal Parkinson's protein by study co-author Thomas Beach, M.D., Ph.D., a neuropathologist with Banner Sun Health Research Institute. The abnormal Parkinson's protein was detected in 14 of the 19 patients who had enough tissue to study. This indicated the need for further analysis. The research team previously had shown that the biopsy was able to detect the protein in 9 of 12 patients with advanced disease.
"This [submandibular gland biopsy] procedure will very likely provide a much more accurate diagnosis of early Parkinson's disease than what is now available," says Dr. Beach. "One of the greatest potential impacts of this finding is on clinical trials, as, at the present time, some patients entered into Parkinson's clinical trials do not necessarily have Parkinson's disease. And this is a big impediment to testing new therapies."
"This study provides the first direct evidence for the use of submandibular gland biopsies as a diagnostic test for living patients with early Parkinson's disease," says Dr. Adler. "This finding in patients with early Parkinson’s disease may be of great use, since accuracy of diagnosis in patients with early disease is not nearly as good as in those having the disease for more than five years.”
The study is now finished but has been followed by a similar Michael J. Fox Foundation-funded study (the “S4” study), being performed in multiple U.S. and Canadian cities. This study will compare submandibular gland needle biopsy with biopsies of the colon and skin. Drs. Adler and Beach are heavily involved in study planning and analysis, while Drs. Lott and Hinni conducted online training sessions for the participating surgeons.
This study was funded by the Michael J. Fox Foundation for Parkinson's Research.
About Banner Sun Health Research Institute
Since 1986, Banner Sun Health Research Institute, part of nonprofit Banner Health, has been a leader nationally and internationally in the effort to find answers to disorders of aging, including Alzheimer’s and Parkinson’s disease. The institute, together with its Arizona Alzheimer’s Consortium partners, has been designated by the National Institutes of Health as one of just 29 Alzheimer’s Disease Centers in the nation. The institute’s Cleo Roberts Center for Clinical Research takes laboratory discoveries to clinical trials that foster hope for new treatments. Banner Health is Arizona’s leading health care provider and largest private employer. For more information, visit bannershri.org.
About The Michael J. Fox Foundation for Parkinson’s Research
As the world’s largest funder of Parkinson’s research, the Michael J. Fox Foundation is dedicated to accelerating a cure for Parkinson’s disease and improved therapies for those living with the condition today. The foundation pursues its goals through aggressively funded, highly targeted research programs, coupled with active global engagement of scientists, Parkinson’s patients, business leaders, clinical trial participants, donors and volunteers. In addition to funding more than $325 million in research to date, the foundation has fundamentally altered the trajectory of progress toward a cure. Operating at the hub of worldwide Parkinson’s research, the foundation forges groundbreaking collaborations with industry leaders, academic scientists and government research funders; increases the flow of participants into Parkinson’s disease clinical trials with its online tool, Fox Trial Finder; promotes Parkinson’s awareness through high-profile advocacy, events and outreach; and coordinates the grass-roots involvement of thousands of Team Fox members around the world.
About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit mayoclinic.org/about-mayo-clinic or newsnetwork.mayoclinic.org.