Pd Subtypes
 

Foundation Commits Up to $1 Million to Characterize Parkinson's Disease Subtypes

September 26, 2006

The Michael J. Fox Foundation for Parkinson’s Research has committed up to $1 million for research projects leveraging existing data and patient populations to initially characterize Parkinson’s disease subtypes — distinct forms of the disease that may differ in onset, progression and response to treatment.

The progression and course of PD vary so widely among affected individuals that the concept of disease subtypes has long been appreciated by clinicians, who have defined subtypes such as “tremor-dominant” and “posture/gait dysfunction” based on clinical features including motor and non-motor symptoms, rate of progression, responses to treatment, and patient characteristics including gender, ethnicity or age of onset. Previous studies, however, have not conclusively established connections between subtypes such as these and predictive disease prognoses.

“Telling a patient that her Parkinson’s is ‘tremor-dominant’ is of little value unless the designation can be used to predict her likely disease progression and tailor an individualized treatment regimen,” said Deborah W. Brooks, the Foundation’s president and CEO. “PD Subtypes prioritizes the work needed to substantively link certain sets of clinical features to particular disease prognoses. The ability to do this will vastly improve clinicians’ ability to treat patients with existing therapies, as well as the development of novel treatments and the design of future clinical trials.”

Under “PD Subtypes the Foundation is seeking highly focused proposals to generate hypotheses about whether and how particular clinical features of PD, present at initial diagnosis, may predict a patient’s prognosis. Applicants should outline plans for retrospective, data-mining studies to leverage existing data and well-characterized sample patient populations. Studies may focus on understanding variability in the progression of individual PD symptoms (i.e., tremor, posture and gait, cognitive dysfunction) or on identifying clusters of clinical features that predict different PD prognoses. Collaboration between clinicians and statisticians/epidemiologists is strongly encouraged, and applicants must demonstrate evidence of access to pre-existing datasets in their applications.

Pre-proposals are required and must be submitted online by November 6, 2006. Information about submitting pre-proposals online can be found on the Foundation’s Web site. Pre-proposals will be reviewed by the Foundation’s scientific staff and a panel of scientific experts. Applicants whose pre-proposals are determined to meet the review criteria will be invited to submit full application proposals. Funding is anticipated by May 2007.

The Michael J. Fox Foundation for Parkinson’s Research is dedicated to ensuring the development of a cure for Parkinson’s disease through an aggressively funded research agenda. To date, the Foundation has funded more than $78 million in research directly or through partnerships.

Interesting
 

Paula, This could be interesting. Thankyou for posting this, as I hadn't realized.
I thought there was only 2 different types, tremor dominant (which I was told was a more benign form of P.D.) and the other kind. Not sure of the proper name for "other kind" but there's no tremor and akinesia rears it's ugly head relatively early and symptoms progress more rapidly.
Thanks,
Lee

Hi Lee
 

That's all they used to say - tremor dominant or rigidity or something dominant and the latter was said to be more threatening for dementia. But these sub types promise to change clinical trials forever, allowing them to identify which drug or treatment works with which subtype...may not have to waste time if it isn't working for some types.

fingers crossed, I think this could be important stuff,
paula

Paula, regarding your comment about dementia, this article is interesting:

Extrapyramidal features in Parkinson's disease with and without dementia and dementia with Lewy bodies: A cross-sectional comparative study

Movement Disorder
Volume 18, Issue 8, Pages 884-889
Published Online: 21 Mar 2003

http://www3.interscience.wiley.com/c...5647/HTMLSTART

"A significant negative correlation between bradykinesia and rigidity, parkinsonian features mediated by dopamine deficiency, and the severity of intellectual impairment has been reported.[8-10][13]

Tremor, on the other hand, may be of good prognostic significance in terms of incident dementia,[15] although this has not been a consistent observation.[12][44]

Others have suggested that motor features mediated by non-dopaminergic pathways, namely, problems with speech, posture, and balance, correlate more closely with incident dementia in PD than tremor, rigidity, and bradykinesia.[5][6][9][11]

Our results are consistent with these findings, in demonstrating an over-representation of the PIGD subtype in a group of patients with PDD, defined according to DSM-IV criteria plus visual hallucinations and/or fluctuating cognition, as well as extending this observation to DLB patients."

Thanks ZF,

just adding that i'm talking about many aspects of pd when I say puzzles -not just gdnf.

That says it the way it's been pretty much - but now we need to create this paradigm and it takes so much obsessive behavior and single purpose of mind. Tremor or rigid is going to get an overhaul and they need patients and we need patient advocates and it can be exciting for everyone . Go straight to the researcher and call them and the bio tech as well.

Perry Cohen, is the master PD advocate. He told us six years ago about this and Amgen just tripped and fell right onto our radar screens.

There are so many connections that could put the pieces of the puzzle together and the trick is getting those directly involved to communicate with you. And with each other. So people need to fall into assigned projects. I couldn't agree more with Ricks ad hoc idea there is so mch to be shared and we are getting tired.

I know if you are still working and don't have the time don't give it a second thought. Uh Oh teacher mode coming on but I have the attention of some serious resesarcher people and not just for drugs or surgery,for all angles...IbKen where are you now? Seeing them I have to bloviate.

We have paved the way through major organizations, sat with the scientitsts had some contact with MJF through his own means. We think we are all Brenda Starrs [big hair?] investigative reporters lol.because we knew Mike was going to mention GDNF at the WPF and he is telling a brilliantly parallel story right on ABC on Boston Legal. Would probably deny by foundation I don't know. But it includes our plight [s] and he is even looking like its his own story as he realizes how fortunate he's been.ho knows? It is like some poetry...who knows? It's close enough.

This is happening now. What is going to happen next. We need a surge of you to make part of a paradigm happen and I'm not exaggerating.

think about it,
sorry but its what I do when I am arouind smart and sometimes retired pwp.

done thanks,
paula

Question. Will forms of Parkinsonism be considered now as a form of Parkinson's?

Mama

Good question Mamafigure ...
 

Zucchini, my neuro told me that dementia and dyskinesia was related to age of onset.

Personally as a young onset, his position is that dementia is unlikely, however dyskinesia is much more likely (and vice versa with age).

He didn't mention tremor as a determining factor.

Should be interesting these results.

Aftermathman.

I went down a rabbit trail tonite trying to find out why reverette mentioned cinnamon in his post today and ended up here.... Now that i am here, i ask for your thoughts on the following: what I've been struggling with as a concept is....should there be a completely different treatment course for tremor dominant as opposed to rigid. How can the same class of meds be efficacious for these almost opposite symptoms ( too much movement vs. not enough movement.) Also, whatever happened to the mjff research into subtypes? How do we even know both these subtypes arise out of the same disease? As always please forgive my complete ignorance....