A new Israeli brain scan technique could lead to routine screening to diagnose cases of Parkinson’s disease at its onset, scientists say.
Pharmaceutical companies are expected to receive approvals in the coming years for drugs to treat Parkinson’s, and a major challenge for doctors is to identify early who is developing the disease and therefore who should receive the drugs.
Regular MRI scans, the usual method of visualizing brain structure, don’t show the onset of Parkinson’s as they aren’t sensitive enough.
The disease — which disproportionately affects Ashkenazi Jews — is normally diagnosed during clinical testing, in which doctors make an assessment based on symptoms rather than on the state of the brain.
There is another method, which assesses the state of the brain, but it involves injecting a radioactive substance, so it isn’t widely used because of its invasiveness and high cost.
Prof. Aviv Mezer said his team of researchers at Hebrew University in Jerusalem has developed an easy-to-scale objective method for diagnosis — one which assesses brain scans based on measurements of decay in the brain, and gives a clear yes or no answer for the presence of the disease.
The researchers have confirmed proof of concept and are working on a tool for use in clinics.
“This is very positive, as scientists prefer objective measurements like this one over the assessment of symptoms by doctors, and could very much advance diagnosis,” Mezer said.
His team used a special type of brain scan called quantitative MRI or qMRI, which provides detailed measurements from scans. They then developed an algorithm to analyze the measurements.
Using this, they were able to get the detailed information that regular MRIs have failed to yield for Parkinson’s diagnosis, namely information on changes in microstructures within the striatum, a region in the forebrain that is critical to motor function.
Previous research shows that the striatum deteriorates during the progress of Parkinson’s disease. As this region is so important in allowing people to control their muscles, it is believed to impair this ability.
While the most noticeable effects are tremors and a hunched stance, patients suffering from Parkinson’s often lose control of their primary and secondary motor skills, suffer from vision, bladder and sleep issues, and can eventually lose their memories and slip into dementia.
Mezer and colleagues set out to find a method for using qMRI imaging to detect this deterioration in its initial stages, and successfully achieved that. They reported their achievement in a peer-reviewed article published on Friday in the Science Advances journal.
“This finding can be used to develop screening tools for Parkinson’s which could help to detect the disease based on brain changes, not on symptoms,” Mezer said. “Successful intervention should be early, so this could actually make it possible to intervene more effectively.”
His lab is already working on such a tool, which he anticipates could be ready for clinical use three to five years down the line.
“Until now we haven’t had a quantitive MRI that shows the extent of decay in striatum that would indicate Parkinson’s, or a way to see it. Our research has given us both,” he said.