Parkinson’s Disease: New Advances Help Early Diagnosis
When primary care physicians notice that a patient has a tremor or other signs of Parkinson’s disease, they typically take a watchful waiting approach. That’s understandable, given that no treatments have been proven to alter the disease’s trajectory. But new advances make it easier to diagnose Parkinson’s earlier than ever, and early referral and diagnosis have important benefits that physicians should be aware of.
These benefits include opportunities to:
Participate in clinical trials of drugs that could slow the disease’s progression.
Work with specialized providers – including physical, speech and occupational therapists – who are experts in helping Parkinson’s patients manage the disease’s physical and psychological impacts.
Start exercise, nutrition and social routines that provide long-term cognitive benefits.
Shorten the period of anxiety that comes when a patient has symptoms but no diagnosis.
Start working toward acceptance and planning for the road ahead.
“It’s common for physicians to wait a year or longer before they refer a potential Parkinson’s patient to a specialist. Our message to them is: Referring patients as soon as they show potential signs of Parkinson’s has concrete benefits that physicians should consider,” says Daniel Burdick, MD, a neurologist at the Eastside Neuroscience Institute and the Booth Gardner Parkinson’s Care Center at EvergreenHealth.
The Eastside Neuroscience Institute is a leader in early Parkinson’s diagnosis. We do DaTscans for early diagnosis and is one of the region’s first centers offering a skin biopsy that gives a strong indication of Parkinson’s. The process comprises a punch biopsy from three sites: above the ankle, above the knee and the back of the neck. The tissue is then evaluated for the presence of α-synuclein, which is found in brain tissue of Parkinson’s patients.
“If the biopsy detects this protein, it indicates that the patient very likely has a category of neurological disease called synucleinopathies, of which Parkinson’s is one,” Dr. Burdick says.
Coming To Terms with Parkinson’s Disease
The sooner a patient is diagnosed, the sooner they can start coming to terms with the disease.
“When patients have the first signs of Parkinson’s, it can cause a lot of anxiety as they worry about the ‘what ifs’,” Dr. Burdick says, “and then the diagnosis itself can be devastating at first.”
An early diagnosis can alleviate that anxiety by giving patients a concrete target to address. It gives patients the opportunity to reach some degree of acceptance, as soon as possible. Then they can start planning for life ahead and taking steps to improve their future quality of life.
“There’s good evidence that Parkinson’s disease progression can be affected by exercise, nutrition and social activity,” Dr. Burdick says. “Early diagnosis helps them make those lifestyle changes as soon as possible, so they can have the best possible long-term outcome.”
Clinical Trials Offer Hope
If Parkinson’s is confirmed in a patient, the Booth Gardner Center offers one of the region’s largest portfolios of clinical trials. The goal is to have a clinical trial for every patient and every stage of Parkinson’s. Current trials include:
A clinical trial of a new medication for patients who are early in their disease. The medication aims to reduce early symptoms, with fewer side effects than current medications.
An early study of a drug that aims to inhibit LRRK2, an enzyme that is overactive in patients with Parkinson’s. The study investigates whether this drug could slow progression.
A clinical trial that tracks the effects of deep brain stimulation (DBS) over time. The Booth Gardner Center has some of the region’s highest volumes of DBS implants, with an outstanding track record of using DBS to reduce tremors and other Parkinson’s symptoms.
“Obviously, a lot of today’s treatments are in the early stages and might not help an individual patient,” Dr. Burdick says. “But many of our patients find comfort and solace in knowing that they’re participation gives really valuable information that could help future patients like them.”
Beyond clinical trials, there are several approaches that can improve quality of life in Parkinson’s patients.
“It’s important to remember that Parkinson’s isn’t just the motor symptoms,” Dr. Burdick says. “The disease also has important neuropsychological components – including anxiety, depression, impaired executive function, attention and memory processing – that are really important to address.”
The Booth Gardner Center is home to a team of physical therapists, nurses, speech therapists, occupational therapists, social workers and other providers who have specialized expertise in helping Parkinson’s patients and their caregivers. These providers work together to provide care that’s tailored to every patient. This includes everything from helping a patient manage neuropsychological issues to supporting their caregiver to helping them identify a facility that can help if they can no longer care for themselves at home.
“Parkinson’s is a complex, multi-system, multi-domain bio-psycho-social disease that requires many people to be involved, and all of those people should have expertise in Parkinson’s,” Dr. Burdick says. “Providing that comprehensive care is the crux of what the Booth Gardner Center was founded to do.”