Lo smartwatch could reveal “traces” of the disease Parkinson up to 7 years before the onset of symptoms. It is the result of a very important study, published in Nature Medicine signed by researchers from the English Institute for Dementia Research (UKDRI) and the Mental Health Innovation Institute (NMHII) of Cardiff University, which opens up, on the general public, to unprecedented possibilities of early diagnosis, trump card for the success of therapy in Parkinson’s, as in any other disease. The researchers recorded the speed of the participants’ movements with a smartwatch for a week; these data were then analyzed by a program artificial intelligence that he was able to accurately predict who, among the study participants, would develop the disease, even after many years.
Parkinson’s disease (woe to call it “disease” again, a term from our distant linguistic past, burdened by a load of stigma, as the campaign recalls #NonChiamatemiMorbo of the Parkinson Italy Confederation) is a neurodegenerative pathology characterized by a slow and progressive course, linked to the destruction of some specialized cells of the brainproducers of dopamine and located in the “black substance”. It is characterized by movement (tremor, stiffness, slowness, postural instability) and balance disorders; but non-motor (anxiety, depression, sleep disturbances) and cognitive symptoms are also often present. The causes of the disease are not fully focused and it is believed that it may result from a combination of genetic predisposition, environmental factors and aging. For at least thirty years now, therapy has been entrusted to the administration of symptomatic drugs (so-called “dopaminergic” therapy, such as levo-dopa, dopamine agonists, amantadine, MAO B inhibitors) which do not cure the disease and can even determine after some time a series of complications, such as the so-called “dyskinesias” (motor fluctuations and uncontrolled involuntary movements). In many cases it is also necessary to resort to treatments for the so-called non-motor symptoms (depression, insomnia, memory problems, among others). On the other hand, over the years it has been discovered that Parkinson’s is not just a dopamine depletion disease; other regions of the brain may be affected by cell loss and by biochemical imbalances. The need and urgency to develop new treatments capable of responding to the needs of patients is therefore strongly felt. Something is finally moving but for the new treatments to have a better chance of success, it is necessary to administer them at the beginning of the disease. And this brings us back to the importance of early diagnosis and the development of new diagnostic tools, such as specific biomarkers of this disease, to be researched ideally through a blood test and to be requested perhaps on the basis of the alert launched by an “intelligent” watch ”. In fact, it is estimated that at the time of diagnosis, patients have already lost 50-80% of their kit neurons dopaminergic. At the moment, great hopes are pinned, both in terms of diagnosis and treatment, on alpha-synuclein, a “toxic” protein which, by accumulating in the brain, can trigger the recall of inflammatory cells which go on to destroy the precious nerve cells. For this reason, alpha-synuclein, in addition to serving as an early stage biomarker (it can be measured both in CSF and in blood), also represents a potential therapeutic target. Other newly identified potential biomarkers are the products of two genes (PLOD3 and LRRN3) overexpressed in the blood of patients already in the initial stage of the disease. Surgical therapy of Parkinson’s can be of great help especially in the more advanced forms of the disease or when the drugs do not give the expected effects. Patients under the age of 65, with disabling tremors resistant to medical therapy or with severe motor fluctuations and dyskinesias (an undesirable effect of dopaminergic therapy), may benefit from so-called “deep brain stimulation” (DBS). The neurosurgeonguided by a special operating room neuronavigator, implants a microelectrode deep inside the brain (basal nuclei), then connecting it to a generator, similar to that of a pacemakerlodged in a skin pouch at chest level. Patients have improvement in motor symptoms and can reduce drug therapy.
Meanwhile, research continues on innovative forms of therapy, from monoclonal antibodies against alpha-synuclein, to “vaccines” against Parkinson’s, to cell therapy with stem cell transplantation, reserved for the most advanced forms of the disease. The UB-312 vaccine, in a very early phase of experimentation (phase 1), stimulates the production of antibodies against alpha-synuclein, the toxic accumulations of which are the basis of Parkinson’s. The foundation Michael J. Fox (the famous American-Canadian actor, star of the film Back to the Future, suffering from Parkinson’s since the age of 29) recently announced that it will fund a project with this vaccine in collaboration with the Mayo Clinic and the University of Texas at Houston. Another line of research, carried out byUniversity of Oxford it is based on ubiquitins, small proteins that signal to the body’s “sweeper cells” which proteins to remove; in the case of Parkinson’s the protein to be scrapped is once again alpha-synuclein.
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