In a new study, researchers found although the name may suggest otherwise, Parkinson’s disease is not one but two diseases, starting either in the brain or in the intestines.
With the help of advanced scanning techniques, they found that Parkinson’s disease can be divided into two variants, which start in different places in the body.
For some patients, the disease starts in the intestines and spreads from there to the brain through neural connections.
For others, the disease starts in the brain and spreads to the intestines and other organs such as the heart.
This explains why patients with Parkinson’s describe widely differing symptoms and points towards personalized medicine as the way forward for people with Parkinson’s disease.
The research was conducted by a team at Aarhus University and Aarhus University Hospital, Denmark.
Parkinson’s disease is characterized by the slow deterioration of the brain due to accumulated alpha-synuclein, a protein that damages nerve cells.
This leads to the slow, stiff movements which many people associate with the disease.
In the study, the researchers used advanced PET and MRI imaging techniques to examine people with Parkinson’s disease.
People who have not yet been diagnosed but have a high risk of developing the disease are also included in the study.
People diagnosed with REM sleep behavior syndrome have an increased risk of developing Parkinson’s disease.
The team showed that some patients had damage to the brain’s dopamine system before damage in the intestines and heart occurred.
In other patients, scans revealed damage to the nervous systems of the intestines and heart before the damage in the brain’s dopamine system was visible.
This knowledge is important and it challenges the understanding of Parkinson’s disease that has been prevalent until now.
The researchers refer to the two types of Parkinson’s disease as body-first and brain-first.
In the case of body-first, it may be particularly interesting to study the composition of bacteria in the intestines known as the microbiota.
The next step is to examine whether, for example, body-first Parkinson’s disease can be treated by treating the intestines with feces transplantation or in other ways that affect the microbiome, the team says.
The discovery of brain-first Parkinson’s is a bigger challenge.
This variant of the disease is probably relatively symptom-free until the movement disorder symptoms appear and the patient is diagnosed with Parkinson’s.
By then the patient has already lost more than half of the dopamine system, and it will therefore be more difficult to find patients early enough to be able to slow the disease.
According to the Danish Parkinson’s Disease Association, there are 8,000 people with Parkinson’s disease in Denmark and up to eight million diagnosed patients worldwide.
This figure is expected to increase to 15 million in 2050 due to the aging population, as the risk of getting Parkinson’s disease increases dramatically the older the population becomes.
One author of the study is Professor Per Borghammer.
The study is published in Brain.
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