Study Rationale: A growing body of evidence suggests that Parkinson’s disease (PD) may begin in the stomach or elsewhere along the gastrointestinal (GI) tract before spreading to the brain. If this “GI-first hypothesis” is valid, the GI tract might be a good place to spot the early signs of PD and to monitor PD progression over time. Understanding whether and how PD starts in the GI tract could lead to novel approaches for the prevention of PD.
Hypothesis: We hypothesize that PD arises first in the stomach or other location in the gastrointestinal tract.
Study Design: We will look for alpha-synuclein aggregates, thought to be the earliest biochemical sign of PD, in 10 locations along the gastrointestinal tract from autopsies of more than 200 people who have been intensively studied for PD during life and after death.
Impact on Diagnosis/Treatment of Parkinson’s disease: If PD starts in the GI tract, we might be able to diagnose PD from biopsies similar to those performed to detect colon polyps or cancer. A “GI-first” origin for PD could also suggest that PD might be triggered by certain foods, chemical additives or ingested environmental chemicals.
Next Steps for Development: If we find that PD might arise in the GI tract, we could further refine tests for detecting the disorder during routine colonoscopy screening for colonic cancer.