Study Rationale:
Parkinson’s disease is a progressive neurodegenerative disorder that does not only affect movement but also the autonomic nervous system. Since most people start developing the disease in their sixties, the ongoing global trend toward population aging is expected to result in increasing numbers of people with Parkinson’s disease. Therefore, there is an urgent need for biomarkers to better understand the progression of the disease and optimize treatment. We have previously shown that we can assess autonomic nerve fiber function with pharmacological stimulation of local goose bump responses on the skin.
Hypothesis:
We hypothesize that quantification of local goose bump responses using a nerve fiber test named QPART can monitor the progression of autonomic dysfunction in Parkinson’s disease.
Study Design:
In this multi-center study we will recruit patients in four university hospitals (Dresden, Boston, Oxford and Budapest). These patients will undergo initial QPART testing which will be repeated six months, one year, two years and three years after the beginning of the study. We will compare goose bump responses with measures of other autonomic functions including blood vessel function and sweat gland function as well as nerve fiber structure in skin biopsies.
Impact on Diagnosis/Treatment of Parkinson’s Disease:
The QPART technique might be more robust and therefore may have higher clinical applicability than other autonomic nerve tests. Therefore, it may be a useful tool in monitoring progression of the disease and helping provide individualized treatment.
Next Steps for Development:
If successful, this study will form the basis for using the QPART technique in clinical assessment of patients with Parkinson’s disease and other neurodegenerative diseases with involvement of the autonomic nervous system. While this process will begin in the participating study centers, it might have the potential to be established in neurological clinics around the globe.