Study Rationale:
There is a lot of anecdotal evidence that the symptoms of Parkinson's disease (PD) may improve markedly during visits to high-altitude destinations. Given the significant, but as yet anecdotal evidence, it is necessary to further explore this interesting phenomenon, using a systematic research approach.
Hypothesis:
We hypothesize that by obtaining both positive and negative travel experiences from Parkinson's patients, we will be able to identify if there is any signal for a potential altitude effect on parkinsonian symptoms; any positive findings will be followed by further controlled studies.
Study Design:
This explorative study consists of two parts. The first part will involve a focused survey, asking patients to share their best and worst experiences with regards to their Parkinson's symptoms within the previous two years of traveling. From this survey, we will obtain personal narratives of patients' experiences. The second stage involves an in-depth survey to capture travel experiences prospectively, obtained during holiday trips that respondents make.
Impact on Diagnosis/Treatment of Parkinson's Disease:
If there is a clear signal for a positive effect of altitude on parkinsonian symptoms, we need to further explore the underlying mechanism of action. Currently, at least two pathways have been described based on laboratory studies, though not yet confirmed in human populations.
Next Steps for Development:
If positive, this study can provide the basis for further research into the positive impact of altitude on symptom severity in PD, including options for new treatments (e.g., hypobaric chambers). This would first require a pilot trial with hypobaric pressure tents to replicate high altitude conditions, with a control group receiving a sham intervention.