Wednesday, June 29, 2022

Powerful brain scanners offer hope for treating some Parkinson’s symptoms

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Ultra-powerful brain scanners could offer hope for treating previously untreatable symptoms in Parkinson’s disease, according to a new study.

Both Parkinson’s disease and a related condition, progressive supranuclear palsy (PSP), are progressive brain disorders that not only impair movement, but also impair motivation and cognition.

Cognition refers to the mental processes that take place in the brain, including thinking, attention, language, learning, memory, and perception.

These symptoms can have a major impact on a patient’s outcome, affecting survival and overall well-being, as well as stress and expense to families.

To understand the causes of these cognitive symptoms, University of Cambridge researchers used a new ultra-high-strength ‘7T’ MRI scanner at the Wolfson Brain Imaging Centre.

They measured changes in the brains of people with Parkinson’s disease, PSP, or people in good health.

The 7T refers to the strength of the magnetic field – most MRI scanners are typically 3T or less.

Patients with Parkinson’s and PSP are often treated with medications like L-DOPA, which compensate for the severe loss of dopamine — a brain chemical that affects mood and feelings of reward and motivation.

But treatment with dopamine does little to help many of the non-motor symptoms, and scientists have started looking at norepinephrine, a chemical that plays a crucial role in brain functions, including attention and arousal, thinking, and motivation.

Professor James Rowe from the University of Cambridge’s Department of Clinical Neurosciences, who led the study, said: “Norepinephrine is very important for brain function.

“All of our brain’s nourishment comes from a tiny region at the back of the brain called the locus coeruleus, which means ‘the bruise.’

“It’s a bit like two short sticks of spaghetti half an inch long: it’s thin, it’s small, and it’s tucked away at the base of the brain in the brainstem.”

The researchers wanted to know how to study this tiny region of the brain because previous MRI scanners weren’t powerful enough.

While most scanners can display structures with the detail of a grain of rice, 7T scanners, which have ultra-strong magnetic fields, achieve a resolution the size of a grain of sand.

This allowed the team to examine patients’ locus coeruleus and confirm that the greater the extent of damage to this region, the more severe their symptoms of apathy and the worse they scored on cognitive tests.

Researchers suggest the results offer hope for new treatments for these symptoms.

A number of drugs that increase norepinephrine have already been clinically tested for other conditions and have been shown to be safe and well-tolerated, the experts say.

Professor Rowe and colleagues are now conducting a clinical trial at the Cambridge University Hospitals NHS Foundation Trust to see if these drugs help relieve symptoms in PSP.

dr Rong Ye of the Department of Clinical Neurosciences at the University of Cambridge, co-author of the study, said: “Not every PSP or Parkinson’s patient will benefit from norepinephrine-boosting drugs.

“They’re more likely to benefit people who have damage to their locus coeruleus – and the greater the damage, the more benefit they’re likely to see.”

“The ultra-powerful 7T scanner can help us identify the patients who we think will benefit the most.

“This will be important to the success of the clinical trial and, if the drugs are effective, means we know which patients need treatment.

“In the long term, this will prove to be more cost-effective than giving norepinephrine boosters to patients who would ultimately see no benefit.”

The research was supported by Parkinson’s UK, the Cambridge Center for Parkinson-Plus and others around the world.

It appeared in Movement Disorders magazine.

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