Parkinson’s is a pandemic. According to experts, this term is by no means an exaggeration when referring to the fastest-spreading neurological disease, which is increasingly affecting younger age groups as well. On the occasion of World Parkinson’s Day, we spoke with Dr. Norbert Kovács, professor of neurology and president of the Hungarian Scientific Parkinson’s Society, about new research aimed at preventing the disease and the currently available therapies.
Written by Miklós Stemler
While in the case of a traditional epidemic, a specific pathogen causes widespread illness, the rapid spread of Parkinson’s disease—which, to the best of our current knowledge, is incurable and involves severe motor dysfunction—is driven by other factors: the disease is caused not by a virus, but by complex environmental factors. The use of the term pandemic is justified by alarming statistics. In the United States alone, 90,000 people are diagnosed with Parkinson’s disease each year, while there are currently about 30,000 registered patients in Hungary. The fight against this chronic neurological disease, which affects tens of millions of people worldwide, is thus increasingly focused on identifying the possible causes and, based on that knowledge, preventing the brain damage that leads to the disease.
A single blood test may be enough soon
– While clinical diagnosis is currently the primary method, meaning that after symptoms appear, we confirm the disease through various tests and diagnostic imaging, in the near future, the focus will rather shift to a biological approach, that is, the examination of the underlying organic lesions associated with the disease. Now we have a considerable amount of information available, for example, regarding various pathological protein accumulations that may be associated with the brain damage causing the disease; though we do not yet know the exact cause and effect relationship,” says Dr. Norbert Kovács, deputy director of the University of Pécs Clinical Centre Department of Neurology and head of the department’s Parkinson’s Centre.
These lesions can be detected well before the onset of symptoms, which is important because by the time symptoms appear, the affected brain areas have already suffered significant damage, limiting the available treatment options. Medication and deep brain stimulation involving surgery are effective in these cases for alleviating the symptoms and slowing the progression of the disease, but it would be a great relief for both the individual and society if these therapies, which involve so much discomfort and expense, were not necessary. However, it is a difficult question to determine how to identify those most at risk for Parkinson’s disease.
– Laboratory tests that can reliably detect the presence of proteins associated with the disease, even during the asymptomatic phase, are considered a relatively recent development. It may be advisable for those with a family history of Parkinson’s disease to undergo such a test, since genetic factors may play a role in the development of the disease. In addition, environmental factors that may be linked to the onset of the disease are receiving increased attention. Specific links have already been established for certain pesticides, and we also know that air pollution is a risk factor. It is important to note that we currently have limited data to determine the exact role of proteins that “predict” Parkinson’s disease. It is possible that these proteins cause the disease, but they may also appear as a consequence of the disease. Therefore, the test results should be interpreted with caution: on the one hand, the presence of these proteins does not necessarily indicate the presence of the disease, and on the other hand, their absence does not completely rule out the possibility of developing the disease, emphasizes Norbert Kovács.
We have the means against it
Due to their simplicity, laboratory tests could play an important role in the future in preventing the disease or delaying its onset, since even a change in lifestyle may be sufficient to achieve this.
– Regular moderate-intensity exercise significantly slows the progression of the disease, even during the symptomatic phase, just as regular coffee consumption may also help prevent the onset of the disease. There is also growing evidence that these methods, which are accessible to most people, can significantly delay the onset of symptoms in at-risk groups, the expert points out.
For people living with the disease, symptomatic treatments can offer relief, which have become increasingly sophisticated and patient-friendly in recent years. These include, for example, remote-programmed deep brain stimulation, which was first introduced in Central and Eastern Europe at the Parkinson’s Center in Pécs, and the latest significant advancement in the region is the rechargeable version, also implemented there. Both significantly improve the lives of patients who have undergone deep brain stimulation, as they no longer have to make strenuous trips to the clinic. An innovation in drug therapy is the subcutaneous pump system, which facilitates the steady absorption of active ingredients and requires only a simple procedure.
However, the true effectiveness of a given therapy or clinical practice can only be ensured and enhanced through continuous, high-quality data collection and analysis, and Norbert Kovács expects this to be the key to a breakthrough.
– Over the past few years, the Parkinson’s Centre in Pécs has also participated in the work of the National Laboratory for Translational Neuroscience, the primary goal of which was to introduce data collection suitable for the use of systematic, modern data analysis methods and to integrate these findings back into the clinical practice in the case of various neurological conditions. The form system we developed provides significant support in applying the most effective therapies at a given stage of the disease, and there are still several opportunities to explore in this area. In the next phase of our work, we hope to have access to data from the Natural eHealth Infrastructure (EESZT), the analysis of which will not only provide feedback on the effectiveness of ongoing treatments but also predict which therapeutic approach is likely to yield the best results in individual cases.
Sometimes common sense can be enough
There are some issues that do not require high-level research and development; instead, the judgment of decision-makers could be sufficient. One such issue is the tax credit for people living with Parkinson’s disease or, more precisely, the lack of it, which, according to the president of the Hungarian Scientific Parkinson’s Society, is becoming an increasingly pressing issue.
– More and more people of working age are living with the disease, and thanks to the effective therapies, many of them are able to maintain their ability to work. However, unlike their peers living with many other chronic conditions, they are not eligible for tax credits, which puts them at a significant disadvantage. “This is typically the kind of measure that would not entail high costs yet would benefit both the individual and society as a whole and would express our appreciation for our fellow citizens living with Parkinson’s disease who are still able and willing to work,” the professor adds.