New framework aims to use medical tests to improve clinical trials for Parkinson’s

A team of international experts and patient organisations have worked together to develop a new staging framework that proposes how 2 important medical tests could and should be used in clinical trials of new treatments for Parkinson’s and related conditions.

The 2 tests have been chosen because they can be used to identify key biological features of Parkinson’s. They are:

• a new test that can identify misfolded alpha-synuclein, a protein that is a feature of Parkinson’s, in fluid taken from the spine via a lumbar puncture
• a brain scan called a DaTSCAN that can tell if there is a lack of dopamine, the chemical that decreases over time in Parkinson’s, inside the brain.

Importantly, both tests are able to identify people in the early stages of Parkinson’s, before obvious symptoms emerge.

The new framework which sets out how these tests could be used in clinical trials has been published today in The Lancet. Read the paper on the Lancet website.

How will this accelerate new treatments?

A huge challenge for Parkinson's clinical trials is that the condition is currently diagnosed and monitored based on symptoms which can vary from person to person, and from hour to hour.

For trials to be successful, it is important that the right people are identified to take part, and that we can measure whether the treatment has the desired effects.

Having tests that can tell us what is happening inside the brain has the potential to revolutionise clinical trials. They will allow us to select the right people and better measure the potential of the treatment under investigation.

This will ultimately speed up the development of therapies that can stop the loss of brain cells in Parkinson's, something that no current treatments can do.

Just for use in research, for now

While DaTSCANs are already used to aid diagnosis of Parkinson’s in some situations, the new staging system and lumbar puncture test is only intended to be used in research at the moment.

This is just the beginning of using these kinds of tests to identify and monitor Parkinson’s. Researchers are already working to improve these tests and develop others to better measure changes in the body and brain that give us vital information about the condition and how it’s developing.

When the global effort to find breakthrough treatments is successful, then tests like these will become part of the way Parkinson’s is diagnosed and treated.

A huge and ongoing collaborative effort

Our Director of Research, Professor David Dexter, comments:

"We’re delighted to have been part of the development of this new framework. Tests that can accurately measure what’s happening inside the body have helped accelerate the development and testing of new treatments for other conditions and we urgently need the same for Parkinson’s.

"This initial framework is just the beginning. These 2 tests are a great start but there are lots of exciting advances happening in this field at the moment. We hope to see more sensitive and patient friendly tests added into the framework in the near future.

"The ultimate goal is to accelerate the development of new treatments that can transform the lives of people with the condition."

Helen Matthews, CEO at Cure Parkinson’s, added:  

"Adding precision to our clinical trials is vital. If we are able to involve the right participants in the right trials through the inclusion of these tests, that would be a big step forward and will enable us to gain clearer answers evaluated on biology rather than clinical assessments."