Highlights from the World Parkinson Congress - Hot Topics

The Hot Topics sessions take place first thing in the morning on each of the congress days. Their aim is to provide a snapshot of some of the exciting research that’s happening across the field of Parkinson’s research. Here we summarise a few of the talks to bring you an insight into the latest updates in Parkinson’s research.

The role of genetics

Genes are sections of our DNA that hold instructions to tell our cells what to do. It’s our genes that determine things from our natural eye or hair colour, to how well our cells can clear away waste or produce energy. Changes in certain genes have been associated with the development of some health conditions, such as Parkinson’s.

A number of the Hot Topics sessions shared results about how studying changes in our genes might help unlock new targets for Parkinson’s treatments in the future. These typically involved studies of large groups of people with Parkinson’s, to look for links between specific genes and certain symptoms, or how quickly the condition progresses.

The ROPAD study

Researchers from Germany presented the latest results of the ROPAD study. This is an international study of over 25,000 unrelated people with Parkinson’s. The aim of the study is to get a better understanding of how relevant changes in 50 genes previously associated with Parkinson’s might be for the community, and for further research.

The researchers are halfway through the study, having analysed results from over 12,500 people with Parkinson’s. They shared that around 15% of people studied so far had a change in one of the genes previously linked to Parkinson’s, the most common of these being GBA1 and LRRK2. The distribution was equal between men and women, but they did find that people with a change in one of these genes were more likely to have been diagnosed with Parkinson’s at a younger age. So people diagnosed under the age of 50 were more likely to have a genetic link.

Read more about the ROPAD study on Centogene's website.

PD GENEration

The Parkinson’s Foundation from the United States presented an update on their PD GENEration study. This study aims to not only provide genetic testing for people with Parkinson’s, but also help those tested understand their results by offering genetic counselling. 

PD GENEration has studied over 10,000 people so far, across the United States and Canada. Like the ROPAD study, they found that around 12% had a change in one of the genes known to be linked to Parkinson’s, and that people diagnosed younger were more likely to have one of these changes.

Read more about the PD GENEration study on the Parkinson's Foundation website.

Global Parkinson’s Genetics programme

Studies like the above can help us understand links between genetic changes and certain symptoms, but can also be used to help plan better and more effective research studies in the future. But the current problem is that large studies like these are not truly representative. The majority of people included in both the ROPAD and the PD GENEration study are white. So we might be missing crucial information about genetics in people of Black, Asian or Mixed Race heritage.

Researchers from the Global Parkinson’s Genetics programme are looking to address this. They presented the results of their study, which involved looking at genetic information from nearly 200,000 people of African heritage. Through this, they identified a change in the GBA1 gene, but not one that had not previously been seen, which was closely associated with Parkinson’s. And it even correlated with more quickly progressing symptoms of the condition. Results like this demonstrate the need for better representation in research, so we have a complete understanding of Parkinson’s in everyone and can create better treatments.

Read about how we're driving forward race equality in research.

Looking inside the cell

Understanding changes in genes and genetics might help improve clinical trials and personalised treatments in the future, but there’s still a lot we don’t know about Parkinson’s to be able to develop these treatments. This is why researchers are continuing to look at changes in the cells of the body, and comparing them between people with and without Parkinson’s, to see if they can find new clues as to what might be a good target for treatment.

A group of researchers in France are trying to understand how Parkinson’s might spread between cells in the brain. Parkinson’s can be associated with clumps of a troublesome protein called alpha-synuclein, which are found in some brain cells of people with Parkinson’s. The clumps stick together and cause damage to the cell, and eventually to surrounding cells. But it’s not fully understood how these clumps travel between cells.

Read a brief history of what we have learned about alpha-synuclein since 1994. 

The group presented some of their results showing that cells experiencing damage in the brain might form tiny channels, called nanotubes, that reach out to neighbouring cells for help. These nanotubes could be used to send extra material between healthy and damaged cells, to try and repair the damaged cells. Things like extra protein building blocks, or energy producing mitochondria, to help out the damaged cell.

However, the researchers showed that these nanotubes might actually cause more harm, by allowing the clumps of alpha-synuclein to travel from the damaged to the healthy cell. This might be one reason that alpha-synuclein starts to spread, and therefore how the condition starts to affect other cells in the brain and cause their death.

More research is needed to understand exactly what these tubes are doing. But trying to prevent the channels forming in unhealthy cells could be an interesting target for future treatments.

Avenues that we need to explore

The Hot Topics sessions also provided the chance for researchers to draw attention to areas of research that need more investigation.

For example, the role of diet and nutrition in Parkinson’s progression or managing symptoms is not well understood. Richelle Flanagan, a dietitian and Co‑Founder of My Moves Matter, used her Hot Topics presentation to highlight the need to include dietitians in the conversation about care for people with Parkinson’s. There’s a lot we still don’t know about how different diets might affect certain symptoms. But what is well known is that people in the Parkinson’s community need to have access to more information about diet, and how to find out what works best for them.

Dr Soania Mathur, Co-Founder of PD Avengers, also used the Hot Topics session to share early results from a study of how research needs to include more women with Parkinson’s. The study has so far collected responses from 2,627 women with Parkinson’s, and has highlighted gaps in research knowledge about particular challenges faced by women with Parkinson’s, such as periods, pregnancy and menopause.

A Parkinson’s Virtual Biotech announcement

Finally, on Friday morning, Dr Adrian Newman-Tancredi from Neurolixis took centre stage at the Hot Topics session to share the company’s results from the latest phase 2a trial investigating NLX-112 for the treatment of levodopa-induced dyskinesias. The trial is the first supported by the Parkinson’s Virtual Biotech to have published results and attracted a great response and questions from the audience.

Read about the NLX-112 trial results in a previous blog.

You can watch recordings of all of the Hot Topics on the World Parkinson Coalition YouTube channel.