PHILADELPHIA—A trio of studies from researchers at the Perelman School of Medicine at the University of Pennsylvania demonstrate new approaches to understanding, treating, and potentially staving off Parkinson’s disease. Studies show that factors such as estrogen exposure and statin use have an impact on the onset of Parkinson’s disease. And a new look at telemedicine demonstrates feasibility in providing care for Parkinson’s patients using remote video visits to expand access and center care around the needs of Parkinson’s patients. The three studies were presented at the 66th Annual Meeting of the American Academy of Neurology.
Statins May Delay Onset of Parkinson’s Disease
Research presented by Yosef Berlyand, an undergraduate in the laboratory of Alice Chen-Plotkin, MD, MSc, Assistant Professor of Neurology, suggests that statins may be beneficial in Parkinson’s disease. In collaboration with Roy Alcalay, MD, and colleagues at Columbia University School of Medicine, members of Dr. Chen-Plotkin’s research group demonstrated that blood levels of the protein Apolipoprotein A1 (ApoA1) are lower in people with Parkinson’s disease than in those without the disease. Patients with Parkinson’s disease taking statins, which can elevate levels of ApoA1, had an older age of disease onset, which appears to be driven by taking statins. Previous work led by Dr. Chen-Plotkin suggested that ApoA1 levels may be a new biomarker for Parkinson’s disease risk. The team is now conducting a follow-up study on plasma ApoA1 and statins, evaluating participants in the Michael J. Fox Foundation’s Parkinson’s Progression Marker Initiative cohort to confirm whether ApoA1–modifying drugs such as statins may be a promising neuroprotective therapy for Parkinson’s disease.
Estrogen Investigated for Protection From Parkinson’s Disease
In another study, an analysis by Kara Smith, MD, a movement disorders fellow in Neurology in Penn’s Perelman School of Medicine, and colleagues investigated the role estrogen plays in decreasing lifetime risk of Parkinson’s disease, in light of the fact that men have a relative risk of 1.5 for having Parkinson’s disease compared to women. In a systematic review of studies using animal models of Parkinson’s disease, the research team found consistent evidence that 17ß-estradiol, in particular, may play a key role in binding to the estrogen receptor and protecting cells from Parkinson’s pathology. The team said further research needs to look at 17 ß-estradiol in more accurate models of Parkinson’s disease before results can be translated to clinical trials in patients with Parkinson’s disease.
Telemedicine Improves Access to Specialty Parkinson’s Care
In an effort to help remove barriers to specialty care experienced by many patients who live far from care or have disabilities that make it difficult to travel, Penn researchers examined use of telemedicine visits to increase access to specialty care for patients with Parkinson’s disease. A research team led by Jayne Wilkinson, MD, and Meredith Spinder, MD, conducted a randomized controlled trial using video telemedicine in the patient’s home or at a facility near the patient. In the case of this study, that location was VA Community-Based Outpatient Clinics, which connected them to a neurologist specializing in movement disorders and Parkinson’s disease who was based at the Parkinson’s Disease Research, Education, and Clinical Center at the Philadelphia VA Medical Center. Early results demonstrate that the process of using telemedicine for Parkinson’s care is feasible, provided similar quality of life, care, and communication, and significantly decreased travel.