Parkinson´s disease: evolution and mechanisms of disease progression in a community-based study population
Swedish Research Council
An unselected population of incident cases with non-drug induced parkinsonism was collected during 5 years and 4 months. Included patients are followed longitudinally with repeated investigations during the first 8 years (to 2017) following inclusion to identify: 1) a diagnostic profile for improved diagnostic accuracy in the early phase of diseases with symptoms of parkinsonism, i.e. Parkinson´s disease (PD) and other idiopathic parkinsonism; 2) the variability in temporal profile for the PD-population for improved assessment of disease prognosis; 3) characteristics and mechanisms of cognitive dysfunction in PD and related consequences. Metabolomics is used to gain insight into disease causing/contributing mechanisms and as a diagnostic and prognostic tool. Cognitive function is studied by multimodal neuroimaging and detailed testing. Close to 500 patients were evaluated for the prospective incidence cohort study and 186 fulfil the inclusion criteria of whom 80% have PD. Cognitive impairment is found in 30% of with PD at baseline and disturbed transient components of working memory have been identified. PD patients have a unique metabolomic CSF profile compared to healthy controls. The project´s substudies are important by themselves but also gain additional value by possibilities to relate findings to other substudies within the same study population. The project addresses questions of central importance to patients. What do I have? What is the cause? What will happen?