Scientists have suggested a new method for categorizing Parkinson’s disease based on biological changes connected to the disorder.
“Without considering the biology, we cannot make progress. And without progress, we will not see much-needed breakthroughs in Parkinson’s,” noted Anthony Lang, MD, a researcher at the Krembil Brain Institute in Canada and a co-author of the paper outlining the method. He expressed his excitement about the new classification system and the potential research projects it will inspire, calling it one of the most thrilling aspects of his career. Lang and his colleagues detailed their classification system in The Lancet Neurology, in a paper titled “A biological classification of Parkinson’s disease: the SynNeurGe research diagnostic criteria.”
New classification may advance development of disease-modifying therapies
The utilization of a biological classification is expected to drive progress in both basic and clinical research, bringing the field closer to the precision medicine necessary for the development of disease-modifying therapies, as stated by the scientists.
Currently, Parkinson’s is diagnosed based on the presence or absence of signs and symptoms indicative of the disease. However, this approach has its drawbacks: it lacks objectivity and means that Parkinson’s cannot be diagnosed until substantial brain damage has occurred, leading to noticeable differences on examination. Lang highlighted the fact that Parkinson’s exists in the brain for one to two decades or longer before clinical manifestations. Therefore, current research should be driven by biological determinants of the disease rather than limited clinical descriptions of symptoms. “We need a radically different way of looking at this disease,” Lang emphasized.
The scientists’ new model classifies patients based on the presence or absence of three types of biological changes typically observed in many, but not all, people with Parkinson’s: the presence or absence of clumps of alpha-synuclein protein in the brain; the presence or absence of detectable neurodegeneration (brain cell death); and the presence or absence of Parkinson’s-associated genetic mutations. The team named this three-step classification model SynNeurGe (pronounced “synergy”), aiming for it to more accurately classify Parkinson’s subtypes and better reflect the disease’s underlying causes.
Model provides ‘much broader, more holistic view of the disease’
Lang stressed the need to acknowledge the dramatic differences in Parkinson’s presentation between patients, stating, “Our model provides a much broader, more holistic view of the disease and its causes.”
Improved classification of underlying biology could also facilitate the development of more targeted treatment strategies. Hugh Johnston, who lives with Parkinson’s and is founding chair of the Krembil’s movement disorders patient advisory board, expressed his optimism about the new approach, calling it a game changer. He believes that this new way of thinking is what they have been waiting for.
