Revolutionary Parkinson’s Diagnosis Model Unveiled In New Study

An international research team, led by Dr. Anthony Lang, a Neurologist and Senior Scientist at the Krembil Brain Institute, has proposed a groundbreaking model for classifying Parkinson’s disease (PD). Despite significant advancements in understanding the biological factors underlying PD, current diagnostic methods rely primarily on clinical features, such as observable motor symptoms. Dr. Lang argues that this traditional approach doesn’t adequately consider the complex biological processes involved and suggests a shift toward a more biologically driven classification. 

In recent decades, researchers have identified key biological factors contributing to PD, including the accumulation of the protein α-synuclein in the brain, genetic predispositions, and neurodegeneration. Biomarkers, which are reliable methods to test for these factors in living patients, have also been developed. However, diagnosis still heavily relies on clinical observations. 

Dr. Lang emphasizes that Parkinson’s exists in the brain for an extended period before clinical symptoms appear, highlighting the need for a more nuanced understanding of the disease’s biological determinants rather than relying solely on clinical descriptions. 

Published in Lancet Neurology, the research team introduced a novel classification model called SynNeurGe, pronounced “synergy.” This biologically based model focuses on the interplay of three key factors contributing to PD: the presence of pathologic α-synuclein in the brain (S), evidence of neurodegeneration as the disease progresses (N), and the presence of gene variants associated with or predisposing an individual to the disease (G). The team believes that this “S-N-G” classification system better captures the biological heterogeneity of PD and its diverse presentations in patients. 

According to Dr. Lang, this new model provides a more holistic view of the disease, acknowledging the dramatic differences between patients and recognizing that PD is not a uniform disorder. The hope is that by understanding distinct disease processes in subgroups of patients, researchers can develop more targeted and effective disease-modifying therapies. 

Dr. Jaideep Bains, co-Director of UHN’s Krembil Brain Institute, commends Dr. Lang for spearheading an international effort to redefine the biological complexity of Parkinson’s Disease. The proposed model, he suggests, will advance and streamline research in the field, ultimately leading to precision medicine for patients. 

While the potential applications of this new model are promising, Dr. Lang cautions that it is currently intended for research purposes only and is not yet ready for immediate clinical use. Nevertheless, the model has generated hope among patients and the medical community, as it represents a pivotal shift towards understanding the molecular basis of PD, differentiating it from other neurodegenerative conditions, and identifying potential therapeutic targets. 

Hugh Johnston, Founding Chair of The Movement Disorders Patient Advisory Board at UHN’s Krembil Brain Institute, who is living with PD, expresses optimism about the new approach. He sees it as a game-changer that aligns with patients’ desire for tailored treatments based on a deep understanding of the individual’s condition. Dr. Lang underscores the importance of looking at the biology to find answers, stating that without this approach, breakthroughs in Parkinson’s may be elusive. He considers the new classification system and the research it will inspire to be one of the most exciting aspects of his career. 

Journal Reference  

A biological classification of Parkinson’s disease: the SynNeurGe research diagnostic criteria, The Lancet Neurology (2024). www.thelancet.com/journals/lan … (23)00404-0/fulltext.