A team at the University of New England is moving closer - literally - to solving the mystery of how Parkinson's disease progresses, and rural Australians will soon play their part.
Parkinson's disease is the second most common neurological disease in Australia, affecting some 80,000 Australians. The number of people living with the disease is predicted to increase by 30-50% over the next decade and it's rare to find a family that hasn't been touched by the condition.
Symptoms of Parkinson's disease include slow movements, muscle rigidity, instability, tremors, depression and anxiety - all caused by the death of cells that produce the neurotransmitter dopamine in the brain. Diagnosing and treating the disease has always been complicated by the fact that there are at least two (and possibly more) subsets of Parkinson's disease - namely early onset and late onset. Unfortunately, by the time many people are diagnosed, 70% of their dopamine-producing neurons have already died.
Researchers at UNE’s School of Psychology are determined to advance the early diagnosis and treatment of Parkinson's, and they're taking cutting-edge technology into rural and regional Australia to further their research.
"Currently, when someone is diagnosed with Parkinson’s disease, it can be difficult to determine what type of Parkinson’s they have or how quickly the condition will progress," said Dr. Deborah Apthorp, who is heading the study. "If we could diagnose Parkinson's earlier, we might be able to slow the progress of the disease, but first of all we have to better understand its progression. Then we can tailor the treatment more appropriately."
A Perpetual Impact Philanthropy Grant will enable the research group to purchase a van and equip it for use as a mobile research lab, powered by the sun and based at UNE. It will enable Dr Apthorp to extend a previous study into Parkinson's, also funded by Perpetual, that she began while at the Australian National University.
"The latest funding will allow us to extend our reach into rural and regional NSW and southern Queensland," she said. "That's something I am very passionate about. Big research studies tend to get funded in big clinics in major cities. People in rural and regional Australia rarely get the opportunity to participate. This is taking the research to the people, and underlines the importance of a regional university and what it contributes to its community."
The team will continue to collaborate with colleagues at the Australian National University, tapping into the expertise of clinicians and data scientists at The Canberra Hospital and ANU’s Research School of Computer Science. In addition to more traditional clinical measures, the research will rely on brain imaging EEG techniques, eye-tracking, visual perception, simple finger-tapping tests, and postural sway to monitor research participants.
A person with Parkinson’s disease finds it harder and harder to maintain their upright posture. As the disease progresses, they start to fall or have difficulty walking. There is also some evidence that speed of eye movement is related to parts of the brain that are impacted by Parkinson’s.
"The issue with Parkinson’s disease is that some people can do well for quite a long time, while others may be confined to a nursing home within five or 10 years," Dr Apthorp said. "This project aims to track a range of early symptoms to determine if any can be used as an indicator of progression.
“The different types of Parkinson’s can look similar at the point of onset, but they may progress very differently. We are hoping the information we collect will differentiate between these different conditions and that, in time, doctors and other primary health professionals are able to conduct simple, accurate tests that can help predict how the disease is likely to progress.”
The mobile lab and research may also have other future applications. "I hope to collaborate with other groups that are conducting rural and regional health research into conditions like cancer, diabetes and multiple sclerosis," Dr Apthorp said. "The van could be very flexible in terms of the equipment it carries to assess symptoms associated with a range of disorders and diseases."
Dr Apthorp said people living in remote and rural Australia typically have difficulty accessing specialised medical care. Patients in the New England region, for example, must travel several hours to consult a specialist neurologist when they are often already struggling with their mobility.
"This project offers the possibility that, eventually, inexpensive technologies such as balance plates, combined with other forms of non-invasive, simple data, could offer sufficient information for individuals to track the state of their health, disease progression and response to medication in the comfort of their own homes, or in a simple rural clinic setting," she said. "Our team has advanced expertise in signal processing and data analysis to develop these new measures. We just need to be able to reach patients and empower them to participate in research that can shape their future.
"Knowing what's in store, how sick they will be and when, could practically and financially change the trajectory of someone's life. That kind of information is very important to the patient. In the shorter term our research can contribute to their improved health and wellbeing as well as medical science's understanding of the condition."
Di Trestrail from the Armidale Parkinson's Support Group welcomed efforts to involve regional people in research.
"Any research into the disease is sorely needed and should include this segment of the population," Di said. "There is such a scarcity of neurologists in rural areas - most of us have had to travel to Tamworth, Brisbane and even Sydney for diagnosis and treatment - and then there is nothing you can do once you are diagnosed. However, the earlier a Parkinson's diagnosis is made, the sooner the person can start introducing some protections to ward off symptoms. Exercise, for instance, makes a huge difference."
But while the research team are now busy planning their bush itinerary, Dr Apthorp said they do not yet have all the equipment they need. "Funding was not sufficient to buy the eye-tracker or pay for research assistants," she said. "The next thing I will be looking for is money to help me carry out this important research. Time is of the essence and this is the kind of research that people can contribute to and have a direct impact."
