Predicting the evolution of patients with Parkinson’s disease based on retinal thickness

One of the biggest obstacles doctors face in the fight against Parkinson’s disease and Alzheimer’s disease is that they have difficulty accessing patients’ diseased brains, especially early in the disease when symptoms have already appeared. very mild or confused with symptoms of other pathologies. By the time of diagnosis, 60% of the dopamine-producing neurons in the substantia nigra, the area of ​​the brain most affected by the disease, have already been lost. This, coupled with its inherent complexity (interference by age, genetic and environmental factors), means that there is no cure, despite the disease being described over a century ago.

A simple way to access patients’ brains without surgery or complicated medical tests is through the retina. But what does the retina have to do with Parkinson’s disease? “At first glance it may seem surprising, but the retina is neural, it is an extension—an extension—of the brain. In this way, we will be able to investigate this by studying this part of the eye,” explains Ane Murueta-Goyena, specialist at the UPV/EHU Center for Neurobiology. Several previous studies—Cruces has been doing this for a decade—have found that patients with this disease have significantly lower retinal thickness—particularly part of this so-called parafoveal region—than healthy people.” but they did it at a specific moment. We did a longitudinal study, meaning we took the same patient and followed him over time to see what changes were happening in the retina. Not only at the moment, but also its evolution over the course of five years. Moreover, the findings have been replicated in the United Kingdom.

These findings are that not all of these patients have the same rate of weight loss and that when it occurs faster, the disease is not yet at a very advanced stage. And vice versa. “Those who appear to have a slower rate of weight loss, and who are more similar to the control patients, are actually those who already have advanced retinal neurodegeneration and those who already have cognitive impairment. “Those whose degeneration increases are those who appear healthier or are in earlier stages.”

Murueta-Goyena used a common ophthalmic examination technique, optical coherence tomography, which is non-invasive and available in any hospital, which will facilitate its adoption as a method of monitoring cognitive degeneration in these patients. “It would be enough to adjust the resolution, since this is a small part of the retina and the changes are very subtle. “You’ll have to go look for them.” Although the disease is best known for tremors and rigidity, it also causes problems with memory and lack of attention, which “in many cases affect daily life much more than motor symptoms, which are treatable and can be alleviated.” They are the ones who explore with their eyes. In Euskadi, approximately 8,000 people suffer from Parkinson’s disease, and 400 new cases are diagnosed every year.

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