Discussions of new staging frameworks — among a diverse international coalition including The Michael J . Fox Foundation and leaders in academia and industry ; the National Institutes of Health and U . S . Food and Drug Administration ; patient-centered nonprofit organizations , including Cure Parkinson ’ s and the Lewy Body Dementia Association ; and members of the patient and family community — are focusing on the biology of Parkinson ’ s . These frameworks aim to accurately observe and capture the first consistent biological definitions of disease , enabling objective scientific rationales for therapeutic development toward next-generation treatment .
The proposed staging system , to be published in early 2024 in The Lancet Neurology , accounts for Parkinson ’ s risk , diagnosis , and functional impairment ranging from slight to severe . An individual ’ s stage is premised on their personal biological profile , including their genetic risk factors and the presence or absence of abnormal alpha-synuclein protein in cerebral spinal fluid as well as dopamine degeneration in the brain . The framework currently applies to approximately 90 percent of people diagnosed with PD and Lewy body dementia .
By addressing the continuum of disease , from the very beginning , when a person may be at risk but without symptoms , through advancing stages , the framework lays a stronger foundation to predict and ultimately prevent disease .
A similar approach to staging using biology was recently taken in Alzheimer ’ s disease , which as a result has now started to see successful trials and new drugs being approved . Alzheimer ’ s research moved quickly from biomarkers to widespread screening with the biomarker , to accelerated drug development , with the first drugs to slow cognitive decline appearing in 2022 and 2023 . This validated model provides the inspiration and motivation to achieve a similar accelerated timeline for Parkinson ’ s research .
A staging system for Parkinson ’ s — based on objective biological data — will transform research by allowing researchers and drugmakers to :
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