World Parkinson’s Day on April 11 provides an opportunity to help the public better understand what Parkinson’s disease (PD) is and to shed light on efforts made by GE Healthcare and other organizations, such as the Parkinson’s Institute and the Institute for Neurodegenerative Disorders, to aid in the diagnosis and treatment of PD.
These organizations, as well as a wide variety of other healthcare organizations and providers, are committed to the support of world-class research, the discovery of therapeutic technologies and advanced diagnostics, and the promotion of a greater understanding of PD. PD is a debilitating neurodegenerative disease that causes a progressive loss of dopamine in the brain, affecting a person’s ability to move parts of his or her body.
This loss of dopamine can cause symptoms that include, among others, resting tremor, slowness of movement, stiffness or rigidity of muscles, difficulty with balance and walking, or difficulty with fine motor movements.
Dr. Carrolee Barlow, CEO of the Parkinson’s Institute, has dedicated her career to improving the treatment, care, and quality of life for Parkinson’s patients and their caregivers, and tells us how an early diagnosis and small modifications can greatly affect the progression of the disease and the quality of life for a PD patient.
Pinpointing the Disease… Early On
The average age of Parkinson’s onset is the late 50s to early 60s, but it can affect people as young as 20, 30 or 40. Further challenging the proactive diagnosis of PD is that many symptoms associated with other conditions may mimic parkinsonian symptoms, making diagnosis difficult, particularly during early clinical stages when symptoms are more subtle and are likely to be overlooked.
However, early diagnosis can be instrumental in making the most of advances in therapeutic options that can drastically slow the disease. Dr. Barlow explains, “There are safe drugs (called MAO-B inhibitors) with few side effects that can slow the decay of dopamine in the brain, which allows movement in the body.” In addition to pharmaceutical remedies, patients can engage in physical therapy and exercise programs designed to assist those with PD. This type of regimented physical movement beginning in early-onset stages of the disease could delay the need for drugs for up to two years. “The earlier you can get started, the easier it is to live a virtually normal life with a few small modifications,” says Barlow.
An imaging tool for providing information, which may be used in making an early diagnosis, is GE Healthcare’s DaTscan™ (Ioflupane I 123 Injection). DaTscan is a radiopharmaceutical imaging agent that works by binding to dopamine transporters (DaTs) in the brain. A specific marker for DaT, DaTscan produces images that provide visual evidence of reduced density of DaTs, which is seen in patients with a parkinsonian syndrome (PS). This information can be used along with other diagnostic tests to help differentiate essential tremor (ET) from tremor due to a PS in patients suspected of having a PS. DaTscan was not designed to distinguish among different forms of PS (idiopathic Parkinson’s disease [PD], multiple system atrophy [MSA], and progressive supranuclear palsy [PSP]) . The effectiveness of DaTscan as a screening or confirmatory test and for monitoring disease progression of response to therapy has not been established.
Caregiving and Treatment
Although PD can be challenging for many patients and their caregivers, there are specialists, treatments, and resources available to manage the condition. According to Dr. Barlow, people can live for 20 to 30 years with the disease, and for many, it is not completely debilitating. “Patients may need some additional help getting into a car or getting out of a wheelchair, but once they are up and going, they can do all kinds of things like walk around, dance with their partner, or even hike a mountain. They do need extra help, but that help is only to get them over the hump to live their lives to the fullest.”
Dr. Ken Marek is President and Senior Scientist of the Institute for Neurodegenerative Disorders and the Lead Investigator for the Parkinson’s Progression Markers Initiative. He tells us that there are many research projects focused on developing more advanced methods to alleviate symptoms of the disease. “Although we have seen breakthroughs in the early diagnosis of Parkinson’s disease,” he says, “long-term progression, cognitive symptoms, gait, and balance symptoms remain a significant challenge for caregivers and physicians.”
But Dr. Marek insists the future is bright. “We are looking into better therapies focused on the underlying disease etiology (like synuclein-targeted therapies).” Moreover,” he says, “it’s now clear that PD degeneration begins years prior to the first onset of symptoms. Now, the goal is to identify at-risk subjects with biomarkers including imaging so that therapies for disease prevention can be tested.”
A Brighter Future
For those personally affected by the disease, a hopeful outlook can make all the difference. “We have found that caregivers and their patients exhibit a ‘We’re all in this together’ kind of attitude,” says Barlow. “They are excited to help their loved ones live their fullest lives by encouraging movement and helping them implement small tasks.”
Barlow says the advice she offers patients is simple: “If you have PD, embrace it. See your doctors, get the right diagnosis, and know there are teams of individuals – from researchers to therapists to doctors to pharmaceutical companies – who are working on finding better diagnoses and treatments to help PD patients. PD will be a part of your life, but it doesn’t have to define your life,” she says.
GE Healthcare’s Commitment
GE Healthcare takes a comprehensive approach to understanding a variety of neurological disorders, such as Parkinson’s disease, Alzheimer’s disease, post-traumatic stress disorder, concussion, traumatic brain injury, and multiple sclerosis, through its ongoing research to uncover the causes, risks, and physical effects of these conditions. By collaborating on research initiatives like the Parkinson’s Progression Markers Initiative and working with highly respected academic centers and the pharmaceutical industry to assist in the development of the next generation of therapies to treat these disorders, GE Healthcare can provide imaging support for clinical trials of therapeutic agents.
MIND Online provides useful information for those who want to learn more about Parkinson’s disease and other neurological disorders such as Alzheimer’s disease and ET. It also offers advice on the benefits of movement as well as resources to support caregivers and patients.
Visit the GE MIND App, which provides mental stimulation to those affected by neurological disorders.
Important Risk and Safety Information about DaTscan™ (Ioflupane I 123 Injection)
INDICATIONS AND USE: DaTscan is a radiopharmaceutical indicated for striatal dopamine transporter visualization using single-photon emission computed tomography (SPECT) brain imaging to assist in the evaluation of adult patients with suspected parkinsonian syndromes (PSs). DaTscan may be used to help differentiate essential tremor from tremor due to PS (idiopathic Parkinson’s disease [PD], multiple system atrophy [MSA], and progressive supranuclear palsy [PSP]). DaTscan is an adjunct to other diagnostic evaluations. DaTscan was not designed to distinguish among PD, MSA, and PSP. The effectiveness of DaTscan as a screening or confirmatory test and for monitoring disease progression or response to therapy has not been established. CONTRAINDICATIONS: DaTscan is contraindicated in patients with known hypersensitivity to the active substance, any of the excipients, or iodine. WARNINGS AND PRECAUTIONS — Hypersensitivity Reactions: Hypersensitivity reactions, generally consisting of skin erythema and pruritus, have been reported following DaTscan administration. Thyroid Accumulation: The DaTscan injection may contain up to 6% of free iodide (iodine 123 or I-123). To decrease thyroid accumulation of I-123, block the thyroid gland at least one hour before administration of DaTscan; failure to do so may increase the long-term risk for thyroid neoplasia. ADVERSE REACTIONS: In clinical trials, headache, nausea, vertigo, dry mouth, or dizziness of mild to moderate severity were reported. In postmarketing experience, hypersensitivity reactions and injection-site pain have been reported. DRUG INTERACTIONS: Drugs that bind to the dopamine transporter with high affinity may interfere with the DaTscan image. The impact of dopamine agonists and antagonists on DaTscan imaging results has not been established. SPECIFIC POPULATIONS — Pregnancy: It is unknown whether DaTscan can cause fetal harm or increase the risk of pregnancy loss in pregnant women. DaTscan should be given to pregnant women only if clearly needed. Like all radiopharmaceuticals, DaTscan may cause fetal harm, depending on the stage of fetal development and the magnitude of the radionuclide dose. Radioactive iodine products cross the placenta and can permanently impair fetal thyroid function. Nursing Mothers: It is not known whether DaTscan is excreted into human milk; however, I-123 is excreted into human milk. Because many drugs are excreted into human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to interrupt nursing after administration of DaTscan or not to administer DaTscan at all. Nursing women may consider interrupting nursing and pump and discard breast milk for six days after DaTscan administration to minimize risks to a nursing infant. Pediatric Use: The safety and efficacy of DaTscan have not been established in pediatric patients. Geriatric Use: There were no differences in responses between the elderly and younger patients that would require a dose adjustment. Renal and Hepatic Impairment: The effect of renal or hepatic impairment on DaTscan imaging has not been established. The kidney excretes DaTscan; patients with severe renal impairment may have increased radiation exposure and altered DaTscan images. DRUG ABUSE AND DEPENDENCE: Ioflupane I 123 Injection is a DEA Schedule II controlled substance. A DEA license is required for handling or administering this controlled substance. OVERDOSAGE: It is unknown whether or not ioflupane is dialyzable. The major risks of overdose relate to increased radiation exposure and long-term risk for neoplasia. In case of radioactivity overdosage, frequent urination and defecation should be encouraged to minimize radiation exposure to the patient. PROCEDURE — Radiation Safety: DaTscan emits radiation and must be handled with safety measures to minimize radiation exposure to clinical personnel and patients.
Prior to DaTscan administration, please read the Full Prescribing Information.