GRAND RAPIDS – Researchers from Michigan State University, Van Andel Institute and Sweden are closer to developing new drugs that target Parkinson’s disease.

The researchers have shown significant associations between high levels of pro-inflammatory markers in cerebrospinal fluid and severity of fatigue, depression, anxiety and cognitive impairment in individuals with Parkinson?s disease.

?We hypothesized that Parkinson?s patients would have higher mean levels of inflammatory markers than those in the reference group and that the highest levels would be observed in those with more severe symptoms of depression, anxiety, fatigue, and cognitive impairment,? said Lena Brundin, M.D., Ph.D., associate professor, MSU College of Human Medicine and researcher at VAI, one of the study?s authors. ?By investigating associations between inflammatory markers and non-motor symptoms we hope to gain further insight into this area, which in turn could open up the possibility of novel treatment options.?

Neuroinflammation has long been suspected to be involved in the development of Parkinson?s disease, specifically in non-motor symptoms such as depression, fatigue and cognitive impairment. Recent research suggests that inflammation could drive some of the cell death that occurs in Parkinson’s disease, and developing new drugs that target this inflammation might slow disease progression.

Parkinson?s disease is the second most common degenerative disorder of the central nervous system and one that currently strikes more than 1 percet of people over the age of 65. The causes of the disease and its development are not yet fully understood.

The aim of the joint study was to measure inflammatory markers in cerebrospinal fluid samples from Parkinson?s patients and a reference group, and to investigate correlations between non-motor symptoms and inflammation.

The results of the study entitled ?Cerebrospinal fluid inflammatory markers in Parkinson’s disease – Associations with depression, fatigue, and cognitive impairment,? were published August 17 in the journal Brain, Behavior, and Immunity.

?The few previous studies investigating inflammatory markers in the cerebrospinal fluid of Parkinson?s patients have been conducted on comparatively small numbers of subjects, and often without a healthy control group for comparison,? Brundin said.

Results from pre-clinical and epidemiological studies suggest that neuroinflammation may play an important role in the death of dopaminergic neurons in the substantia nigra, which is the pathological hallmark of Parkinson?s disease.

Eighty-seven Parkinson?s patients were enrolled in the study between the years 2008 and 2012. Sixteen of the patients suffered from Dementia in Parkinson?s disease. Patients were recruited from neurological clinics in southern Sweden to the Sk�ne University Hospital in Lund, Sweden, by Associate Professor Oskar Hansson?s research group. Thirty-three individuals comprising the reference group were mainly recruited by contacting spouses of patients but also by recruitment during public lectures.

Study participants underwent a general physical examination, and routine blood screening and complete medical history was taken. Study participants were evaluated by a licensed and experienced medical doctor using the Unified Parkinson?s Disease Rating Scale (UPDRS)-3, the Hoehn & Yahr scale, and the Schwab & England scale. Parkinson?s disease diagnosis was verified according to the National Institute of Neurological Disorders and Stroke diagnostic criteria. Dementia in Parkinson?s disease was diagnosed according to the Clinical Diagnostic Criteria for Dementia Associated with PD.

Researchers quantified the following inflammatory markers: C-reactive protein (CRP), interleukin-6, tumor necrosis factor-alpha, eotaxin, interferon gamma-induced protein-10, monocyte chemotactic protein-1 (MCP-1), and macrophage inflammatory protein 1-β.

The study was carried out in collaboration with researchers from Lund University, Lund, Sweden, Sk�ne University Hospital, Lund, Sweden, Mayo Clinic College of Medicine, Jacksonville, Florida, Michigan State University College of Human Michigan and Van Andel Institute Center for Translational Medicine in Grand Rapids.

?The degree of neuroinflammation was significantly associated with more severe depression, fatigue, and cognitive impairment even after controlling for appropriate confounders such as age, gender, somatic illness and, when appropriate, dementia diagnosis, and Parkinson?s disease duration,? Brundin said. ?Inflammation in Parkinson?s disease research is an important topic that will be explored in September at gathering of world Parkinson?s experts at Van Andel Institute.?

On September 18-19 Van Andel Institute hosts the second annual Grand Challenges in Parkinson?s disease symposium. The event brings together global leaders in Parkinson?s and neurodegenerative disease research for two days of collaboration, insight and discovery. This year?s conference focuses on the role of inflammation in Parkinson?s, which organizers believe might play a pivotal role in treating the disease.

Jay Van Andel, the VAI co-founder, suffered from Parkinson?s disease prior to his death.