Ep 28 - Dr Victor Dieriks - Early Detection of Parkinson's Diseases

Good Clinical has teamed up with Te Titoki Mataora, the MedTech Research Translator, to bring you the Te Titoki Mataora Podcast Series.

Today’s guest is Dr Victor Dieriks, the Head of the Apha Synuclein Lab at the Centre for Brain Research at the University of Auckland. Dr Dieriks studies the role of alpha synuclein in the development of Parkinson's Disease and Multiple System Atrophy (MSA).

Parkinson’s disease (PD) is currently the fastest-growing chronic neurological disorder globally. An estimated 12 million people are living with PD, with around 12,000 of those residing in New Zealand.

Unfortunately, no treatments presently target the underlying mechanisms of PD, and clinical studies aimed at discovering disease-modifying medications are limited. This means that a truly effective, curative treatment remains years away. However, numerous interventions are available today that can significantly improve the quality of life for those with PD.

Dr Victor Dieriks has two active projects with Te Titoki Matora, MedTech Research Translator Project #1: Developing a more New Zealand-centric approach to the management and treatment of Parkinson's disease. Dr Dieriks emphasizes the importance of actively involving patients and understanding their priorities, rather than solely relying on the perspectives of healthcare professionals and researchers.Patients1 with PD often express their desire for improved dignity and quality of life, rather than just a focus on a cure or restoring mobility. Project #2: involves the use of tears (eye fluid) as a potential biofluid source for detecting Parkinson's disease biomarkes. Tears are a relatively pure and stable biological fluid, making them a promising target for developing a non-invasive diagnostic test that can be easily obtained. A core aspect of this project is reducing the burden on the healthcare system, particularly the long wait times to see a neurologist for diagnosis. By developing a simple, tear-based test, patients can potentially bypass the need for more invasive procedures and receive earlier prognosis and treatment. Podcast Takeaways: Parkinson's disease is not a single disease, but rather a collection of diseases with multiple causes The normal function of alpha-synuclein is not fully understood, but it is known to play a role in neuronal communication and potentially in the gut and microbiome Current treatments for Parkinson's, like levodopa and deep brain stimulation, only address the symptoms and cannot stop the underlying disease progression A major challenge is that current therapies are tested too late, only after 70% of the relevant neurons have already died. Early detection is key, and recent breakthroughs have shown that alpha-synuclein clumps can be detected in spinal fluid or even potentially in less invasive samples like skin or nasal swabs, years before symptom onset While genetic risk factors can be screened for, they only account for a small percentage of Parkinson's cases. Other risk factors include environmental exposures like metals, pesticides, and viral/bacterial infections that cause inflammation In the absence of a cure, lifestyle interventions like exercise, healthy eating, and moderate coffee consumption can help delay the onset and progression of Parkinson's. Exercise, in particular, has been shown to have neuroprotective effects mediated by the hormone irisin. The gut-brain axis is also implicated in Parkinson's, with constipation and other gut symptoms often preceding the motor symptoms. Chapters 0:00 Introduction 01:10 "Parkinson's Disease" is a misnomer 02:50 Dieriks Lab Focus 06:00 Peculiarities of Neurodegenerative Diseases 09:00 Role of alpha synuclein 14:00 Treatment's available for Parkinson's Disease 19:00 Risk factors for Parkinson's Disease 24:00 Alternative sampling methods for determining risk of PD 27:20 Interventions for slowing development 31:00 Coffee 32:12 Gut-brain Axis 35:25 New Zealand-centric approach to management and treatment