Possible Cause Of, and Treatment For, Non-Familial Parkinson’s

Feb. 6, 2013 — Columbia University Medical Center (CUMC) researchers have identified a protein trafficking defect within brain cells that may underlie common non-familial forms of Parkinson’s disease. The defect is at a point of convergence for the action of at least three different genes that had been implicated in prior studies of Parkinson’s disease. Whereas most molecular studies focus on mutations associated with rare familial forms of the disease, these findings relate directly to the common non-familial form of Parkinson’s.


The study was published today in the online edition of the journalNeuron.

The defective pathway is called the “retromer” pathway, in part because it can guide the reutilization of key molecules by moving them back from the cell surface to internal stores. In this study, defects in the retromer pathway also appear to have profound effects on the cell’s disposal machinery, which may explain why Parkinson’s disease brain cells ultimately accumulate large protein aggregates. The trafficking defects associated with Parkinson’s can be reversed by increasing retromer pathway activity, suggesting a possible therapeutic strategy. No current therapies for Parkinson’s alter the progression of the disease.

The researchers also found evidence that, even in unaffected individuals who simply carry common genetic variants associated with an increased risk of Parkinson’s disease, these molecular changes are at work. This supports the notion that early treatment approaches will be important in tackling Parkinson’s disease.

“Taken together, the findings suggest that drugs that target the retromer pathway could help prevent or treat Parkinson’s,” said study leader Asa Abeliovich, MD, PhD, associate professor of pathology and cell biology and of neurology in the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at CUMC.

In recent years, through genome-wide association studies (GWAS), researchers have identified about 10 common genetic variants that appear to have small effects on the risk of non-familial Parkinson’s, However, it has been hard to delve deeper into the impact of these variants. “When you look at patient brain tissue at autopsy, it’s usually too late — all the critical dopamine neurons are long gone and the damage has been done,” said Dr. Abeliovich.

In the current study, Dr. Abeliovich and his CUMC colleagues used an unusually broad array of approaches — including analyses of Parkinson’s disease-associated genetic variations, patient brain tissue, in vitro tissue culture studies of brain neurons, and fruit fly (Drosophila) models that harbor genetic variants related to those associated with Parkinson’s disease.

The researchers found that common variants in two genes previously linked to Parkinson’s disease, LRRK2 and RAB7L1, led to an unexpectedly similar impact on human brain tissue. The effects of the variants were found to be highly overlapping, pointing to a common pathway of action. Prominent cellular changes were observed in the retromer pathway, which is involved in the trafficking of proteins from the Golgi apparatus (which packages proteins for delivery to other cell components) to the lysosomes (which recycle proteins and other molecules). Mutations that affect the retromer pathway have also been found in familial Parkinson’s disease. Earlier studies from Columbia’s Taub Institute have shown that genetic variants in genes associated with retromer function are linked to Alzheimer’s disease and retromer component levels appear altered in Alzheimer’s disease brains, suggesting a broader role for retromer dysfunction in neurodegenerative diseases of aging, according to Dr. Abeliovich.

The impact of the RAB7L1 and LRRK2 variants was apparent even in individuals with no signs or symptoms of Parkinson’s disease. This suggests that there is a pre-disease state in unaffected carriers of the two genetic variants that favors early disease onset and that, in theory, could be targeted therapeutically.

The CUMC researchers also demonstrated that overexpression of one of the variants, RAB7L1, can overcome the effects of the other variant. Similarly, expression of VPS35, a gene involved in the retromer pathway, can suppress LRRK2 mutant pathology. “It will be interesting to look for drugs that directly target these retromer components or that more generally promote flow through the pathway,” said Dr. Abeliovich.

The title of the paper is “RAB7L1 interacts with LRRK2 to modify intraneuronal protein sorting and Parkinson’s disease risk.” The other contributors are David A. Macleod, Herve Rhinn, Tomoki Kuwahara, Ari Zolin, Gilbert Di Paolo, Brian D. McCabe, Lorraine N. Clark, and Scott A. Small, all at CUMC.

The study was supported by grants from the Michael J. Fox Foundation and the National Institutes of Health (NS064433, NS060876, NS060113, A6008702, AG025161, and AG08702-21.


Story Source:

The above story is reprinted from materials provided byColumbia University Medical Center.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

  1. David A. MacLeod, Herve Rhinn, Tomoki Kuwahara, Ari Zolin, Gilbert Di Paolo, Brian D. MacCabe, Karen S. Marder, Lawrence S. Honig, Lorraine N. Clark, Scott A. Small, Asa Abeliovich. RAB7L1 Interacts with LRRK2 to Modify Intraneuronal Protein Sorting and Parkinson’s Disease RiskNeuron, 2013; 77 (3): 425 DOI:10.1016/j.neuron.2012.11.033
Columbia University Medical Center (2013, February 6). Possible cause of, and treatment for, non-familial Parkinson’s. ScienceDaily. Retrieved February 7, 2013, from http://www.sciencedaily.com/releases/2013/02/130206130946.htm

Parkinson’s Treatment Can Trigger Creativity: Patients Treated With Dopamine-Enhancing Drugs Are Developing Artistic Talents, Doctor Says

Jan. 14, 2013 — Parkinson’s experts across the world have been reporting a remarkable phenomenon — many patients treated with drugs to increase the activity of dopamine in the brain as a therapy for motor symptoms such as tremors and muscle rigidity are developing new creative talents, including painting, sculpting, writing, and more.


Prof. Rivka Inzelberg of Tel Aviv University’s Sackler Faculty of Medicine first noticed the trend in her own Sheba Medical Center clinic when the usual holiday presents from patients — typically chocolates or similar gifts — took a surprising turn. “Instead, patients starting bringing us art they had made themselves,” she says.

Inspired by the discovery, Prof. Inzelberg sought out evidence of this rise in creativity in current medical literature. Bringing together case studies from around the world, she examined the details of each patient to uncover a common underlying factor — all were being treated with either synthetic precursors of dopamine or dopamine receptor agonists, which increase the amount of dopamine activity in the brain by stimulating receptors. Her report will be published in the journal Behavioral Neuroscience.

Giving in to artistic impulse

Dopamine is involved in several neurological systems, explains Prof. Inzelberg. Its main purpose is to aid in the transmission of motor commands, which is why a lack of dopamine in Parkinson’s patients is associated with tremors and a difficulty in coordinating their movements.

But it’s also involved in the brain’s “reward system” — the satisfaction or happiness we experience from an accomplishment. This is the system which Prof. Inzelberg predicts is associated with increasing creativity. Dopamine and artistry have long been connected, she points out, citing the example of the Vincent Van Gogh, who suffered from psychosis. It’s possible that his creativity was the result of this psychosis, thought to be caused by a spontaneous spiking of dopamine levels in the brain.

There are seemingly no limits to the types of artistic work for which patients develop talents, observes Prof. Inzelberg. Cases include an architect who began to draw and paint human figures after treatment, and a patient who, after treatment, became a prize-winning poet though he had never been involved in the arts before.

It’s possible that these patients are expressing latent talents they never had the courage to demonstrate before, she suggests. Dopamine-inducing therapies are also connected to a loss of impulse control, and sometimes result in behaviors like excessive gambling or obsessional hobbies. An increase in artistic drive could be linked to this lowering of inhibitions, allowing patients to embrace their creativity. Some patients have even reported a connection between their artistic sensibilities and medication dose, noting that they feel they can create more freely when the dose is higher.

Therapeutic value

Prof. Inzelberg believes that such artistic expressions have promising therapeutic potential, both psychologically and physiologically. Her patients report being happier when they are busy with their art, and have noted that motor handicaps can lessen significantly. One such patient is usually wheelchair-bound or dependent on a walker, but creates intricate wooden sculptures that have been displayed in galleries. External stimuli can sometimes bypass motor issues and foster normal movement, she explains. Similar types of art therapy are already used for dementia and stroke patients to help mitigate the loss of verbal communication skills, for example.

The next step is to try to characterize those patients who become more creative through treatment through comparing them to patients who do not experience a growth in artistic output. “We want to screen patients under treatment for creativity and impulsivity to see if we can identify what is unique in those who do become more creative,” says Prof. Inzelberg. She also believes that such research could provide valuable insights into creativity in healthy populations, too.


Story Source:

The above story is reprinted from materials provided byAmerican Friends of Tel Aviv University.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

American Friends of Tel Aviv University (2013, January 14). Parkinson’s treatment can trigger creativity: Patients treated with dopamine-enhancing drugs are developing artistic talents, doctor says. ScienceDaily. Retrieved January 18, 2013, from http://www.sciencedaily.com/releases/2013/01/130114111622.htm