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This report is from the NINDS Parkinson's research website and was
prepared by the NINDS.
SEE:
  Parkinson’s Disease Research Agenda Implementation Review Meeting
http://www.ninds.nih.gov/news_and_events/PD_Research_Agenda_2002.htm

"Parkinson’s Disease Research Agenda Implementation Review Meeting Cites
Progress, Future Directions, and Common Themes
January 9 and 10th, 2002
Bethesda, MD

Scientists, patient advocates, and representatives of nine National
Institutes of Health (NIH) components gathered January 9-10 to review
progress made in implementing the agency’s Parkinson’s Disease Research
Agenda. In her welcoming remarks, NIH Director Dr. Ruth Kirschstein spoke
of the “unprecedented push, unseen ever before,” that the NIH has made in
Parkinson’s disease research since the document was written. Originally
released in March 2000, the Agenda describes areas of significant
scientific opportunity in Parkinson’s research to be explored over the
following five years. The January 2002 meeting reviewed progress made
towards accomplishing the goals set forth in the Agenda, identified newly
emerging areas of interest, and prioritized future research goals.

The general consensus of the attendees is that the NIH is doing a good
job implementing the Agenda’s initiatives. However, participants
identified additional areas of interest too new to have been stressed in
the original document, and at least one area, rehabilitation, where
current knowledge of the field indicates that additional efforts would be
worthwhile.

Two breakout groups-one on the basic mechanisms of Parkinson’s disease,
the other on its treatment-discussed goals believed to be obtainable over
the next 3 years. At the closing plenary session, participants identified
several common themes that reinforce these goals:

Emphasize translational research. Commonly described as “bench to bedside
and back,” such research incorporates both basic and clinical components
into one interactive program to the benefit of both. While such programs
are traditionally run by one center or group, the possibility of a
virtual center was also discussed, as was the possibility of expanding
NIH Intramural efforts in this area. The NIH is already planning a
program that may address many of these needs.
Better understand the abnormal brain circuitry seen in Parkinson’s
disease. Although many factors that may contribute to the breakdown of
dopamine neurons have been identified, the cellular targets and processes
are not fully understood. Such knowledge would enable scientists to
devise therapies to treat patients after these neurons have been
depleted.
Increase studies on non-motor aspects of Parkinson’s disease. These
symptoms, which include dementia, depression, sleep abnormalities, and
speech and swallowing problems, often bother individuals with Parkinson’s
more than tremor and rigidity.
Locate risk and susceptibility factors and identify physiologic, genetic
and environmental biomarkers to aid in preclinical diagnosis, evaluate
progression of the disease, assess therapies, and speed clinical trials
while reducing their costs. Large population studies would help achieve
these goals.
Pursue research related to gene therapy. Studies to determine the best
vectors for delivering gene therapy and encouraging sharing of vectors
should be emphasized.
Develop better animal models, particular for dyskinesias and non-motor
symptoms.

Other significant issues targeted by the participants include:

The need for clinical trials of neuroprotective agents and ways to reduce
or eliminate dyskinesias.
The development of surrogate measures, such as imaging and behavioral
markers, to better assess non-motor symptoms, disease progression, and
screen at-risk populations.
Studies on the long-term effects of deep brain stimulation on both motor
and non-motor symptoms, its mechanism of action, and its unintended
consequences.
Role of behavioral interventions such as voice therapy and exercise.
Scientifically proven assessments of current treatments .
Studies on how aberrations in the processing of the alpha-synuclein
protein leads to the death of dopaminergic nerve cells.
Development of assays to screen drugs.
The need to draw young investigators and scientists from other fields
into Parkinson’s research.
The development of resource banks to facilitate access to animal models
and critical research tools.

“The feedback from all the participants was extremely gratifying,” said
Dr. Audrey S. Penn, Acting Director of the National Institute of
Neurological Disorders and Stroke, which hosted the meeting, “but I was
particularly encouraged by the positive feedback from the patient
advocates.”

A detailed account of the meeting proceedings is being prepared for
submission to the Congress and will be available on the Parkinson’s
Disease Research Web site
(http://www.ninds.nih.gov/parkinsonsweb/index.htm) after it is cleared
for release.


Reviewed January 30, 2002

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