After a decade of pioneering research, the Parkinson's Progression Markers Initiative (PPMI) by The Michael J. Fox Foundation for Parkinson's Research (MJFF) will see a major expansion. Entering its most ambitious phase yet, the clinical study will grow its in-clinic recruitment from 1,400 to 4,000 participants by the end of 2023. This is the latest step in PPMI's mission to maintain the most robust open-access Parkinson's data set in the world.
University of California San Diego School of Medicine joined PPMI shortly after its launch in 2010, and is now one of nearly 50 clinical sites around the world participating in the expansion. The international effort seeks to identify biomarkers of Parkinson's disease to promote development of better treatments, potential cures and perhaps even prevention of the disease.
"When the Foundation started in 2000, we set out to change the game on how Parkinson's research gets done," said founder and actor Michael J. Fox, who was diagnosed with the disease in 1991.
"Two decades later, I'm proud that we have continued to meet this challenge and have become more than just a research organization, but a space where patients bring their wisdom and energy. PPMI's expansion is about getting this done, curing Parkinson's, boiling down to a biomarker that we can identify early on and prevent the disease from ever impacting another family."
UC San Diego School of Medicine is now recruiting people recently diagnosed with Parkinson's and people aged 60 and older who do not have the disease, but are living with certain risk factors, which include genetics, gender, head trauma and exposure to certain environmental toxins.
Participants will undergo tests including motor, neuropsychiatric and cognitive examinations; brain imaging with DaTscan and MRI; and blood, urine, cerebrospinal fluid and DNA sampling.
In addition to the 4,000 in-clinic study participants, PPMI is also recruiting up to 100,000 additional participants to contribute over the web. The Foundation has set up an online platform where anyone over the age of 18 with or without Parkinson's can participate.
PPMI is revolutionizing the field's understanding of Parkinson's biology. We have already obtained incredibly rich information that no other study has been able to, but there is still much more to uncover."
Douglas Galasko, MD, PPMI principal investigator, co-director, Shiley-Marcos Alzheimer's Disease Research Center and professor, Department of Neurosciences, UC San Diego School of Medicine
The latest iteration of the study will benefit from new research tools that were not around when it began, including advanced brain imaging techniques, new cognitive assessments and wearable digital devices for tracking motor movement.
The findings will not only inspire new biological targets for treating Parkinson's disease, said Galasko, but also increase the efficiency of clinical trials.
"One of the biggest things we found in the initial studies was that Parkinson's looks a little different in each person. This variability makes it difficult for clinical trials to assess whether a treatment is actually working. By developing more rigorous measures to track disease progression, we can help clinical trials use fewer participants and more quickly decide if a drug or therapy is going to work."
Galasko also highlighted the importance of PPMI's approach in studying early stages of Parkinson's disease. He said the earlier physicians can intervene, the greater the chance they will be able to slow progression of the disease and extend the patient's quality of life.
Variability in disease expression has inspired another aspect of UC San Diego School of Medicine's recruitment plans.
"We're especially interested in having the people we recruit reflect the diversity of people who live in San Diego and Southern California," said Galasko. "A lot of what we've learned about Parkinson's so far comes from study populations that are not fully representative of all people who live with the disease. In this next phase of recruitment, we're trying to better understand the disease in people from all backgrounds."
UC San Diego is recruiting from the Southern California region, and works with participants to arrange transportation and lodging for in-clinic visits.