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Crotty GF, Keavney JL, Alcalay RN, Marek K, Marshall GA, Rosas HD, Schwarzschild MA. Planning for Prevention of Parkinson Disease: Now Is the Time. Neurology 2022; 99:1-9. [PMID: 36219787 PMCID: PMC10519135 DOI: 10.1212/wnl.0000000000200789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/11/2022] [Indexed: 11/15/2022] Open
Abstract
Parkinson disease (PD) is a chronic progressive neurodegenerative disease with increasing worldwide prevalence. Despite many trials of neuroprotective therapies in manifest PD, no disease-modifying therapy has been established. Over the past several decades, a series of breakthroughs have identified discrete populations at substantially increased risk of developing PD. Based on this knowledge, now is the time to design and implement PD prevention trials. This endeavor builds on experience gained from early prevention trials in Alzheimer disease and Huntington disease. This article first reviews prevention trial precedents in these other neurodegenerative diseases before focusing on the critical design elements for PD prevention trials, including whom to enroll for these trials, what therapeutics to test, and how to measure outcomes in prevention trials. Our perspective reflects progress and remaining challenges that motivated a 2021 conference, "Planning for Prevention of Parkinson: A Trial Design Symposium and Workshop."
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Affiliation(s)
- Grace F Crotty
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Jessi L Keavney
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Roy N Alcalay
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Kenneth Marek
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gad A Marshall
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - H Diana Rosas
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Michael A Schwarzschild
- From the Department of Neurology (G.F.C., M.A.S.), Massachusetts General Hospital, Boston, MA; Parkinson's Foundation Research Advocates Program (J.L.K.), Parkinson's Foundation, Miami, FL/New York, NY; Department of Neurology (R.N.A.), Columbia University Irving Medical Center, New York, NY; Institute for Neurodegenerative Disorders (K.M.), New Haven, CT; Center for Alzheimer Research and Treatment (G.A.M.) and Center for Neuroimaging of Aging and Neurodegenerative Diseases (H.D.R.), Department of Neurology, Brigham and Women's Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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