Early Molecular Biomarkers for Differentiating Parkinsonian Syndromes (BIOMARK-PS)
Identification of Molecular Biomarkers, Including microRNAs and Metabolites, Enabling Early Differentiation of Parkinson's Disease and Atypical Parkinsonian Syndromes in a Prospective Observational Study.
This prospective observational study aims to identify and preliminarily validate molecular biomarkers, including microRNAs and metabolites, for the early differentiation of Parkinson's disease (PD) from atypical parkinsonian syndromes (APS). The study will enroll up to 100 patients with PD, 50 patients with suspected APS, and 50 healthy controls.
Participants will undergo clinical assessments and provide blood, urine, and stool samples at baseline and after 12-18 months of follow-up. Molecular analyses, including microRNA profiling, metabolomics, RNA sequencing (RNA-seq), and microbiome analysis, will be performed to identify disease-specific diagnostic signatures.
The primary objective is to detect differences in molecular profiles among patients with PD, patients with APS, and healthy controls. Secondary objectives include evaluating the diagnostic accuracy of biomarker panels and assessing longitudinal changes in these biomarkers over time.
Although participants will not receive direct therapeutic benefits, the study may contribute to the development of non-invasive tools for the early diagnosis and improved differentiation of parkinsonian disorders.
Panoramica dello studio
Stato
Tipo di studio
Iscrizione (Stimato)
Contatti e Sedi
Contatto studio
- Nome: Jacek Kuźnicki, Professor
- Numero di telefono: +48 22 5970700
- Email: jacek.kuznicki@iimcb.gov.pl
Luoghi di studio
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Warsaw, Polonia, 03-242
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw
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Contatto:
- Dariusz Koziorowski, Professor
- Email: dariusz.koziorowski@wum.edu.pl
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Warsaw, Polonia, 00-416
- Department of Neurology, CMKP Prof. Witold Orłowski Clinical Hospital, Warsaw
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Contatto:
- Urszula Fiszer, Professor
- Email: ufiszer@cmkp.edu.pl
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
The study population will consist of patients with suspected neurodegenerative parkinsonism associated with PD or APS, diagnosed according to the MDS 2015 criteria. Eligible participants must present with bradykinesia accompanied by at least one additional cardinal motor symptom, including rigidity and/or resting tremor. Patients aged between 40 and 80 years, with a duration of parkinsonian symptoms shorter than 3 years, and an abnormal DaTscan confirming presynaptic dopaminergic neuronal degeneration will be included. All participants must provide written informed consent prior to enrollment.
Participants will be excluded if they have secondary or drug-induced parkinsonism, other central nervous system disorders that could explain parkinsonian symptoms (including neoplastic or vascular conditions), active malignancy, infection, or autoimmune inflammatory disease.
Descrizione
Inclusion Criteria:
Patients with suspected neurodegenerative parkinsonism in the course of PD or APS, defined according to the 2015 MDS criteria as bradykinesia accompanied by at least one additional symptom: rigidity and/or resting tremor.
Age between 40 and 80 years. Written informed consent for participation in the study. Duration of parkinsonian symptoms shorter than 3 years. Abnormal dopamine transporter single-photon emission computed tomography (DaTscan) result confirming presynaptic dopaminergic neuronal degeneration.
Exclusion Criteria Lack of consent to participate in the study. Secondary or drug-induced parkinsonism. Other central nervous system (CNS) disorders (e.g., neoplastic or vascular processes) that could account for the symptoms.
Active malignancy, infection, or autoimmune inflammatory disease. Severe systemic diseases, including advanced heart failure (New York Heart Association [NYHA] class III-IV), poorly controlled diabetes mellitus, renal failure with glomerular filtration rate (GFR) ≤ 60 mL/min/1.73 m², or hepatic failure.
Presence of a known monogenic mutation causing parkinsonism according to the Online Mendelian Inheritance in Man (OMIM) classification.
Antibiotic therapy or use of probiotics within 3 months prior to the study visit.
Pregnancy or breastfeeding.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Differential expression of selected microRNAs
Lasso di tempo: 18 months
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Identification of microRNA in peripheral blood enabling the differentiation of PD and APS at an early stage of the disease.
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18 months
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Differences in metabolomic profiles
Lasso di tempo: 18 months
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Identification of metabolomic profiles in peripheral blood enabling the early differentiation between PD and APS.
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18 months
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Ability of biomarkers to differentiate PD and APS
Lasso di tempo: 18 months
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Assessing the diagnostic accuracy of biomarkers in differentiating PD from APS-analysis of receiver operating characteristic curves.
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18 months
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Changes in molecular (miRNA, metabolomic) profiles over time
Lasso di tempo: 18 months
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Longitudinal analysis comparing molecular characteristics assessed at two distinct time points: T0 (baseline clinical visit) and T2 (follow-up assessment conducted 12-18 months later).
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18 months
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Identification of clinical predictors of atypical parkinsonian syndrome development.
Lasso di tempo: 18 months
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Comprehensive clinical characterization of participants at baseline (T0) and follow-up (T2) to identify clinical features associated with PD and APS, and to support final diagnostic classification according to Movement Disorder Society (MDS) criteria. At the baseline visit (T0), detailed clinical data will be collected, including the severity of motor symptoms assessed using the MDS-UPDRS scale in both ON and OFF states (following a 12-hour withdrawal of dopaminergic medication), as well as non-motor symptoms evaluated with the MDS-NMS, RBDSQ, and GIDS-PD scales. Demographic data, family history of neurological disorders, and information regarding known PD-associated genetic mutations will also be recorded. Cognitive function and mood disturbances will be assessed using the MoCA, Beck Depression Inventory, Beck Anxiety Inventory, and Frontal Assessment Battery. In all patients examined in the OFF state, blood pressure and heart rate. |
18 months
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Collaboratori e investigatori
Investigatori
- Investigatore principale: Jacek Kuźnicki, The International Institute of Molecular and Cell Biology in Warsaw
Pubblicazioni e link utili
Pubblicazioni generali
- Chen L, Chen J, Weng W, Wu M, Zhou X, Yan P. Bibliometric analysis of microRNAs and Parkinson's disease from 2014 to 2023. Front Neurol. 2024 Sep 25;15:1466186. doi: 10.3389/fneur.2024.1466186. eCollection 2024.
- Eckert T, Tang C, Ma Y, Brown N, Lin T, Frucht S, Feigin A, Eidelberg D. Abnormal metabolic networks in atypical parkinsonism. Mov Disord. 2008 Apr 15;23(5):727-33. doi: 10.1002/mds.21933.
- Trupp M, Jonsson P, Ohrfelt A, Zetterberg H, Obudulu O, Malm L, Wuolikainen A, Linder J, Moritz T, Blennow K, Antti H, Forsgren L. Metabolite and peptide levels in plasma and CSF differentiating healthy controls from patients with newly diagnosed Parkinson's disease. J Parkinsons Dis. 2014;4(3):549-560. doi: 10.3233/JPD-140389.
- Khoo SK, Petillo D, Kang UJ, Resau JH, Berryhill B, Linder J, Forsgren L, Neuman LA, Tan AC. Plasma-based circulating MicroRNA biomarkers for Parkinson's disease. J Parkinsons Dis. 2012;2(4):321-31. doi: 10.3233/JPD-012144.
- Margis R, Margis R, Rieder CR. Identification of blood microRNAs associated to Parkinsonis disease. J Biotechnol. 2011 Mar 20;152(3):96-101. doi: 10.1016/j.jbiotec.2011.01.023. Epub 2011 Feb 3.
- Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson's disease. Lancet Neurol. 2021 May;20(5):385-397. doi: 10.1016/S1474-4422(21)00030-2.
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Inizio studio (Stimato)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Sinucleinopatie
- Manifestazioni neurologiche
- Malattie del cervello
- Malattie del sistema nervoso centrale
- Malattie del sistema nervoso
- Disordini mentali
- Disturbi neurocognitivi
- Malattie degli occhi
- Demenza
- Tauopatie
- Malattie Neurodegenerative
- Disturbi del movimento
- Malattie parkinsoniane
- Malattie dei gangli basali
- Malattie dei nervi cranici
- Disautonomi primarie
- Malattie del sistema nervoso autonomo
- Oftalmoplegia
- Disturbi della motilità oculare
- Paralisi
- Condizioni patologiche, segni e sintomi
- Segni e sintomi
- Morbo di Parkinson
- Atrofia multisistemica
- Paralisi sopranucleare, progressiva
- Malattia del corpo di Lewy
Altri numeri di identificazione dello studio
- KB/40/2026 (Altro identificatore: Medical University of Warsaw Bioethical Comittee)
Piano per i dati dei singoli partecipanti (IPD)
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