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Patients with Parkinson's disease deserve treatment for more than just their symptoms

We can alleviate Parkinson's patients' ailments, but it is not yet possible to cure the disease itself. Patients continue to get worse as the disease progresses. Therefore, doctor and Ph.D. Helle Bogetofte Barnkob dedicates her career as a researcher to finding out how to stop the disease from evolving.

By Mikkel Linnemann Johansson, , 10/27/2021

Helle Bogetofte Barnkob has been fascinated by Parkinson's disease since she worked in a research project at Harvard University in Boston, Massachusetts while studying medicine.

- It's hugely interesting because the disease is still a big mystery. We know very precisely which area of the brain is being affected. We can also see what goes wrong and we know that the disease occurs when the dopamine-containing nerve cells in the midbrain die. But we still do not understand exactly why this is happening, she says.

Therefore, research into Parkinson's disease is also an area where new knowledge can potentially have a huge impact on future diagnosis and treatment. At the same time, it is a debilitating disease that greatly reduces the quality of life for patients, who experience that they gradually gain less control over their movements until their mobility is so hampered that they are unable to live independently.

- It is a relentless disease that steals patients' freedom and ultimately their lives. It is a patient group that deserves that we do everything we can to reduce the grip that this disease has on their lives, says Helle Bogetofte Barnkob.

The severe tremors and movement disorders that many associate with Parkinson's disease occur when the nerve cells with high concentrations of dopamine begin to die. Dopamine is a sign substance that has two main functions. One is to regulate our mood and emotions through signals to, among other things, our frontal lobes. The second function is to control our motor skills and thus our mobility.

Thus, patients with Parkinson's disease experience tremors because the nerve cells with the dopamine that controls motor skills begin to die. In addition, albeit to a lesser extent, the nerve cells that contain the dopamine that regulates our mood and emotions also die.

- Therefore, it is also seen that patients with Parkinson's disease have an increased risk of, for example, depression, says Helle Bogetofte Barnkob.

As a former doctor at Odense University Hospital's department of neurology, she has been very close to patients with Parkinson's disease. And therefore she also knows what a difference good treatment options can make.

One can treat medically so that the remaining nerve cells in the midbrain begin to produce more dopamine. Ultrasound treatments can inhibit the tremors and surgical procedures in which an electrode is implanted in the brain can also attenuate the disruptive signals that make it difficult for patients to control their movements.

But unfortunately, the patient's condition will continue to worsen because the nerve cells continue to die, says Helle Bogetofte Barnkob.

Research to benefit more patients

That is why she is currently researching the root causes of Parkinson's disease. At SDU, she uses stem cells formed from skin cells or blood cells to cultivate nerve cells, precisely those nerve cells with a high concentration of dopamine that are particularly exposed to Parkinson's disease.

The nerve cells are grown as so-called organoids, which develop into nerve tissue in three dimensions and can grow up to 5 mm in diameter.

Healthy nerve tissue is then compared to nerve tissue based on stem cells from patients with Parkinson's disease.

- This way, we can see the differences and from there make a disease modeling of Parkinson's disease. Thereby we gain knowledge about the disease mechanisms and can potentially find a way to slow down the development of the disease, Helle Bogetofte Barnkob explains.

Within Parkinson's disease, two variants are typically mentioned. One hereditary and one sporadic. The hereditary is due to a mutation in the genes and is the cause of between 5 and 10 percent of the diagnosed cases. This is the variant that Helle Bogetofte Barnkob has researched so far.

The sporadic occur as a consequence of environment combined with other genetic risk factors and is the cause of between 90 and 95 percent of the diagnosed cases of Parkinson's disease.

- As this variant affects far more people, it is in my eyes also particularly interesting. As a doctor, I could make a significant difference for the individual patient, but as a researcher I can hopefully contribute to the fact that in the future we can offer the absolutely crucial treatment to the vast majority of patients, she says.

Therefore, she has also started to focus more on the sporadic variant. Here, a connection has been found between an environment where one comes into contact with, for example, pesticides or other specific types of toxins, and an increased incidence of Parkinson's disease. Therefore, oxidative stress is suspected as an explanatory cause behind the more frequent variant of Parkinson's disease.

Oxidative stress occurs, among other things, when the body is exposed to toxins that affect the nerve cells' ability to handle oxygen. This causes the nerve cells to produce more so-called free radicals, which put pressure on the nerve cell and overwhelm its antioxidant systems.

- This has already been seen in brain tissue from deceased patients. With our technique, where we examine the disease in our cultured nerve tissue, we get the opportunity to examine the disease in living cells. We need to see what defects occur in the proteins, which are the small building blocks that make up our cells. It will give us a whole new knowledge and hopefully reveal where we must take action to slow down the loss of nerve cells in sporadic Parkinson's disease, says Helle Bogetofte Barnkob.

Editing was completed: 27.10.2021