Predicting cognitive impairment in people with Parkinson’s disease

Dr. Alexandru Hanganu
Assistant Professor
University of Montreal

Dementia and other forms of cognitive impairment are one of the most distressing symptoms of late-stage Parkinson’s disease. Currently, there’s no way to predict who will develop them, or to intervene early if treatments are discovered.

At the University of Montreal, Dr. Alexandru Hanganu, an assistant professor, is developing an algorithm to predict who is at risk for these cognitive problems. He’s using his expertise in neuroimaging to chart the changes that occur in the brains of people with Parkinson’s who also experience depression, anxiety, sleep disturbances or impulse control difficulties. These are called neuropsychiatric symptoms. Hanganu’s research is made possible through a New Investigator Award from Parkinson Canada National Research Program in the amount of $88,432 over 2 years.

Hanganu believes people with these symptoms are at risk of Parkinson’s, even if they haven’t yet been diagnosed with the illness.

“My hypothesis is that neuropsychiatric symptoms can be used to predict the evolution of Parkinson’s disease and its appearance, the first stage being the prediction of cognitive performance,” he says.

Using Magnetic Resonance Imaging (MRI), Hanganu will scan the brains of people with Parkinson’s who have already been diagnosed with mild cognitive impairment, and who also have some neuropsychiatric symptoms. He’s comparing those results to scans of people with Parkinson’s who don’t have cognitive impairment, but do have depression, anxiety, or other neuropsychiatric symptoms.

Hanganu will give each person in his study one burst of Transcranial Magnetic Stimulation, a noninvasive technology that uses a magnetic field to stimulate areas of the brain. He’ll measure the changes in the brain after TMS to see how these people’s brains can adapt to changes.

Hanganu will then combine that data with data from a large, online archive of brain scans.

Altogether, they will allow me to create a predictive algorithm that will enable me to tell each patient what their risk is of developing Parkinson’s disease or cognitive impairment over time—or both,” he says.

Having this information about their risk of cognitive impairment would allow people to plan for their future, he says. It would also help doctors decide what type of treatment is appropriate.

For example, giving someone with depression higher doses of levodopa, the medication currently prescribed to control the movement symptoms of Parkinson’s, might make their cognitive problems worse, he says.

Hanganu also hopes if other treatments are developed to halt or improve cognitive impairment, his algorithm would allow people to access those treatments earlier.

Choosing a career in research into Parkinson’s disease is something Hanganu did because he can, he says.

“My brain circuits and my social environment and my gut bacteria—they just have the required energy, perseverance and structure to invest all this time on this study,” he says.