Understanding the Complexity of Parkinson’s Disease

Per Borghammer’s “aha” moment occurred almost two decades ago when he stumbled upon a research paper exploring the link between REM sleep behaviour disorder (RBD) and the development of Parkinson’s disease. The study focused on the loss of nerve cells in the heart as a potential early indicator of Parkinson’s, rather than the traditional approach of examining the brain.
It was discovered that individuals with RBD, a condition where people physically act out their dreams during REM sleep, exhibited significant depletion of neurons in the heart responsible for regulating heart rate and blood pressure. This neuronal loss, particularly in the production of the neurotransmitter norepinephrine, was so severe that it rendered their hearts undetectable on imaging scans using radioactive tracers.
Interestingly, while RBD is strongly associated with the development of Parkinson’s, not all Parkinson’s patients experience RBD symptoms. This led Borghammer to speculate that Parkinson’s disease may manifest in different ways, depending on the pattern of neuron loss. Some individuals may initially experience neuron loss outside the brain, gradually progressing inward, while others may primarily exhibit brain-specific neuron loss from the onset.
By delving into the complexities of Parkinson’s disease progression, researchers like Borghammer are paving the way for more personalized and targeted treatment approaches that consider the diverse manifestations of this neurodegenerative condition.