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Title: The genetics of cognitive decline in Parkinson’s disease.
Student: Leon Smyth
Supervisor(s): Doctor Toni Pitcher, Professor Martin Kennedy
Sponsor: The Helen Poole and Ian McDonald Memorial Summer Studentship / Canterbury Medical
Research Foundation.
Parkinson’s disease (PD) is a movement disorder caused by degeneration of brain tissue which
affects one in five hundred New Zealanders. The tremor (shaking) and the problems with walking which are
caused by PD impact on the quality of life of affected people. However, there are other important issues
which arise due to PD which are less well-known and get less attention. These include problems sleeping,
depression and dementia. People who suffer from PD are three times more likely to have dementia than
the general population, and approximately one third of PD patients develop dementia. This has implications
for the health care system, and also the future, with New Zealand’s aging population. The genetics of PD
have been thoroughly researched over the past fifteen years, and are quite well understood. On the other
hand, the genetic component of dementia in PD has been overlooked.
This study acted as a pilot for a larger, ongoing study of cognition in PD patients in Christchurch. It
included a cohort of 209 people. This was subdivided into:
• 58 healthy, age-matched controls.
• 77 PD patients with normal cognition.
• 42 PD patients with mild cognitive impairment (MCI), a pre-dementia condition.
• 32 PD patients with dementia.
Each patient gave blood samples, from which DNA was extracted. In this pilot, twenty different genes were
analysed by Sequenom MassArray in Auckland. This is a mass spectrometer, which can detect the
molecular differences between two genetic variants. While two genetic tests failed, the process was a
success, allowing eighteen of the twenty genetic regions to be tested in all the samples (3 852 tests) in a
single day. The genetic data which was gathered from Auckland was then correlated with clinical and
cognitive data from the New Zealand Brain Research Institute.
Ultimately, no single genetic variant was found to have a statistically significant association with
dementia in PD. This said, some trends were observed. The ApoE gene is slightly more common in PD
patients. Eighteen percent of PD patients with dementia or MCI had at least one risk variant compared with
13% of control PD patients (p = 0.0967). However, this gene is known to be correlated with Alzheimer’s
disease. This means that the increased risk of dementia in people affected by PD is probably due to an
increased risk of Alzheimer’s rather than their dementia being related to PD per se. Moreover, no increase
in risk of PD related dementia was found when a panel of genetic risk variants was created to generate a
cumulative risk for each patient.
e1bb9e29-0f7f-4404-aca9-e61626b34441-150422034430-conversion-
gate01.doc
These results therefore indicate that, if there is a relationship between dementia and Parkinson’s
disease, the genetic component plays only a weak role in this. It is possible that, given a larger study, the
featherweight effects of a very large number of genes may be found to exert an effect. This study, while not
producing any significant results, is also important in identifying some possible lead genes to assess in
larger studies.
e1bb9e29-0f7f-4404-aca9-e61626b34441-150422034430-conversion-
gate01.doc

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Lay Report

  • 1. Title: The genetics of cognitive decline in Parkinson’s disease. Student: Leon Smyth Supervisor(s): Doctor Toni Pitcher, Professor Martin Kennedy Sponsor: The Helen Poole and Ian McDonald Memorial Summer Studentship / Canterbury Medical Research Foundation. Parkinson’s disease (PD) is a movement disorder caused by degeneration of brain tissue which affects one in five hundred New Zealanders. The tremor (shaking) and the problems with walking which are caused by PD impact on the quality of life of affected people. However, there are other important issues which arise due to PD which are less well-known and get less attention. These include problems sleeping, depression and dementia. People who suffer from PD are three times more likely to have dementia than the general population, and approximately one third of PD patients develop dementia. This has implications for the health care system, and also the future, with New Zealand’s aging population. The genetics of PD have been thoroughly researched over the past fifteen years, and are quite well understood. On the other hand, the genetic component of dementia in PD has been overlooked. This study acted as a pilot for a larger, ongoing study of cognition in PD patients in Christchurch. It included a cohort of 209 people. This was subdivided into: • 58 healthy, age-matched controls. • 77 PD patients with normal cognition. • 42 PD patients with mild cognitive impairment (MCI), a pre-dementia condition. • 32 PD patients with dementia. Each patient gave blood samples, from which DNA was extracted. In this pilot, twenty different genes were analysed by Sequenom MassArray in Auckland. This is a mass spectrometer, which can detect the molecular differences between two genetic variants. While two genetic tests failed, the process was a success, allowing eighteen of the twenty genetic regions to be tested in all the samples (3 852 tests) in a single day. The genetic data which was gathered from Auckland was then correlated with clinical and cognitive data from the New Zealand Brain Research Institute. Ultimately, no single genetic variant was found to have a statistically significant association with dementia in PD. This said, some trends were observed. The ApoE gene is slightly more common in PD patients. Eighteen percent of PD patients with dementia or MCI had at least one risk variant compared with 13% of control PD patients (p = 0.0967). However, this gene is known to be correlated with Alzheimer’s disease. This means that the increased risk of dementia in people affected by PD is probably due to an increased risk of Alzheimer’s rather than their dementia being related to PD per se. Moreover, no increase in risk of PD related dementia was found when a panel of genetic risk variants was created to generate a cumulative risk for each patient. e1bb9e29-0f7f-4404-aca9-e61626b34441-150422034430-conversion- gate01.doc
  • 2. These results therefore indicate that, if there is a relationship between dementia and Parkinson’s disease, the genetic component plays only a weak role in this. It is possible that, given a larger study, the featherweight effects of a very large number of genes may be found to exert an effect. This study, while not producing any significant results, is also important in identifying some possible lead genes to assess in larger studies. e1bb9e29-0f7f-4404-aca9-e61626b34441-150422034430-conversion- gate01.doc