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Incremental Clarity in Neurodegenerative Diseases

Just when I thinkI've got a handle on where things stand in neuroscience, the next step in theprocess takes a turn that surprises me. In December and early January, years ofresearch unfolded in a few weeks time as papers published the work of Penn researchersand were able to deepen our understanding of a variety of conditions, both rareand common, hopefully getting closer to refining or finding effectivetreatments as a result.

For Parkinson'spatients, the latest research shows that the diseaseis not to blame for the impulse control symptoms one-fifth of Parkinson'spatients experience. Rather, researchers believe that treatmentstargeting the dopamine system may be a cause. Knowing the risk of thetreatment, physicians will be able to monitor and track patients over time, tosee if the risk of impulsivity increases over the duration of treatment.

Also on theneurodegenerative front, neurologistshave come up with a non-invasive way to parse out the difference between thetwo most common form of dementia - Alzheimer's disease and FrontotemporalLobar Degeneration (FTLD). They are using an MRItechnique to predict the ratio of two important markers for the diseases - theproteins total tau and beta-amyloid - found in the cerebrospinal fluid. This builds off other work at Penn,where the initial test to measure the levels of these proteins was developedand tested. It's among the growing list of tests developed and investigatedhere at Penn, including ASL-MRI, PET, and a recently FDA approved amyloid-beta tracer for PET scans.

The better the tests, the more hope and opportunity toplace people in clinical trials that are most likely to reach the given targetand hopefully curb disease. Earlier in December, another study from the PennMemory Center found that, contrary to the trend of non-spousal Alzheimer'scaregivers, most caregivers that participate in clinical trials arespouses of the person with Alzheimer's. Researchers hope that they can reduce barriers to make iteasier for other caregivers to co-participate in these trials with their lovedones living with Alzheimer's.

Theseincremental gains in combination show a ramped up pace for neurodegenerativediseases, and in Neurology in general. Now, the focus is on translating theadvances into clinical care, as soon as the research is shown to be effectiveand accurate, providing more hopeful momentum for these devastating conditions.

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