Dr Laura Wright, Research Associate and Lecturer, and Dr Rachael Lawson, Senior Lecturer and Janet Owens Parkinson’s UK Senior Research Fellow, led the project which was funded by the Lewy Body Society and supported by the NIHR Newcastle BRC. The study combined data from multiple cohort studies (the ICICLE-PD and SUPErB studies) in participants with early Parkinson’s and dementia with Lewy bodies. These previous cohort studies were conducted by researchers within the Translational and Clinical Research Institute at Newcastle University.
The study was a collaboration between several researchers within the NIHR Newcastle BRC Dementia, Mental Health and Neurodegeneration Theme. Co-authors included Dr Paul Donaghy, Prof David Burn, Prof John-Paul Taylor, Prof Alison Yarnall, Prof Fiona Matthews, Dr Michael Firbank, Dr Hilmar Sigurdsson, Dr Julia Schumacher and Prof Alan Thomas.
This study was one of the first to investigate brain functional connectivity in relation to neuropsychiatric symptoms, such as depression, anxiety, apathy and hallucinations, using MR imaging. Those symptoms are common in individuals living with a Lewy body disease, either Parkinson’s disease or dementia with Lewy bodies. They are usually associated with dementia, but it is now recognised that they also occur in the very earliest stages of cognitive decline.
Findings in the paper highlighted significant associations between understudied symptoms such as depression, apathy and anxiety with functional connectivity changes. The changes were within well-known neural networks associated with mood disorders in individuals with mild cognitive impairment related to Parkinson’s disease. In the early stages of dementia with Lewy bodies, however, the findings were unclear, despite the symptoms being more common and more severe than Parkinson’s participants. This suggested that the underlying brain processes in the brain might be different in the two conditions.
“Neuropsychiatric symptoms are common in Lewy body disease and can be extremely distressing both for the person living with these conditions, but also for their loved ones. There is a real unmet need with research in this area to understand changes in the brain and identifying new targets for treatment. This study is important because it gives us potential new avenues to look for treatments, but also highlighted that additional research in larger more diverse Lewy body groups are needed.”
Dr Laura Wright, Research Associate and Lecturer, Translational and Clinical Research Institute
Despite having been identified as a major contributor to quality of life and a top research priority in people living with both Parkinson’s and dementia, our current understanding of the underlying mechanisms of neuropsychiatric symptoms in Lewy body diseases is relatively poor and, therefore, treatment options remain limited. The present study represents an important contribution towards the identification of potential targets for symptomatic treatment to alleviate the burden of neuropsychiatric symptoms, improve care and improve the lives of people living with Lewy body dementia.
Dr Wright is currently developing a new study to investigate this understudied area in more detail to help identify new treatments for people living with Parkinson’s and dementia with Lewy bodies.