Whole Clinic Research Enrollment in Parkinson’s Disease: The Molecular Integration in Neurological Diagnosis (MIND) Study

Article type: Research Article

Authors: Tropea, Thomas F.^a | Amari, Noor^a | Han, Noah^a | Rick, Jacqueline^a | Suh, EunRan^b | Akhtar, Rizwan S.^{a; 1} | Dahodwala, Nabila^a | Deik, Andres^a | Gonzalez-Alegre, Pedro^a | Hurtig, Howard^a | Siderowf, Andrew^a | Spindler, Meredith^a | Stern, Matthew^a | Thenganatt, Mary Ann^a | Weintraub, Daniel^{c; d} | Willis, Allison W.^a | Van Deerlin, Vivianna^b | Chen-Plotkin, Alice^{a; *}

Affiliations: [a] Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA | [b] Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA | [c] Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA | [d] Parkinson’s Disease Research, Education and Clinical Centers (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA

Correspondence: [*] Correspondence to: Alice S. Chen-Plotkin, MD, 3West Gates, 3400 Spruce Street, Philadelphia, PA19104, USA.Tel.: +1 215 573 7193; E-mail: chenplot@pennmedicine.upenn.edu.

Note: [1] Current address: Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

Abstract: Background:Observational studies in Parkinson’s disease (PD) have focused on relatively small numbers of research participants who are studied extensively. The Molecular Integration in Neurological Diagnosis Initiative at the University of Pennsylvania aims to characterize molecular and clinical features of PD in every patient in a large academic center. Objective:To determine the feasibility and interest in a global-capture biomarker research protocol. Additionally, to describe the clinical characteristics and GBA and LRRK2 variant carrier status among participants. Methods:All patients at UPenn with a clinical diagnosis of PD were eligible. Informed consent included options for access to the medical record, future recontact, and use of biosamples for additional studies. A blood sample and a completed questionnaire were obtained from participants. Targeted genotyping for four GBA and eight LRRK2 variants was performed, with plasma and DNA banked for future research. Results:Between September 2018 and December 2019, 704 PD patients were approached for enrollment; 652 (92.6%) enrolled, 28 (3.97%) declined, and 24 (3.41%) did not meet eligibility criteria. Median age was 69 (IQR 63_75) years, disease duration was 5.41 (IQR 2.49_9.95) years, and 11.10%of the cohort was non-white. Disease risk-associated variants in GBA were identified in 39 participants (5.98%) and in LRRK2 in 16 participants (2.45%). Conclusions:We report the clinical and genetic characteristics of PD patients in an all-comers, global capture protocol from an academic center. Patient interest in participation and yield for identification of GBA and LRRK2 mutation carriers is high, demonstrating feasibility of PD clinic-wide molecular characterization.

Keywords: Parkinson’s disease, LRRK2, GBA, clinical protocols

DOI: 10.3233/JPD-202406

Journal: Journal of Parkinson's Disease, vol. 11, no. 2, pp. 757-765, 2021