The advent of unexpensive mutlipurpose devices like the Wii, the Kinect, the iPhone, and other motion capturing devices have opened up the opportunity for patients to track with objective measures the evolution and treatment of their Parkinson's Disease. Beyond this QuantifiedSelf approach, this have also created the possibility to run simple clinical trials at a very low cost, that could be funded thanks to the new crowdfunding approach.
3. What is Parkinson’s Disease?
Neurological degeneration of substantia nigra’s cells
Cells producing dopamine
Disease characterized by tremors, bradykinesia (slowness),
rigidity
Diagnostic is currently only clinical (observation)
DaTScan can spot dopaminergic deficits and help differentiate with other
disorders but is not an official base for a diagnostic
Only evaluation by a neurologist is recognized for diagnosis
Looking for biomarkers – PPMI Michael J Fox Foundation’s
initiative
DatScan measures?
Cerebral Spinal Fluid analysis?
Blood levels?
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4. Causes of Parkinson’s
We don’t know!
But we know that
Dopamine producing cells in the Substantia Nigra (SN)
degenerate
Basal ganglia cells do not receive enough dopamine and can’t
perform their complex job for motor, and mood, processing
loops
Motor alterations of movements is more and more pronounced,
“potentially” until a bed-ridden stage
“Usually” leading to a constant degradation in Quality of Life
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5. What’s the treatment?
Compensate the loss of dopamine by supplying more levodopa,
a precursor that is transformed in dopamine
by the Substantia Nigra cells
Though, we can’t monitor directly the number of SN cells
We could see, thanks to a heavy procedure (DaTScan),
the uptake of dopamine in basal ganglia improving
But mainly, we can see the improvement in motor condition
Which is the basis for an official diagnosis
Exercise is also shown to be important (as potent as dopamine agonists,
another drug class)
“Use it or loose it” situation
Probably improves uptake of dopamine
Put neuroplasticity in motion
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6. The situation is
Motor symptoms are the only easily
observable impact of the disease
Depression is difficult to evaluate, and can be made worse by
motor problems
Every Parkinson’s patient is different
Mechanisms are extremely complex and idiopathies probably
very different
Symptoms vary greatly among patients
Levodopa has a short plasma half-life cycle (1 hour)
Should be taken several times a day
Proper doses throughout the day and adherence
to schedule are critical
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7. Why the Wii (or the Kinect, or the
iPhone,..) can help?
Helps you exercising
Monitors your movements
Provides measures or indexes that you can
track (e.g. Wii-Fit age)
Several studies are built on using the Wii to create physical
exercises, and monitor their impact
Wii has been an early (objective) indicator
for a UK lady prior to her diagnosis
Wii could serve to quantify objective measures among a large
set of patients, and control group
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15. Crowdfunding clinical trials
Using un-expensive material to monitor
patient and control groups
Opening the scope of hypotheses to be quickly tested
Exercise, dietary regimens
Existence of sub-types for the disease
Big Data coming to medical research
23AndMe gathered genetic material from
6500+ people with Parkinson’s, leading to
new correlations between certain genes and the disease
We could create a database of daily-living measures for
symptoms and impact of drugs (are there compounds
slowing down progression?)
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16. If you’re interested in a crowdfunding
challenge for quantified-self trials
Let’s emulate #SciFund Challenge success. If you’re interested in
seeing a similar Challenge for #quantifiedself #medicaltrials:
Show this presentation around
Contact me at fbaud@p2pventure.org
2012 FundMyMedicalResearch.org – http://twitter.com/FundMyMR
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