Researchers Find 2 New Early Signs of Parkinson’s

A study of the health records of over a million people in East London has identified two conditions that might be early symptoms of Parkinson’s disease: hearing loss and epilepsy.

Recognizing these as possible signs of Parkinson’s may help providers diagnose the disease earlier, which could help people get access to treatment sooner.

What Is Parkinson’s?

Parkinson’s disease is a progressive disease of the brain and nervous system that affects a person’s ability to move.

However, people with the disease can have a range of symptoms, some of which are not related to movement.

What’s more, not everyone with Parkinson’s will have the same symptoms or experience them to the same degree.

Spotting Parkinson’s Sooner

The timing of when a person starts having symptoms that could signal Parkinson’s can also affect when they will be diagnosed.

The new study found that many of the common symptoms of Parkinson’s—like tremors and memory problems—may show up many years before the diagnosis is made.

“Tremor, which is one of the most recognizable symptoms of Parkinson’s, was seen 10 years before eventual diagnosis in our study,” Cristina Simonet, MD, a neurologist and a PhD candidate at Queen Mary University of London and the lead author of the study, told Verywell. “This is too long for patients to wait.”

Rachel Dolhun, MD, the senior vice president for medical communications at the Michael J. Fox Foundation for Parkinson’s Research, told Verywell that the diversity of the patients in the new study is important,

Dolhun—who was not involved in the research—said that gathering more information about Parkinson’s from underrepresented groups of patients is necessary to better understand it.

Waiting Too Long for a Diagnosis

The long wait time between the onset of symptoms of Parkinson’s and a diagnosis has been noted by researchers in the past.

“We don’t have anything that can definitively diagnose or exclude Parkinson’s disease,” said Dolhun. “Instead, it’s based on a doctor’s examination.”

Adding hearing loss and epilepsy to the potential signs and symptoms of the disease could help providers spot it sooner.

Primary care providers play a key role in recognizing the symptoms of Parkinson’s sooner. If they do, they can refer a patient to a specialist who can then make the diagnosis or confirm it.

There is no cure for Parkinson’s, but Dolhun said that an earlier diagnosis is key for ensuring that patients can access support sooner.

For example, there are treatments that can help them maintain their physical abilities and independence for as long as possible.

Other Clues to Diagnosis

The study also noted that other conditions—like type 2 diabetes, high blood pressure, low blood pressure, constipation, depression, and erectile dysfunction—were also more likely to be seen in people who were later diagnosed with Parkinson’s.

Simonet said that providers may need to ask their patients about these symptoms as well.

“Patients sometimes are not aware of non-motor symptoms—such as constipation, depression, or erectile dysfunction—being common manifestations of Parkinson’s,” said Simonet. “Therefore, they will not report these symptoms to their GP. That is why direct questioning is so important.”

When the researchers looked at medical records of patients with Parkinson’s in the UK Biobank (a large database of medical information from volunteers in the United Kingdom) they saw the same findings.

Why Is There a Delay?

“Parkinson’s disease is a slow, progressive condition,” said Simonet. “We do not expect all symptoms to start at once from one day to another.”

According to Simonet, there is a pre-diagnostic phase when the motor (movement) symptoms and non-motor symptoms of Parkinson's emerge over time.

The researchers did suggest one possible reason for the delay in diagnosis.

Even if patients have “classic” signs of Parkinson’s like tremors and memory problems, providers may have a harder time evaluating symptoms in patients from traditionally under-represented groups.

The Study

The researchers looked at the medical records of a large number of people from a part of London that is more racially diverse and economically challenged than the rest of the United Kingdom.

Why East London?

The researchers chose East London for their study because of its diverse, racially mixed population, in contrast to other studies of Parkinson’s that have been conducted in largely White populations.

East London is about 45% Black, South Asian (Indian and Pakistani), or mixed race, compared to 14% of the U.K. as a whole.

Since the U.K. has its National Health Service (NHS), everyone in East London has access to healthcare. Therefore, a patient’s economic status is not a factor when seeking or receiving treatment.

Who Was Included?

The researchers combed through the electronic health records of more than one million people who lived in East London between 1990 and 2018 and who had been treated at primary care practices.

Then, they matched each of 1,055 patients who were diagnosed with Parkinson’s disease with 10 patients of the same sex and age (10,550 patients total) who did not have Parkinson’s.

The researchers specifically looked at three time periods before the diagnosis of Parkinson's was made: less than 2 years, between 2 and 5 years; and 5 to 10 years.   

What Did the Findings Show?

The findings of the study suggested that some of the known early signs of Parkinson’s may happen earlier than research has shown. The researchers also identified two new potential early symptoms of Parkinson's.

Memory Problems, Other Health Conditions

The researchers found that memory problems were more common in people who were later diagnosed with Parkinson’s than what previous studies had shown.

In addition, there was a greater association between high blood pressure and type 2 diabetes and an increased risk of Parkinson’s seen in these patients.

Hearing Loss

With hearing loss, the researchers looked at hearing problems that were severe enough that a patient need a referral for a hearing test.

This outcome was associated with a later diagnosis of Parkinson’s and was present up to 5 years before diagnosis.

Epilepsy

The researchers said that the finding of epilepsy as a possible symptom of Parkinson’s was “notable.” However, Simonet said that Parkinson-like symptoms can also be caused by medications that are used to treat epilepsy.

Future Research

More research—especially in large, diverse patient groups—is needed to understand the complex way that Parkinson’s unfolds.

Dolhun said that there is an ongoing clinical study called the Parkinson’s Progression Markers Initiative that is investigating ways to diagnose Parkinson’s earlier. The initiative hopes to enroll 100,000 people online.

“This is about detecting Parkinson’s earlier and tracking the disease over time so we can treat it at all stages and ultimately, prevent the disease altogether,” said Dolhun.

In the U.K., there is a similar project, called the PREDICT-PD study that is working on finding new ways to identify people who are at high risk for developing Parkinson’s.