Donders Institute for Brain, Cognition and Behaviour
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Thesis defense Tainá Macherini Marques (Donders series 514)

9 September 2021

Promotors: Dr ir M.M. Verbeek, Prof dr B.R. Bloem
Co-promotor: Dr H.B. Kuiperij

Discriminating Parkinsonian Disorders using fluid biomarkers to improve early diagnosis

Parkinsonian disorders, like Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy, are progressive and fatal diseases without any pharmacological treatment to slow or stop the neuronal loss that causes movement and cognitive impairment. At the early disease stage, symptoms of the various parkinsonian disorders largely overlap, turning the establishment of a correct diagnosis into a challenge. Providing an accurate diagnosis at an early stage to individuals could help them and their families to better understand the course of the diseases, life expectancy, future expectations, as well as costs for treatment. Currently, diagnosis of parkinsonian disorders is based on physical examination of motor and non-motor symptoms, imaging scans, such as MRI, and response to dopaminergic medication, but this does not always provide an accurate diagnosis at an early stage. Fluid biomarkers may offer a great potential to help clinicians to accurately establish an early diagnosis. In this thesis, we have focused on the identification and validation of such fluid biomarkers for parkinsonian disorders, especially at the early disease stage when the symptoms are overlapping and the diagnosis is a challenge. Our findings showed moderate to high diagnostic accuracy for novel individual biomarkers, and when they were included in panels, combining fluid and clinical assessments, we could reach even higher accuracy levels. To summarize, our studies support the development of fluid biomarkers for the discrimination of parkinsonian disorders.