The last few years have been particularly rough for the beloved and beleaguered actor Michael J Fox.
The upbeat optimism that has won him countless hearts has taken a pounding.
In 2018, Fox had a tumour on his spinal cord removed. It was benign, and unrelated to Parkinson’s disease, which he’s battled for more than 30 years. But it threatened him with paralysis. After recovering from surgery, he suffered a painful arm break.
In 2020, when working on the TV legal drama The Good Fight, he found his memory was failing, a common problem driven by Parkinson’s progress. He couldn’t remember his lines.
‘It got worse’
Last year, Fox told PEOPLE magazine: “It got worse. I broke my cheek, then my hand, then my shoulder, had a replacement shoulder put in and broke my arm, then I broke my elbow. I’m 61 years old, and I’m feeling it a little bit more.”
It hasn’t been all bad. In November, Fox accepted an Academy Award for humanitarian work. Namely, raising more than US$1.5 billion for Parkinson’s research.
Next month, an emotional documentary about his life is due for release.
What’s got him excited
What he’s most excited about, though, is a genuine “game changer” in Parkinson’s research.
Short version: researchers have successfully trial a test that can accurately detect a biomarker for the disease in people that haven’t as yet developed symptoms.
Fox has said he is “deeply moved” by the breakthrough.
He told Stat News he keeps going back to documentary footage of his childhood.
At that time there was no way to know Fox would eventually develop the disease.
Soon, he said, a child like he was might be able to simply get a nasal swab at age 2 or 3 or 4.
“It’s all changed. It can be known and treated early on. It’s huge.”
First some background
In its healthy form, a protein called alpha-synuclein is thought to help control the release of neuro-transmitters. However, the role of the protein isn’t well understood,
On the dark side, an abnormal form of the alpha-synuclein protein accumulates in clusters that are “misfolded” – or incorrectly folded.
It’s thought that the slow deterioration of the brain in people with Parkinson’s disease is caused by these abnormal clusters.
The attendant damage to nerve cells in the brain leads to the slow, stiff movements and tremors that present with the disease.
The key to an early diagnosis?
For 200 years, the diagnosis of Parkinson’s has been based on observations. There is no specific test for it.
A neurologist will look at your medical history, review of signs and symptoms, and undertake a neurological and physical examination.
By then, of course, the disease is well in progress. The diagnosis can’t be fully confirmed until the patient has died.
That may soon change if the findings of the new study, involving more than 1100 people, and led by researchers at Penn Medicine, hold up.
The researchers trialled a new technique – known as the alpha-synuclein seed amplification assay – that identifies the build-up of abnormal protein deposits in cerebrospinal fluid.
The molecular test successfully identified nearly 90 per cent of participants with the typical form of the disease.
The test picked up the disease in at-risk patients who hadn’t yet been diagnosed or suffered the onset of symptoms like loss of smell or compromised movement.
In volunteers who did not have Parkinson’s, the test showed the absence of the disease 96 per cent of the time.
It gets better
The findings suggest that the test can identify “at-risk people and those with early, non-motor symptoms prior to diagnosis”.
In other words, the test, as per its name, essentially amplifies the presence of the abnormal misfolded protein, and detects the disease before those tremors and other motor symptoms are apparent.
The researchers say this could, in the future, “support a framework for early detection and prevention of disabling motor symptoms”.
That is, if the disease can be caught early enough, and the mechanisms become better understood, those stiff and frozen movements could be nipped in the bud.
What makes the study a “game changer, as it’s being described, is it marks the first time scientists and clinicians can monitor, detect and define Parkinson’s disease using objective, biological terms – rather than clinical observations.
Where to from here?
As STAT News reported: “It is an advance that may soon be used to develop better diagnostics, but more importantly could rapidly accelerate the search for treatments for the disease.”
At the moment, alpha-synuclein can only be detected by undergoing a lumber puncture, not the most pleasant procedure.
The hope is that the new assay could be improved to the extent that it could pick up those abnormal proteins in blood, from skin biopsy, or a swab of the nose.
However, as STAT noted: “There is still a long way to go before people can be screened this way. And using the new discovery to craft better drug trials and speed treatments to market could take a decade.”
However, the Fox Foundation, “always optimistic and impatient, believes it can do the work in three to five years”.
How Michel J Fox feels about it?
In a statement from the foundation, he said:
“I am deeply moved by this breakthrough and endlessly grateful to the researchers, study participants and funders who have endeavored to bring us this far… Together we are making a cure for Parkinson’s inevitable.”
