Morris K. Udall Center for Parkinson’s Disease Research at The Feinstein Institute for Medical Research

Director: David Eidelberg, M.D.

Website: Under Development

Central Theme

The Udall Center at The Feinstein Institute for Medical Research focuses on a unique patient-oriented approach using validated functional brain networks to develop novel approaches/solutions to basic problems of diagnosis and management confronted each day by Parkinson’s disease (PD) patients, clinicians and caretakers. Findings from Center projects will shed light on the relationship between functional brain organization in the resting state (PET, rest state fMRI) and neural activation during cognitive processing (event-related fMRI), and provide unique information on how both interact to shape performance in PD patients and healthy people. Project 1 addresses the serious clinical problem of levodopa-induced dyskinesias, which ultimately affect nearly all PD patients. Project 2 examines the network basis for individual differences in the cognitive response to dopaminergic treatment with a view to predicting which patients will develop untoward cognitive side effects under different treatment conditions. Project 3 aims to establish the feasibility of a new network-based algorithm for providing earlier and more accurate differential diagnosis than is currently possible.

Center Structure

Six cores will support the research activities of three Projects: the Administrative, Clinical, Statistics and Data Management, Imaging, and Education and Training cores.  The activities of each core are independent. That said, these activities will be highly coordinated across the Clinical, Cognitive and Behavioral, and Imaging Cores in that the data output of these cores will be entered into the database created in the Statistics and Data Management core.

The specialized Udall Center mechanism allows Feinstein investigators to collaborate with scientific leaders in important translational research areas. For instance, investigators in Dr. Eidelberg’s laboratory have developed a productive working relationship with Dr. Mark Gluck and his team at Rutgers University (Newark, NJ) in the area of cognitive processing in Parkinson’s disease. This collaboration will develop further in the course of the fMRI/behavioral studies of probabilistic category learning and neuro-economic decision making planned over the next five years. Similarly, the involvement of Dr. Angela Cenci-Nilsson at Lund University (Sweden) offers a true translational collaboration in the study of the role of the microvasculature in the pathogenesis of levodopa-induced dyskinesias (LID). Professor Cenci-Nilsson’s unique expertise provides the basis for a unique collaboration spanning the gap between experimental animal studies and human investigation in Parkinson’s disease. Moreover, the proposed studies conducted at the sleep disorders centers at North Shore – LIJ Health System, Stanford University, and the University of Pennsylvania, overseen respectively by Drs. Harley Greenberg, Emmanuel Mignot and Howard Hurtig, will offer new insights about imaging biomarkers for the diagnosis of PD. 

Recent Significant Advances

N/A

Resources Available

Animal Models: Rat model of L-dopa-induced dyskinesia (LID) at Lund University.

Other Resources: Clinical ratings (off-state UPDRS), a standardized neuropsychological testing battery, off-state FDG PET data, off-state, routine anatomical MRI, DNA banking, and brain donation/banking.

Plans for the Coming Year

In addition to starting our projects (see below), we also plan to set up a website for our new Udall Center and to organize a Centricity Series on Parkinson’s Disease for the summer 2011. 

Project 1

Year 1: (1) For specific aim 1, we will enroll and study 15 PD patients on chronic levodopa therapy with levodopa-induced dyskinesias, and 15 patients chronic levodopa therapy with uncomplicated responses over 5 years. A total of 6 subjects will be enrolled in year 1; (2) We will enroll and study 15 healthy controls over 5 years; (3) For specific aim 2, we will enroll and study 30 drug-naïve patients over 4 years. All patients will return after 3 and 12 months; (4) For specific aim 3, 200 rats will be used per year for all proposed experiments.

Project 2

Year 1: (1) For all three specific aims, we will enroll and study a total of 45 subjects over 5 years. 15 subjects will be on chronic levodopa treatment and have two evaluations 2 1 month apart. 30 drug-naïve PD patients will return after 3 months and 4 months for follow-up evaluation; (2) We will enroll a total of 15 healthy controls over 5 years as described in aim 1.

Project 3

Year 1: (1) We will enroll and study a total of 120 subjects across centers for specific aim 1, divided over 5 years. 24 subjects will be enrolled in year 1; (2) We will enroll and study 60 subjects across centers for specific aim 2; (3) We will enroll and study 20 subjects across centers with RBD for specific aim 3.

Select Recent Publications

N/A

Public Health Statement

The Udall Center at The Feinstein Institute for Medical Research employs rigorously validated Parkinson’s disease (PD)-related networks to address vital issues that impact heavily on the care of today’s PD patients.

Because dopaminergic treatment is generally so effective for the motor symptoms of PD, at least early on, it is easy to dismiss the very real problems that ultimately develop: levodopa-induced dyskinesias and cognitive and behavioral changes for some patients. Understanding these phenomena should not only help us improve the lives of patients, but will provide unique insight into the pathophysiology of PD and perhaps other neurodegenerative disorders. Likewise, the validation of an automated pattern-based method for early diagnosis will help streamline trials of new therapies for PD as well as for atypical parkinsonian syndromes.

Other Developments of Interest

Imaging Collaboration

The NIH awarded supplemental funding for a collaborative study between the University of Pennsylvania and The Feinstein Institute Udall Centers on “Parkinson’s disease and dementia”. The purpose of this study is to validate clinical measures for staging clinical severity in PD, PD-MCI, and PDD using MRI datasets from the two Centers.