IAG’s team contributes into the design and execution of clinical trials. Specifically, in Parkinson’s disease (PD), we are supporting the considerable amount of effort dedicated to finding new effective therapeutic agents for patients, with several symptomatic and disease-modifying therapies currently being evaluated in clinical trials, according to a recent comprehensive review. Collaboratively, we also work on developing and validating biomarkers, which may assist in early diagnosis and objective measurement of disease progression.
Better biomarkers may also allow for shorter and more efficient clinical trials.
In relation to patient selection for drug development programs, it is important to note that the clinical presentation of Parkinson’s disease is heterogeneous and overlaps with other conditions, including the parkinsonian variant of multiple system atrophy (MSA-P), progressive supranuclear palsy (PSP) and essential tremor. Brain MRI uses different sequences and contrasts to study brain structure and function while SPECT and PET imaging use ionising radioactive ligands to quantitatively measure receptors, transporters or enzymes at nanomolecular level with high specificity and power of resolution.
Imaging of the brain in patients with parkinsonism has the ability to increase the accuracy of differential diagnosis, patient selection and assessment of the disease progression.
- MRI: structural MRI is useful to differentiate PD from secondary and atypical forms of parkinsonism. Structural MRI can also be useful in the identification of structural lesions associated with other forms of parkinsonism, such as those underlined by vascular pathology or neoplasms. Structural MRI can also be useful for measuring the degree and distribution of brain atrophy.
- Advanced MRI modalities, including diffusion-weighted imaging (DWI), spectroscopy, arterial spin labelling (ASL) and resting-state functional MRI can assist in detection of and discrimination of PD cases from other forms of parkinsonism.
- Functional MRI measures blood oxygenation-level dependent (BOLD) signal, which is sensitive to localised changes in levels of blood oxygenation in brain regions that are activated.
- Imaging with PET or SPECT are powerful methods to detect in vivo changes in the brain at molecular level.
- SPECT: 123I-ioflupane (DaTSCANTM) SPECT is used in the differential diagnosis between PD and non-degenerative tremors.
- Another pathognomonic characteristic of PD is the impairment of the sympathetic nervous system. Cardiac 123I-metaiodobenzylguanidine SPECT and 18F-fluorodeoxyglucose PET are valid in the differential diagnosis between PD and atypical parkinsonism (MSA-P, PSP).
- Using PET imaging with 18F-fludeoxyglucose (18F-FDG), patterns of regional brain metabolism can be measured using a map of regional abnormalities of known disease-specific templates obtained in established patient cohorts.
IAG’s team has deep understanding of challenges associated with design and execution of Parkinson’s Disease trials.
We understand that optimal clinical trial design is crucial. Chosen imaging modality and associated image analysis will help to prove the efficacy of the therapy. We will recommend the optimal imaging and help selecting the trial endpoints. Once the trial is designed, IAG’s team will select and train the sites, assist with imaging data collection and review.
Reach out to our expert team, as you are designing and planning your trial. <imaging.experts @ ia-grp.com>
About IAG, Image Analysis Group
IAG, Image Analysis Group is a strategic partner to bio-pharmaceutical companies developing new treatments to improve patients’ lives. Our dynamic Strategy, Trial Solutions and Bio-Partnering divisions work closely to meet critical needs of biotechnology companies: funding, clinical development, and monetization of their assets. We fuse decades of therapeutic insights, risk-sharing business model and agile culture to accelerate novel drug development. IAG broadly leverages its core imaging expertise, proprietary technology platform DYNAMIKA and capabilities to support an objective early go no/ go decision and drive excellence for tomorrow’s innovative therapeutic agents with speed.
Experience: Scoring Systems
- Quantitative assessment of PET and SPECT
- Assessment of DaT scans
- MRI Assessment
- DaT scan
- MRI / SPECT
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