The brain-first form of the disease is harder to address, however, due to the variant of the disease being relatively symptom-free until the movement disorder symptoms appear and the patient is formally diagnosed, making it more difficult to find patients early enough to slow the disease. By then the patient has already lost more than half of the dopamine system, says Borghammer.

"Different genes or other factors (microbiome, infection, inflammation) may cause one type or the other," he said. "If we can identify such factors, we can perhaps develop new treatments to alter the cause of the disease and even prevent it altogether. But a lot of research still has to be done before we get there."


Previous research indicated that there could be more than one type of Parkinson's disease. What makes the study the most comprehensive ever is that follow-up exams with participants are scheduled after three and six years so that all procedures and scans can be repeated. This enables researchers to better understand the two different types of Parkinson’s disease.

Borghammer and his colleagues are expanding their cohort of patients to include more than 100. Each will be scanned with multiple scanning techniques so that researchers can assess the differences between them and potentially identify their risk factors.

All will be followed up for 10 years and scanned every three years to track their disease progression. Studies of blood, urine, and stools, and biopsies to search for causative factors will also be conducted, and animal models that reflect both types of Parkinson's disease will be created for further study.

The findings were published in Brain.

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