Prof. Dr. Daniela Berg
Organization: Hertie Institute for Clinical Brain Research
Phone number: +49 (0)7071 29 83119
Department: Department for Neurodegenerative Diseases
Area: CIN Members
Scientific topic: Biomarkers of Parkinson's Disease
Field of Research
With a prevalence of about 2% in the population over 60 years of age, Parkinson’s disease (PD) is one of the most common neurodegenerative disorders. The ageing population is demanding that greater attention be paid to the development of more effective diagnostic and therapeutic strategies. However, implementation of effective therapies requires correct diagnosis – as early as possible – knowledge of the disease’s progression, and an understanding of its causes and etiology. As there is still a substantial lack of knowledge with regard to all these aspects, the Clinical Neurodegeneration group is conducting a number of large prospective longitudinal studies of patients and individuals at risk of the disease in national and international co-operations to determine diagnostic and progression markers and to contribute to the understanding of the underlying neurodegenerative process. Selected examples of recent findings include:
- substantia nigra hyperechogenicity in healthy individuals older than 50 years determined by transcranial sonography indicates a more than 17 times greater risk of developing PD in the following three years;
- elevated levels of the insulin Growth Factor 1 (IGF-1) can be a marker for PD and putatively for individuals at risk of PD;
- increased gray matter volume of different anatomical structures associated with motor loops determined by MRI in asymptomatic LRRK2 mutation carriers seems to indicate compensatory mechanism in these motorically still healthy individuals due to motor network plasticity
- changes in the metabolite ratio of the substantia nigra determined by MRI-Spectroscopy indicate a PD-specific alteration
A further focus of the group is the standardization of quantitative assessments including: subtle axial motor deficits (such as gait and sway deficits) using an accelerometer-based measurement system; fine motor function; and autonomic dysfunction by special devices. Incorporating these techniques will permit new insights into the pathophysiology and progression of symptoms, not only in symptomatic but also in pre-symptomatic stages of neurodegeneration.
In collaboration with Prof. Thomas Gasser’s group, the Clinical Neurodegeneration group has been critically involved in the development and maintenance of the Hertie Biobank, which is currently the basis for many national and international co-operations that promote effective research into PD and other neurodegenerative disorders. Moreover, based on the wish to improve therapy, the group has expanded its involvement in a number of mono- and multicenter clinical studies, phase II to IV, for all stages of PD.
Subgroups of Parkinson’s disease and other Parkinsonian syndromes
In response to the demand for early, individualised, and more effective therapeutic treatment, one focus of the group is identifying patients with a potentially higher risk of dementia to develop a clearer categorization of dementias in Lewy body diseases. Major efforts have been put into the characterization of PSP (progressive supranuclear palsy) through the use of clinical, biochemical and neuroimaging parameters to better understand PSP subgroups and for future therapeutic interventions.
Essential tremor is the most frequent movement disorder, with a prevalence of 1-5%. However, our understanding of the etiology of this disorder is limited. To better understand subtypes and to facilitate differential diagnosis a large cohort of tremor patients has been collected and is currently being characterized with thorough quantitative assessment batteries. Standardized protocols are being established and genome-wide association studies are being performed in co-operation with national and international groups, in order to uncover the secrets of this common movement disorder.
Restless Leg Syndrome
Restless-Leg-Syndrome (RLS) is a sensorimotor disorder affecting about 10% of the German population. The observation that treatment effects are often very limited led to a large study, which revealed that poor treatment success, regarding improvement of RLS symptoms, quality of life and number of RLS related physician contacts, is primarily related to the presence of neuropsychiatric comorbidities. This finding has been internationally received with great interest as it directly affects treatment strategies.
genome-wide association studies (GWAS), linkage studies, genotyping, LRRK2 transgenic mouse model system, primary cell culture, induced pluripotent stem (iPS) cells, biobanking, functional neuroimaging, MRI, transcranial sonography, ambulatory sleep recording, neuropsychological testing, quantitatvie sensory and autonomic testing, accelerometry, determination of olfaction
brain-imaging; degeneration/ regenaration; neuro-geneticsneurolgy; neuronal stem cells
- Simón-Sánchez J, Schulte C, Bras JM, Sharma M, Gibbs JR, et al. (2009). Genome-wide association study reveals genetic risk underlying Parkinson's disease. Nat Genet. 41(12):1308-12.
- Maetzler W, Liepelt I, Berg D (2009). Progression of Parkinson's disease in the clinical phase: potential markers. Lancet Neurol. 8(12):1158-71.
- Liepelt I, Behnke S, Schweitzer K, Wolf B, Godau J, Wollenweber F, et al. (2009). Pre-motor signs of PD are related to SN hyperechogenicity assessed by TCS in an elderly population. Neurobiol Aging. [Epub ahead of print]