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A systematic review of biomarkers for disease progression in Parkinson's disease

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McGhee, David J. M., Royle, Pamela, Thompson, Paul A., Wright, David E., Zajicek, John P. and Counsell, Carl E. (2013) A systematic review of biomarkers for disease progression in Parkinson's disease. BMC Neurology, 13 (1). 35. doi:10.1186/1471-2377-13-35

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Official URL: https://doi.org/10.1186/1471-2377-13-35

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Abstract

Background:
Using surrogate biomarkers for disease progression as endpoints in neuroprotective clinical trials may help differentiate symptomatic effects of potential neuroprotective agents from true disease-modifying effects. A systematic review was undertaken to determine what biomarkers for disease progression in Parkinson’s disease (PD) exist.

Methods:
MEDLINE and EMBASE (1950–2010) were searched using five search strategies. Abstracts were assessed to identify papers meriting review in full. Studies of participants with idiopathic PD diagnosed by formal criteria or clearly described clinical means were included. We made no restriction on age, disease duration, drug treatment, or study design. We included studies which attempted to draw associations between any tests used to investigate disease progression and any clinical measures of disease progression. The electronic search was validated by hand-searching the two journals from which most included articles came.

Results:
183 studies were included: 163 (89%) cross-sectional, 20 (11%) longitudinal. The electronic search strategy had a sensitivity of 71.4% (95% CI 51.1-86.0) and a specificity of 97.1% (95% CI 96.5-97.7). In longitudinal studies median follow-up was 2.0 years (IQR 1.1-3.5). Included studies were generally poor quality - cross-sectional with small numbers of participants, applying excessive inclusion/exclusion criteria, with flawed methodologies and simplistic statistical analyses.

Conclusion:
We found insufficient evidence to recommend the use of any biomarker for disease progression in PD clinical trials, which may simply reflect the poor quality of research in this area. We therefore present a provisional ‘roadmap’ for conducting future disease progression biomarker studies, and recommend new quality criteria by which future studies may be judged.

Item Type: Journal Article
Subjects: Q Science > QH Natural history
Q Science > QP Physiology
R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Divisions: Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR)
Library of Congress Subject Headings (LCSH): Parkinson's disease , Parkinson's disease -- Etiology, Biochemical markers , Clinical trials , Neuroprotective agents
Journal or Publication Title: BMC Neurology
Publisher: B M J Group
ISSN: 1471-2377
Official Date: 12 April 2013
Dates:
DateEvent
12 April 2013Published
2 April 2013Accepted
Volume: 13
Number: 1
Article Number: 35
DOI: 10.1186/1471-2377-13-35
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-0707-10124[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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