A major international study into Parkinson’s disease has revealed significant blind spots in meeting the needs of people in the Middle East, despite individuals from the region carrying a key genetic variant associated with the condition, reports BritPanorama.
Research conducted by the US National Institute on Ageing and the German Centre for Neurodegenerative Diseases examined the genetic risk of over 100,000 individuals. The progressive brain disorder leads to mobility issues, sleep disturbances, mental health challenges, and other bodily dysfunctions.
Findings published in The Lancet Neurology indicate that the Middle East is under-served by gene-targeted therapy, with screening protocols potentially overlooking critical risk indicators in the diverse populations of the region. Among those with Middle Eastern ancestry, a causal variant in the LRRK2 gene was identified in 4.4 percent of individuals with Parkinson’s disease, which is more than double the overall study rate.
The LRRK2 gene variant, along with the PRKN gene variants present in 1.3 percent of the population, significantly contributes to cases of early-onset Parkinson’s disease. Despite the prevalence of these genetic anomalies, they remain largely unexplored outside European studies, prompting calls for broader research into ageing-related diseases.
Dr Lara Lange, a study author and researcher at the National Institute on Ageing Laboratories of Neurogenetics, noted that some genetic variants can elevate a person’s risk of developing the disease by up to five times compared to non-carriers. “Our research shows that nearly 12 percent of Middle Eastern Parkinson’s patients harbour an identifiable and potentially actionable genetic variant, primarily in LRRK2 and GBA1, which are targeted by leading precision drugs globally,” Dr Lange stated.
She highlighted the disadvantage for patients, as nearly all clinical trials for these treatments currently occur in North America and Europe. This situation presents an opportunity for medical hubs in the Gulf region. “By expanding local screening and hosting clinical trials, we can ensure these next-generation therapies are accessible and effective for Middle East populations,” she added.
On the rise
Globally, Parkinson’s disease-related disabilities and fatalities have escalated, rising from 3 million cases in 1990 to approximately 12 million by 2025. The manifestation of Parkinson’s depends on a complex interplay of genetic factors, age, lifestyle, and environmental elements.
The age-standardised prevalence of the disease in the Middle East is about 83 per 100,000 people, with rates continually climbing due to ageing populations and changing lifestyles. Dr Muhammad Ghatali, a neurologist at Mubadala Health in Dubai, emphasized that while Parkinson’s is not completely preventable, understanding genetic susceptibility can facilitate earlier treatment.
Clinical diagnosis typically focuses on common symptoms, but if patients present under 50, genetic factors take precedence. Current treatment relies on levodopa (dopamine), supported by innovations like MR-guided focused ultrasound to provide lasting relief from tremors.
While people carrying LRRK2 or GBA1 variants may differ in risk levels, many never develop Parkinson’s disease. “Disease prevalence rises significantly with age, but these neurological disorders are being recognised and diagnosed earlier,” Dr Ghatali noted.
The UAE stands out for global Parkinson’s research opportunities due to its highly diverse population, which can facilitate the understanding of genetic and biological influences on disease risk and progression across varied ancestries.
Lifestyle interventions
Beyond clinical research, public health initiatives are crucial to mitigate the disease burden throughout the Arabian Gulf. Early clinical detection, improved access to specialist care, symptomatic treatments, and lifestyle changes such as regular exercise can enhance long-term quality of life. Recent studies indicate that the context of physical activity—for leisure or professional purposes—may significantly influence dementia risk.
A meta-analysis involving over 4.2 million participants found that leisure-time exercise, like walking or cycling, is linked to a notably reduced risk of dementia, while occupational physical activity can correlate with a heightened risk. Tracking participants aged 45 to 93 over ten years allowed for an in-depth analysis of dementia-related diagnoses.
Dr Khaled Al Saffar, a neurologist at Medcare Hospital in Dubai, pointed to emerging evidence supporting healthy lifestyles in safeguarding brain health and reducing cognitive decline risks. “Regular physical activity is crucial as it fosters cardiovascular health, circulation, and overall brain functionality,” he remarked.
Family history and genetic predispositions do not guarantee disease development. The recent research accentuates the necessity of comprehending genetic risk across diverse populations rather than assuming uniform applicability of findings from singular ancestry groups.
Developing new dementia treatment options is lengthy and expensive; however, artificial intelligence is revolutionising this landscape by uncovering new therapeutic uses for existing, FDA-approved drugs. Research has uncovered a significant reduction in dementia risk associated with the GSK-produced shingles vaccine, Shingrix, offering a potential new avenue for intervention.
“Treatment has evolved from merely prescribing medication to considering the patient holistically, encompassing movement, balance, cognitive function, and overall quality of life,” Dr Al Saffar stated. The demand for specialist neurological care is anticipated to surge as populations age and the capacity to identify and manage these conditions improves, necessitating an evolution in specialist services as research advances.
