This project presents new thoughts in the field of Parkinson’s disease PD surgery and aims to foster the development of PD treatment by systematically collecting rich multidisciplinary data about outcomes and predictors of currently available neurosurgical PD treatment options (deep brain stimulation, gamma knife radiosurgery within the ventral intermediate nucleus) as well as investigating new treatment targets to be used in Gamma knife radiosurgery for PD by applying innovative microscale dosimetry methodology and 3D printed personalized patients phantoms. During the project novel molecular (ncRNA expression), radiological (brain voxel based morphometry) and neuropsychological (quality of life, cognitive functioning) outcome predictors will be analyzed, that would help to formulate recommendations how to increase the efficacy of patients’ selection for surgical procedures and to reduce risk of complications. All the radiological, molecular and clinical findings
will be evaluated comprehensively for the establishment of the most effective PD treatment strategy.
Project funding:
Research Council of Lithuania (RCL), National Research Programme “Healthy Ageing”
Project results:
The main project results are:
1. 13 miRNAs were detected (miR-7, miR-21, miR-29c, miR-30b, miR-93, miR-153, miR-155, miR-181a, miR-195, miR-200a, miR-214, miR-221, miR-331) in serum exosome samples from patients with Parkinson’s disease (PL) treated using different treatment startegies (Gamma knife surgery, Deep brain stimulation, palidotomy, thalamotomy or conservative treatment).
2. Relationships between clinical, functional, psychological health, quality of life and non-coding RNA expression profiles. Associations of miRNAs with PL symptoms such as tremor, dyskinesia, balance, etc. have been found. Relationships between miRNA expression and cognitive parameters such as IQ, mental flexibility, psychomotor and learning speed, duration of attention have also been identified. Found correlations indicated a potential of miRNAs to predict disease progression and to select treatment strategies and therapeutic treatments.
3. The concept of microscale dosimetry of small targets using an individualized patient-specific phantom has been developed and preliminary studies of dose distribution in a small target (Gamma Knife technique) using dose gels have been performed. Modified nPAG-type dose gels were found to be suitable for dose distribution assessment in irradiated target since they provided 0.2 mm spatial and 0.1 Gy dose resolution. Materials having tissue equivalent density were selected for phantom model development and realization via 3D printing.
Recommendations for PL treatment strategies based on a comprehensive assessment of individual radiological molecular and clinical data are provided.
Recommendations for verification of planned patient treatment doses in gamma knife therapy using gel dosimetry are provided.
Period of project implementation: 2020-04-01 - 2021-12-31
Project coordinator: Vilnius University
Project partners: Kaunas University of Technology
