Hereditary Parkinson s Disease Natural History Protocol

The majority of subjects with the degenerative Parkinson's Disease (PD) present in the 7th and 8th decades of life. In contrast, this neurologic disease can present within the first 5 decades of life. This early onset presentation is more likely to have a direct genetic cause relative to the etiology of the degenerative form of the disease. Our understanding of the genetic causes of early onset Parkinson's Disease (EOPD) may help us find therapies for both the genetic and degenerative illnesses. Data from our laboratory and others show that genetic mutations associated with EOPD, disrupt cellular stress-response programs. These perturbations, in turn, impair cell-repair process, which is hypothesized to increase susceptibility to dopaminergic neuron degeneration linked to EOPD and degenerative PD. At the same time, patients with EOPD have a variable age of onset (spanning from 8 years to 41 years in the subjects in our cohort) and disease penetrance (severity of symptoms). The hypothesis we propose to test is whether the number and allele distributions of EOPD susceptibility gene mutations account for the variable age of onset and disease penetrance. This hypothesis will be tested in this natural history protocol by genotyping subjects with EOPD to define their genetic defects and to explore the cellular reparative function in these individuals using peripheral blood cells, skin biopsy derived fibroblasts and induced pluripotential stems cells derived from these subjects. In parallel, the phenotype of these subjects will be evaluated by the NINDS Parkinson's Clinic. Together, these data should advance our insight into the genotype-phenotype in EOPD pathophysiology.