Virendra Mishra, PhD

"It is not a very clear picture. In fact, it’s actually quite muddy. We don’t know how it exactly works because it is not the classical Alzheimer disease where most participants will get hippocampal atrophy.”

Virendra Mishra, PhD, was recently tasked with leading a research project that will use biomarkers to develop a predictive mathematical model to identify specific individuals with Parkinson disease (PD) who may develop dementia. Mishra, an associate staff researcher at Cleveland Clinic, claims that dementia affects nearly 50% to 80% of those living with PD within 12 years of diagnosis.

While the prevalence of PD dementia has been documented through research, there still remains no single test—or combination of tests—that conclusively determines if a person has PD dementia. Previous studies have suggested that there is overlap within the hippocampal region, which has provided more knowledge on the similarities between the 2 disorders. Although this has been an area of high observation, Mishra claims there are multiple regions that need to be focused on, in order to accurately predict PD dementia.

, Mishra discussed what has been previously observed in PD dementia, and the areas of concern that still need further examination.

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The Cleveland Clinic researcher discussed the unknowns about Parkinson disease dementia and what has been previously observed in clinical studies.

Virendra Mishra, PhD: Previous Data on Parkinson Disease Dementia

“As a clinician, we would be able tell a participant that you’re on the track to develop this dementia and then maybe come up with ways to manage the disease because the participant is now aware.”

After receiving a $3.8 million grant from the National Institute of Neurological Disorders and Stroke at the National Institutes of Health (NIH), Virendra Mishra, PhD, and his fellow colleagues at Cleveland Clinic are tasked with 

developing a predictive mathematical model

 to identify specific individuals with Parkinson disease (PD) who may develop dementia as their disease progresses. Mishra, an associate staff researcher, will aim to understand how functional brain connectivity and structural brain connectivity differ in dementia in PD, while also identifying the best biomarkers that predict this process.

Despite dementia occurrence rates nearing approximately 50% to 80% of those living with PD, there are still no FDA-approved diagnostic tools that can predict this disorder. If successful, Mishra explained that the predictive model could offer physicians benefits from both a clinical and research standpoint.

, Mishra details that potential impact of the model if it is successful in the study, as well as elucidated the specific benefits that both research and clinical care settings could gain from an operational and effective prediction model.

The Cleveland Clinic researcher described the 2-fold potential use for how his predictive Parkinson disease dementia model may be used pending the success of the study. 

Virendra Mishra, PhD: Predicting Parkinson Disease Dementia

"We want to understand which model is better suited to understand the white matter disorganization that can help predict dementia. That is 1 part of the project. The second part is to understand the connectivity.”

Recently, the National Institutes of Health (NIH) 

, expected to total $3.8 million, to support its project, “Towards Generating a Multimodel and Multivariate Classification Model From Imaging and Non-Imaging Measures for Accurate Diagnosis and Monitoring of Dementia in Parkinson’s Disease.” The program is meant to address the clinical concern that despite high levels of dementia affecting those living with Parkinson disease (PD) later in their disease course, there is still no predictive method available for use.

Virendra Mishra, MD, associate staff, Cleveland Clinic, will be heading the operation that will use biomarkers spanning imaging, blood, cerebrospinal fluid, and genetics to develop a predictive mathematical model to identify specific individuals with PD who may develop dementia as their disease progresses. Mishra hopes the research will lead to a method that can be applied in clinical care with a greater-than-chance success rate to improve patient outcomes.

, Mishra provided full details of his upcoming study, including the aims and goals, and how he and his colleagues plans on creating this predictive model.

The Cleveland Clinic researcher details a study that will use biomarkers to develop a predictive model to identify individuals with Parkinson disease who may develop dementia. 

Virendra Mishra, PhD

Articles

Virendra Mishra, PhD: Previous Data on Parkinson Disease Dementia

Virendra Mishra, PhD: Predicting Parkinson Disease Dementia

Virendra Mishra, PhD: Building a Model to Predict Parkinson Disease Dementia