Shanghai Parkinson's Study
Condition: Parkinson's Disease
MeSH terms: Parkinson Disease
Study type: Observational

Summary: 
      Background:

        -  Parkinson disease (PD) is the second most prevalent neurodegenerative disease, affecting
           more than 1 percent of the elderly population in the United States and other Western
           countries. Although effective treatments can alleviate symptoms in early PD, no cure or
           treatment slowing disease progression has been identified, and patients will eventually
           develop severe physical and mental disabilities and often die of complications. More
           research is needed on the causes of and appropriate preventive strategies for PD.

        -  The Shanghai Women s Health Study (SWHS) was established 10 years ago by investigators
           from the Vanderbilt University, the Shanghai Cancer Institute (SCI) and the National
           Cancer Institute (NCI) of the US. Their primary aim was to examine several unique
           dietary hypotheses on cancer among Chinese women. Researchers from the National
           Institute of Environmental Health Sciences and SWHS investigators are now interested in
           studying PD patients from SWHS to evaluate biological and environmental factors that may
           have put them at risk for PD.

      Objectives:

        -  To initiate a long-term prospective study on PD in Chinese women from the Shanghai Women
           s Health Study.

        -  To examine a set of biological and environmental factors that may raise or lower risk of
           developing PD.

      Eligibility:

      - All participants of the SWHS cohort are eligible.

      Design:

        -  Researchers will contact self-reported PD cases from the SWHS, confirm (or reject) the
           self-report, and invite them to a clinical examination at a coordinating hospital in
           Shanghai.

        -  Cases that confirm the self-report will be invited to visit the coordinating hospital
           for clinical examinations, including a PD clinical workup, blood and urine collections,
           a cognitive assessment and relevant neuropsychological testing, and an interview on
           additional risk factor exposures that are not available from baseline surveys.

        -  For those who could not participate in the clinical examination, researchers will ask
           for a few details about the diagnosis and treatment history and ask for permission to
           obtain medical records relevant to PD diagnosis from government or hospital agencies.

        -  For self-reported PD cases who are now deceased, researchers will follow a similar
           procedure by asking for consent and help from the next-of-kin.
    

Detailed description: 
      We propose to clinically examine self-reported Parkinson s disease (PD) patients from the
      well established Shanghai Women s Health Study (SWHS) and thus initiate a long-term PD
      research in this unique Chinese women cohort. The SWHS cohort was established in late 1990s
      by Dr. Wei Zheng from Vanderbilt University in collaboration with investigators from the
      Shanghai Cancer Institute (SCI) and the National Cancer Institute (NCI) of the US. Their
      primary aim was to examine several unique dietary hypotheses on cancer among Chinese women.
      From 1996 to 2000, the SWHS successfully recruited 74,942 Chinese women, aged 40 to 70, from
      selected communities in a single district in Shanghai with an overall consent rate of 92%.
      All participants completed a comprehensive baseline survey, 88% donated urine, 76% donated
      blood, and an additional 12% donated buccal cells.1 Follow-up surveys have since been
      conducted biennially with consistent participation rates of 95% or higher. Through the 3rd
      follow-up, the cohort has documented 220 self-reported PD cases and we expect to identify
      another 80 self-reports during the ongoing 4th follow-up survey (2007-2010). We hereby
      propose to clinically examine self-reported PD patients to achieve the following two major
      aims.

      Aim #1: To initiate a long-term prospective study on PD in this unique Chinese women cohort

      Aim #2: To examine the following specific hypotheses among women

        1. <TAB>Higher plasma levels of pro-inflammatory biomarkers predict higher PD risk.

        2. <TAB>Higher plasma uric acid is associated with a lower PD risk

        3. <TAB>Environmental tobacco smoke (ETS) is associated with lower PD risk

             1. Self-reported ETS exposure is associated with a lower PD risk

             2. Higher urine level of cotinine is associated with a lower PD risk

      We hereby propose a prospective study on PD in a unique women-only cohort. The infrastructure
      and the many desirable characteristics of this cohort offer us a rare opportunity for PD
      research in women, particularly on biomarkers. We expect to establish it as a long-term and
      excellent resource for PD research in women in the future. In the short term, we plan to
      examine several promising PD hypotheses that have not been adequately evaluated among women.
      These findings will apply directly to Chinese women and may also have implications for women
      in the West. PD etiological research is under-represented in women. Therefore, research in
      the SPS may not only corroborate findings on women in the west, but also lead to the
      identification of novel risk factors that could be generalizable to Western women.
    

Observational model: Cohort
Time perspective: Prospective
Keywords: Lifestyle; Environment; Neurodegenerative Diseases; Elderly; Public Health; PD; Parkinson Disease