Parkinson's disease and Lewy body dementia

Our work

Our group aims to understand how dementia happens in Parkinson’s disease and the underlying causes of Lewy body dementia. We do this through combining advanced neuroimaging techniques with measures of clinical severity and abnormal proteins.
Our programme of work includes projects investigating the neural circuits causing visual hallucinations using high-field MRI, as well as understanding contributing factors to dementia in Parkinson’s such as small vessel disease. 
We seek to develop biomarkers of disease that could be applied in clinical trials and in real-world clinical settings. Our ultimate aim is to help to develop treatments to prevent or slow the progression of dementia in Parkinson’s.

Our Team

• Professor Rimona Weil – Professor of Neurology and Honorary Consultant Neurologist at the National Hospital for Neurology and Neurosurgery, Queen Square
• Dr Angelika Zarkali – Senior Clinical Research Fellow and Honorary Consultant Neurologist
• Dr George Thomas – Post-doctoral Research Fellow
• Dr. Sabrina Kalam – Neurology Registrar and Clinical Research Fellow
• Naomi Hannaway – Research Fellow and PhD Student
• Ivelina Dobreva – Research Assistant and PhD Student

Our Research 

Understanding how dementia happens in Parkinson’s

Dementia is common in Parkinson’s, but the underlying processes that cause it are not clear. We are currently running a large study examining brain changes in people with Parkinson’s, and following-up changes over time. The study involves detailed brain imaging, including advanced MRI techniques, and measures that relate to protein changes including PET scans, blood tests and optional lumbar punctures. 

Lewy body dementia

Lewy body dementia is an umbrella term that includes both Parkinson’s dementia and dementia with Lewy bodies. The brain changes that cause these conditions are not fully understood. It is also not clear how different these conditions are. We are running a study involving people with different forms of Lewy body dementia to address these questions. People who take part undergo an MRI brain scan, blood test and thinking and memory tests.

Cerebral small vessel disease and Parkinson's 

Changes in the brain caused by wear and tear relating to blood vessels(small vessel disease) are linked with factors such as high blood pressure and diabetes. These changes can impact the progression of Parkinson's and influence the development of cognitive symptoms.  Using advanced neuroimaging techniques, and markers of protein changes in the blood and spinal fluid, we can better understand the relationship between small vessel disease and Parkinson’s, and work out which people are at higher risk of developing dementia.

Hallucinations in Parkinson’s and Lewy body dementia

Hallucinations are common in both Parkinson’s and Lewy body dementia. They are thought to arise due to an imbalance in the feedback signals in the brain. We are using high-field MRI, which is a stronger form of MRI scanning, to investigate how hallucinations happen in Parkinson’s and Lewy body dementia. This type of scan gives us higher resolution information about the brain, and means that we can test how brain circuits are affected in people who have hallucinations.

Our work is funded by the Wellcome Trust, Rosetrees, Alzheimer's Research UK, Parkinson's UK, The Lewy Body Society, GP2, and University College London Hospitals Biomedical Research Centre. 

Patient and public involvement

We are committed to the involvement of patients and the public at all stages of our research projects.

Increasing access and involvement of underrepresented people into research on Parkinson’s dementia

A large number of groups are underrepresented in research. These include people from different ethnic minorities, such as people from Black African and South Asian communities. It also includes people from lower socio-economic backgrounds and rural areas. 
We are undertaking a research and engagement project that aims to understand the barriers to research participation from these communities; and also to engage people from these communities into our research. Our aim is to understand whether there are differing mechanisms underlying dementia in Parkinson’s in people from different ethnic backgrounds.
 

Patterns of Perception in Parkinson’s (PoP-PD)

Patterns of Perception in Parkinson’s disease (PoP-PD) is a collaborative research engagement project, funded by Wellcome and supported by Parkinson's UK. It aimed to explore fears and concerns associated with discussing dementia within the Parkinson’s community, and to co-produce a pair of information resources to support dialogue and awareness of Parkinson’s dementia and improve care and support. It was delivered in collaboration with people living with Parkinson’s, healthcare professionals, researchers, engagement specialists, Parkinson’s UK, and artists at Central Saint Martins. The information resources were awarded a prize for "Sharing and Learning" by the Parkinson's Excellence Network, and are available for download from Parkinson's UK at the following links: 

• Thinking and memory changes in Parkinson’s. Designed for people living with Parkinson’s and their families, this information resource provides information and support about Parkinson’s dementia. You can also request print copies of this resource from Parkinson's UK.
• A toolkit for detecting and managing Parkinson’s dementia. Designed for healthcare professionals, this information resource provides practical guidance on the diagnosis and management of Parkinson’s dementia and dispels the idea that there is nothing that can be done about Parkinson’s dementia. Print copies can be requested from Parkinson's UK.