# Biomarkers of cognitive decline in Parkinson's Disease

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2021 · $712,267

## Abstract

PROJECT SUMMARY/ABSTRACT: Biomarkers of Cognitive Decline in Parkinson's Disease
While patients with Lewy body disorders (LBD) share the core feature of deposition of misfolded alpha-synuclein
(aSyn) into neuropathological inclusions, they exhibit pronounced heterogeneity in both initial clinical
phenomenology, as well as in trajectory of outcomes. Specifically, among human patients with aSyn inclusions
in neurons (or neuronal synucleinopathy), some manifest predominantly with cognitive symptoms and dementia
from disease onset – resulting in a clinical diagnosis of dementia with Lewy bodies (DLB). Others manifest
predominantly with motor symptoms – resulting in a clinical diagnosis of Parkinson’s disease (PD). Among PD
patients, most subsequently develop significant cognitive decline and eventual dementia (PD with dementia, or
PDD), while others do not, and the time course to PDD varies widely. The reasons for these differences in
phenomenology among synucleinopathy patients are not well understood. This project aims to define
endophenotypes within the LBD spectrum using objectively-measured biomarker characteristics,
developing predictors of cognitive decline in PD and comparing these molecular signals to those found
in DLB and Alzheimer’s disease (AD) patients. We use both unbiased screening approaches and hypothesis-
driven approaches to develop genetic and biochemical biomarkers in three Aims:
Specific Aim 1: Develop biochemical biomarkers of differential PD cognitive progression. Through
unbiased screening of >1000 plasma proteins in >300 PD patients from multiple cohorts, we have derived a
candidate list of 10 plasma proteins that predict future cognitive decline. We will assay these markers in >1000
additional PD subjects, developing multi-protein classifier panels for accurate prediction of cognitive trajectory.
We will characterize these proteins in comparator groups of DLB and AD patients, as well as neurologically-
normal controls.
Specific Aim 2: Investigate causal influences on cognitive trajectory among LBD patients using
Mendelian randomization. We will use Mendelian randomization (MR) to test the hypotheses that candidate
biochemical biomarkers and AD-related disease processes causally influence cognitive trajectory in LBD. To do
this, we will use as instrumental variables for MR single nucleotide polymorphisms (SNPs) nominated from (1)
their relationships with protein levels of candidate biochemical biomarkers or (2) their genome-wide association
with AD risk. These SNPs may then be developed as genetic biomarkers predicting cognitive trajectory in LBD.
Specific Aim 3: Determine whether biochemical and genetic biomarkers predictive of cognitive decline
differ for PD with vs. without GBA mutations. We propose to use a unique resource in development at the
University of Pennsylvania – the Molecular Integration in Neurological Disease (MIND) Initiative – to compare
biochemical and genetic biomarkers predictive of cognitive decline i...

## Key facts

- **NIH application ID:** 10224754
- **Project number:** 5R01NS115139-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** ALICE S CHEN-PLOTKIN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $712,267
- **Award type:** 5
- **Project period:** 2019-09-19 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10224754

## Citation

> US National Institutes of Health, RePORTER application 10224754, Biomarkers of cognitive decline in Parkinson's Disease (5R01NS115139-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10224754. Licensed CC0.

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