Parkinson disease progresses more slowly in patients who have higher levels of urate, a chemical that at very high level is associated with gout, scientists have found. While it's unknown whether the high levels actually somehow protect patients or simply serve as a marker of protection, the finding supports the idea that patients and doctors may one day be able to better predict the course of the illness. The study, led by scientists at Massachusetts General Hospital and the Harvard School of Public Health and including physicians at the University of Rochester Medical Center, was published online in the Archives of Neurology. The new findings are based on biological samples, primarily blood and cerebrospinal fluid, collected from people with Parkinson disease who participated in a landmark study known as DATATOP, which was conducted two decades ago. DATATOP, conceived and led by Rochester neurologist Ira Shoulson, M.D., is best known for shifting the landscape of neurology clinical research. Shoulson convinced dozens of investigators around the world to work together, pooling their resources to ask questions about potential new treatments for the disease – big questions that could be answered only with participation by hundreds of people with the disease. Beginning in 1987, Shoulson and colleagues studied 800 people with Parkinson disease, looking at whether the drug deprenyl (selegiline), vitamin E, or a combination might slow the progression of the disease. The answer was a definitive "no" for vitamin E, while deprenyl provided patients with some relief.But the scale and scope of the study proved to be useful beyond the specific questions it was designed to answer. The mountain of information collected on the 800 participants over eight years provided one of the great repositories of data about Parkinson disease ever assembled: thousands of blood, urine, and cerebrospinal fluid samples, as well as notes from more than 16,000 physical examinations of patients by doctors and nurses. The data was central to the new study, which was led by Michael A. Schwarzschild, M.D., Ph.D., of Massachusetts General Hospital, and Alberto Ascherio, M.D. of the Harvard School of Public Health, who have been studying a possible role for urate in protecting patients against the effects of Parkinson disease. They found that the disease progressed more slowly in participants with the highest levels of urate than in people with the lowest levels.
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