An Investigation of Auditory Processes in Parkinson's Disease: Risk Factors and the Potential Utility of Corrective Hearing Treatments.

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Parkinson's Disease (PD), the second most pervasive neurodegenerative disorder after Alzheimer's Disease (3), is a multifaceted movement disorder, which currently affects ~137,000 people in the UK (4,5). While we know that PD occurs due to the progressive loss of dopamine neurons in the basal ganglia of the brain (6), we do not know what causes the loss of dopamine neurons to occur. Subsequently, PD is currently incurable (7). Therefore, the management, and identification of potential risk factors associated with PD is of particular clinical importance. PD and dementia, particularly dementia with Lewy bodies, share similar neuropathologies, brain chemistry, and symptoms (8). Importantly, approximately 80% of people with PD are affected by dementia (9). Hearing loss is a potentially modifiable risk factor for dementia, such that even mild hearing loss doubles dementia risk (10). Given the interrelatedness of dementia and PD, it may be that hearing loss is also a potentially modifiable risk factor for PD. While some studies have begun to acknowledge the relatedness of PD and hearing loss, large scale analyses are needed to fully determine whether hearing loss is a risk factor of PD or whether hearing loss is a secondary consequence of impaired sensory processing or medication consumption that occurs over the course of PD progression. Therefore, I propose to conduct a large-scale secondary data analysis, using the UK Biobank, of the relatedness of hearing loss, the diagnosis of PD the severity of Parkinsonian symptomology, anti-Parkinsonian medication consumption, and demographics (e.g. race, sex, and nationality). This analysis will be conducted in collaboration with renowned researchers in the fields of auditory neuroscience (Prof. Plack; ManCAD, SENSE-Cog, C4AR), neurodegeneration (Prof. Crawford; C4AR), and perception (Dr Linkenauger). Health inequalities are disparities in our understanding, and treatment, of health conditions. Although, North African and Ashkenazi Jewish individuals are more likely to develop PD, ethnic minorities are grossly underrepresented in research. Akin to the ESRC objectives, Parkinson's UK has launched an initiative that aims to tackle health inequalities. In line with these objectives, the proposed study will also analyse the influence of demographic characteristics including race, nationality and sex, on (a) the overall occurrence of PD and (b) the relatedness of hearing loss and PD.The proposed fellowship aims to:(i) Disseminate findings with academics: Previous PhD findings, and new findings will be presented at large international conferences and through peer-reviewed publications. (ii) Generate non-academic output: In collaboration with Professor Hedley Emsley, I will organise a research symposium (targeted to individuals working with people with PD). I will also organise a research workshop for individuals with PD. In addition to these workshops, a summary infographic will be developed and shared with workshop/symposium attendees, members of Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire Neuroscience, and the C4AR. (iii) Conduct a large-scale secondary data analysis investigating the relatedness of hearing loss and PD (using the UK Biobank). The results of these exploratory analyses will form the basis of funding applications.(iv) Enhance my research skills and collaborative networks: By completing additional research, I will enhance my data analysis skills and develop new collaborations with experts in the field. These skills and collaborations will allow me to conduct further research in the future. (v) Develop funding applications: During the fellowship, I will develop funding applications: The ESRC New Investigator grant, and the ESRC Secondary Data Analysis Initiative. These grants will investigate the propensity and effects of hearing loss in individuals with both early stage and advanced PD, and the potential utility of treatments to correct hearing loss in PD