Gender and Hormonal Differences in Parkinson's Disease

描述(申请人提供)：本申请针对瑞秋·桑德斯-普尔曼博士的职业发展，她是一名研究荷尔蒙对帕金森氏症和其他神经退行性疾病影响的临床研究员。在这笔赠款期间，她将重点研究性别差异和荷尔蒙在帕金森氏病(PD)发展中的作用。由于激素生理复杂，雌激素化合物既可能致癌，也可能有益，因此评估雌激素和性别差异的作用以及临床试验的规划需要多学科的知识和培训。这位候选人已经构建了一个培训计划，重点是流行病学、神经科学和神经内分泌学、认知和运动障碍方面的培训，使用的是研究、课程、讲座和巡视的综合计划。她的主要赞助人理查德·利普顿博士将监督这些方法以及候选人在流行病学和认知方面的发展，以及整个培训。联合发起人苏珊·布雷斯曼博士将在运动障碍领域提供指导。由Anne Etgen博士、Nanette Santoro博士和Charles Hall博士组成的顾问团队将分别补充神经科学、神经内分泌学和生物统计学方面的专业知识。 为了解决与性别相关的帕金森病风险差异和帕金森病的临床特征，以及荷尔蒙因素是否导致这些差异，提出了三项不同研究设计的独立研究。这些研究旨在为特定的研究问题提供补充答案，并让候选人接触到三种主要类型的流行病学研究：1)基于临床的前瞻性研究，探讨早期帕金森氏症自然病史和病程中的性别差异；2)药房记录的病例对照研究，以评估外源性雌激素是否降低帕金森病的风险；3)在已建立的队列研究中，对性别和内源性激素水平在运动控制措施中在衰老和临床前帕金森氏症中的作用进行横断面和前瞻性评估。通过培训计划和监督研究的汇总，候选人将成为一名独立研究员，为回答有关激素在神经退行性疾病和运动障碍中的作用的问题做好充分准备。

DESCRIPTION (provided by applicant): This application is directed to the career development of Dr. Rachel Saunders-Pullman as a clinical researcher in the study of hormonal effects on Parkinson's Disease and other neurodegenerative disorders. During the period of this grant she will focus on gender differences and the role of hormones in the development of Parkinson's disease (PD). As hormone physiology is complex, and estrogenic compounds can be carcinogenic as well as beneficial, the assessment of the role of estrogen and gender differences and the planning of clinical trials requires multi-disciplinary knowledge and training. The candidate has constructed a training program with areas of emphasis in epidemiology, neuroscience and neuroendocrinology, cognition and movement disorders using an integrated plan of research, coursework, lectures, and rounds. Her primary sponsor, Dr. Richard Lipton will oversee the methods and the candidate's development in epidemiology and cognition as well as the overall training. The co-sponsor, Dr. Susan Bressman will provide guidance in the field of movement disorders. A consultant team of Dr. Anne Etgen, Dr. Nanette Santoro and Dr. Charles Hall will complement with expertise in neuroscience and neuroendocrinology and biostatistics, respectively. In order to address gender related differences in risk of PD and clinical features of PD, and whether hormonal factors account for these differences, three separate studies with differing study designs are proposed. These studies were designed to provide complementary answers to specific research questions and to give the candidate hands-on, mentored exposure to three major types of epidemiologic research 1) a clinic-based prospective study of gender differences in the natural history and disease course in early PD, 2) a case-control study of pharmacy records to assess whether exogenous estrogen decreases the risk of PD and 3) a cross-sectional and a prospective evaluation of the role of gender and endogenous hormone levels on motor control measures in aging and pre-clinical parkinsonism in an established cohort study. Through the aggregate of the training program and supervised research, the candidate will emerge as an independent researcher well prepared to answer questions of the role of hormones in neurodegenerative diseases and movement disorders.