Gender and Hormonal Differences in Parkinson's Disease

描述（由申请人提供）：本申请旨在促进Rachel Saunders-Pullman博士的职业发展，作为激素对帕金森病和其他神经退行性疾病影响研究的临床研究员。在此期间，她将专注于性别差异和激素在帕金森病（PD）发展中的作用。由于激素生理学是复杂的，雌激素化合物可以是致癌的，也可以是有益的，评估雌激素的作用和性别差异以及临床试验的规划需要多学科的知识和培训。候选人已经建立了一个培训计划，重点领域是流行病学，神经科学和神经内分泌学，认知和运动障碍，使用研究，课程，讲座和轮次的综合计划。她的主要赞助商，理查德利普顿博士将监督的方法和候选人的发展，流行病学和认知以及整体培训。共同发起人Susan Bressman博士将提供运动障碍领域的指导。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PD风险和PD临床特征的性别相关差异，以及激素因素是否可以解释这些差异，提出了三项具有不同研究设计的独立研究。这些研究旨在为特定研究问题提供补充答案，并为候选人提供三种主要类型的流行病学研究的实践和指导：1）基于临床的前瞻性研究，研究早期PD的自然史和病程中的性别差异，2）一项药房记录的病例对照研究，以评估外源性雌激素是否降低PD的风险; 3）一项交叉研究，在一项已建立的队列研究中，对性别和内源性激素水平对衰老和临床前帕金森症运动控制措施的作用进行了分段和前瞻性评价。通过培训计划和监督研究的汇总，候选人将成为一名独立的研究人员，为回答激素在神经退行性疾病和运动障碍中的作用问题做好充分准备。

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.