Racial Disparities in Parkinson Disease- Clinical Phenotype, Management and Genetics

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Racial Disparities in Parkinson Disease- Clinical Phenotype, Management and Genetics Project Summary Parkinson disease (PD) is a progressive, disabling neurological disorder. Studies investigating the features of the disease in Black populations are uncommon, with some suggesting that Blacks with PD are more disabled, with greater disease severity, and with different clinical features compared to White PD patients. These health disparities are likely to influence the quality of care for AA with PD. The specific aims of this study are to investigate 1) PD symptoms and signs in Black participants, 2) the management of PD in these participants, and 3) to determine genotype-phenotype relationships. Based on prior studies, the main study hypotheses are that Blacks with PD have more severe motor features, greater impact on their quality of life, less therapeutic options, and dissimilar genetic variation compared to Whites with PD. Aim 1 investigates motor, non-motor, and quality of life scales in 400 Black and 200 White participants recruited at seven different US sites. Aim 2 investigates management in the same participants including medication, non-medication and surgical treatments. As part of this Aim, clinical guidelines will be developed for PD treating clinicians to raise awareness of racial disparities in PD. In collaboration with PD foundations, educational programming will be developed for the Black PD community to improve self-management skills and reduce disparities. In Aim 3, a collaboration with the Global Parkinson’s Genetics Program will be utilized to determine genotype-phenotype relationships in the Black participants. The overall goal of this study is to investigate racial disparities in Blacks with PD by studying key components of the disease and then disseminate the findings to the neurologic and patient community with targeted education and guidance. This study will result in new scientific knowledge with in-depth characterization of racial disparities in PD, and will change clinical practice by raising awareness of differences in the PD clinical phenotype, patient-reported outcomes, and PD recognition and management. The results will also impact public health since recognition of differences in disease manifestations and management in Black patients will improve healthcare delivery and quality of care in this underserved and understudied population.