How Breathing Patterns May Help Early Diagnosis of Parkinson’s disease

Parkinson's disease is a complex and often misunderstood neurological condition. It is, in fact, the second most common neurodegenerative disease (after Alzheimer’s disease), affecting about 10 million people worldwide. Parkinson's disease primarily affects movement, leading to tremors, stiffness, slow movement, and balance issues. However, Parkinson's disease may also influence another vital aspect of our health: our breathing patterns. Understanding how these patterns change in individuals with Parkinson’s could open new avenues for diagnosis and treatment. In our study, we found specific breathing alterations in Parkinson’s disease, and hypothesize that these may help early diagnosis in the future.

The Importance of Breathing

Breathing is an automatic function we often take for granted. It involves a complex interplay of muscles and neural pathways that regulate the timing of inhalation and exhalation. We note that the parts of the brain that control breathing are among the first to suffer damage in Parkinson’s disease. This connection led us to hypothesize that people with Parkinson's disease might have altered breathing patterns that could reflect the underlying changes in their health.

The Research Study: Observing Breathing in Action

To explore this idea, we conducted a study involving 28 individuals diagnosed with Parkinson’s disease, primarily at a relatively early stage (mostly H&Y stage II), and 33 healthy individuals who served as a control group. The study participants wore a small electronic device that continuously tracked their nasal airflow over 24 hours (see figure). This device recorded how their breathing changed throughout their daily activities, providing a realistic picture of their daily respiratory patterns.

Key Findings: Breathing Patterns are altered in Parkinson’s Disease

We found that individuals with Parkinson’s disease exhibit significantly different breathing patterns compared to their healthy control group. Specifically, their inhalations tend to be longer and less variable (see figure). In simpler terms, people with Parkinson's disease are taking longer, steadier breaths, while those without the disease have a more dynamic breathing pattern with greater fluctuations in breath rate.

Implications for Diagnosis

Perhaps the most exciting aspect of our research is its potential for diagnosis. We found that by analyzing just 30 minutes of recorded breathing data, we could identify Parkinson’s disease in individuals with an impressive 87% accuracy rate. This means that breathing patterns could serve as a valuable tool for detecting Parkinson's disease early, which is crucial for effectively managing the disease.

Furthermore, we found a correlation between alterations in breathing patterns and the severity of Parkinson’s symptoms, measured by a standardized scale called the MDS-UPDRS (Movement Disorder Society - Unified Parkinson’s Disease Rating Scale). This suggests that breathing patterns could help identify the disease and provide insights into its advancement in a particular individual.

Why This Matters

For those living with Parkinson's disease, early diagnosis and tailored treatments can make a significant difference in quality of life. Recently, there has been remarkable progress toward developing disease-modifying therapies—treatments that can slow or even halt the disease's progression. However, by the time Parkinson's is diagnosed based on clinical motor symptoms,  many dopaminergic neurons in the movement modulating area known as the substantia nigra may already be damaged. Early diagnosis could change this scenario, allowing for interventions before this damage occurs.

Moreover, understanding the links between breathing and neurological health could have broader implications beyond Parkinson’s disease. It might offer insights into other conditions that affect brain function, such as Alzheimer’s disease, paving the way for more comprehensive approaches to treatment and management.

Conclusion: A New Breath of Hope

Our findings imply altered respiratory patterns relatively early in the Parkinson’s cascade. However, for this to be valuable for diagnosis, this remains to be tested in pre-clinical individuals: Can we not only verify Parkinson’s with this method, but rather also predict it. This remains the critically needed continuation of this effort. In turn we would like to end with a speculation: since nasal respiratory patterns are closely linked to brain activity, we propose that it may be worthwhile to explore whether a training program aimed at enhancing the specific breathing patterns we identified—specifically increasing variability—may help delay disease progression.