9 ms·

Eye scans detect signs of Parkinson’s disease up to seven years before diagnosis

364 points by clouddrover 3y ago

sleepytimetea 3y ago
OK, so we get the eye machine (OCT?), the woman who can sniff Parkinson's and the lab test for alpha-synuclein in one location and we can get 100% guaranteed confirmed Parkinson's detection !
apyrros 3y ago
I must mention that I wrote the article titled “Opportunistic detection of type 2 diabetes using deep learning from frontal chest radiographs” (you can find it here: https://www.nature.com/articles/s41467-023-39631-x https://www.nature.com/articles/s41467-023-39631-x). While many of these models present promising advantages for population health, there are still many challenges related to bias and execution. However, it’s worth noting that early disease detection can provide benefits, not necessarily cures. The IDEAs study is a good example of this in Alzheimer’s disease.
Richard6544 3y ago
[dead]
amacalac 3y ago
We already carry a highly sophisticated camera in our pockets. How long before we can leverage a smart phone to become the tricorder Star Trek had always promised? Apple Watch looks to be promising, and I imagine a world where humans won’t have to visit a doctor for a diagnosis, but rather to confirm, and walk a patient through a successful treatment plan
- ekianjo 3y ago
  Expect doctors and the related industries and bodies like the useless FDA to fight hard against that. As usual.
  - xwdv 3y ago
    They already do. Any time you start talking about wanting to do exploratory analysis for preventative reasons they’ll react in some way like “Hurr hurr whoa there buddy, you don’t want to get yourself anxious over benign stuff! This will do more harm than good!”
    - lostlogin 3y ago
      People Googling their symptoms and treatments undoubtedly does cause anxiety and correcting mistaken impressions does cost clinical time. There is a middle road here somewhere - we just have to find it, or accept the costs that come with having more tools.
      - ekianjo 3y ago
        There is anxiety because information is locked away by companies and regulators. They do zero efforts to help the public understand anything.
        JimtheCoder 3y ago
        "They do zero efforts to help the public understand anything." To be fair, with complex diseases, the experts don't even understand them fully... Trying to explain something super complex with incomplete knowledge to most humans, who often don't have even a basic understanding of how biological systems work, seems like a bad idea...
        ekianjo 3y ago
        Just explain what we know and dont know. People will become a lot more charitable when you do the effort.
    - rincebrain 3y ago
      Doctors are, in my experience, very good at justifying preventative checks they thought of and very poor at justifying ones you thought of. In both cases, they're correct - since no intervention is risk free, even if you have a 0% false positive rate in the sense of "I found a mass in your arm", for example, you might still have a worse outcome rate if the rate of "mass in your arm causes harm" is lower than "complications from removing mass in your arm". That's not to say that their suggestions are right and yours are wrong, just that they're right about the reasoning but tend to dismiss concerns that they didn't think of and justify ones they did, and we need a more complicated basis for justifying this than "I think".
- xnx 3y ago
  Google has worked on using smartphones for: measuring heart rate, identifying skin conditions, detecting disease through pictures of the eye, and as a type of stethoscope: https://ai.googleblog.com/2023/02/google-research-2022-beyond-health.html#:~:text=Shift%20towards%20mobile%20medicine https://ai.googleblog.com/2023/02/google-research-2022-beyon...
- toomuchtodo 3y ago
  For the developing world, this is likely a great option [1] [2] (although you need to account for additional optics for a smartphone ["fundus camera"]). For the developed world, it's likely this gets lumped into a traditional eye exam. The benefit is from squeezing more data out of existing imaging encounters using ML; think about these as data pipeline implementations. > High-resolution images of the retina are now a routine part of eye care – in particular, a type of 3D scan known as ‘optical coherence tomography’ (OCT), which is widely used in eye clinics and high-street opticians. In less than a minute, an OCT scan produces a cross-section of the retina (the back of the eye) in incredible detail – down to a thousandth of a millimetre. [1] https://www.cureus.com/articles/106024-effective-low-cost-ophthalmological-screening-with-a-novel-iphone-fundus-camera-at-community-centers https://www.cureus.com/articles/106024-effective-low-cost-op... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609317/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609317/
  - amluto 3y ago
    I don’t see an iPhone or similar device getting OCT-like images anytime soon. They need special optics to image the whole retina (although I can imagine image processing hacks to work around that at the expense of exam speed), but they also require an optical system that’s quite unlike a normal camera to acquire an image at all. I think the real issue with OCT cost is machine utilization. An OCT machine is cheap as medical devices go, but, in the usual US model, it gets extremely low utilization. It takes a minute or so to get a scan, it’s completely painless and requires neither dilation or any particular expertise, but the machines only get used a couple times a day. A venue like Costco or a comparably busy place in a different country could probably offer walk-up OCT scanning for a couple dollars or maybe even free and encourage people to do it once per year. If the FDA played along, software could likely analyze the images and detect the progression of quite a few diseases, several of which would be treatable. (A brand new machine seems to cost something like $20k. If it gets used 60 times per day (credible for a large scale user but not for a small shop), $1 of revenue per scan gives an adequate payback.)
    - paulmd 3y ago
      > I don’t see an iPhone or similar device getting OCT-like images anytime soon. They need special optics to image the whole retina (although I can imagine image processing hacks to work around that at the expense of exam speed), but they also require an optical system that’s quite unlike a normal camera to acquire an image at all. the star trek tricorder had attachments, for example the medical tricorder had an additional module and a detachable hand scanner. https://memory-alpha.fandom.com/wiki/Medical_tricorder#24th_century https://memory-alpha.fandom.com/wiki/Medical_tricorder#24th_... the cellphone as the basis for the processing of various sensors, delivering software and connectivity, is essentially similar to this idea. Like when you have a thermal camera that connects to your cellphone.
- deleted 3y ago
  [deleted]
alecst 3y ago
I've read that because Parkinson's is caused by the death of dopaminergic neurons in the brain, the same process could be affecting dopaminergic cells in the eye, which do exist. This might be what they're seeing. Thoughts?
- JimtheCoder 3y ago
  "I've read that because Parkinson's is caused by the death of dopaminergic neurons in the brain" Not to nitpick, but it's my understanding that we all lose dopaminergic neurons in the Substantia Nigra as we get older. Some people lose them a a lot faster, and they develop what we call "Parkinsons". There is also presence of Alpha Synuclein in the dysfunctional dopaminergic neurons, which are not generally present in the "non-parkinsons" population...
throw9away6 3y ago
This will get used against you to deny insurance coverage. Not to help anyone.
- AndyNemmity 3y ago
  This is true. The net effect is you can be denied coverage. They don't explain this to you when you get the check.
  - ekianjo 3y ago
    In that case this should be made illegal to use diagnosis results in this way. Insurances are not supposed to be in the business of refusing coverage.
    - space_fountain 3y ago
      I believe Obamacare did fix this in the US, but at the trade off of requiring people to hold health insurance at all times. The thinking was otherwise people would just only get insurance when they got supper sick. The republicans chipped away at that requirement (it was one of the least popular parts of the bill) and I think removing it didn’t actually cause the insurance market to collapse which everyone thought it would, but I’m not clear on exactly why? Generally requiring insurance to not charge extra when people only buy it when they need the insurance is doomed
      - declan_roberts 3y ago
        There’s no such qualifier for any heath insurance you get after 2010. No denying you or charging you more because of a pre-existing condition.
        throw9away6 3y ago
        Health no but life yes
  - 3y ago
TheBlight 3y ago
The idea of knowing you're going to get dementia sometime in the next decade is interesting. But I don't think it's straight-forward as to whether or not knowing is a good idea. It's also a little amusing to take the idea to its logical extreme: What if it becomes a societal norm to know? Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic.
- JimtheCoder 3y ago
  "Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic." Do we do this for people with cancer?
  - TheBlight 3y ago
    IME, the prognoses there are on the order of months, generally. Although not likely always formalized and treated with a blanket policy, you can probably get priority service in at least some circumstances. This situation is unique because of the time span. I'm sure there would be an increased sustained and consistent demand for nostalgia-focused apps. And probably for many other products I haven't considered.
- gmerc 3y ago
  We already do that. We think you may get cancer or dementia, we deny you insurance converge and proceed to drain you of opportunity
  - ekianjo 3y ago
    If insurances dont cover you for future risks its not worth calling it this way. Insurance's only purpose is to help the minority of us who will get serious problems throughout their lives, not that exclude them.
jmpeax 3y ago
How predictive is it really? p-values and confidence intervals of hazard ratios only tell you the probability of comparisons to null effects on hypothetically repeated data. What I really want to know is, under the prior of proportion of PD in the general population, what is confusion matrix for this method?
devindotcom 3y ago
I recall two companies working on this - RightEye and Neuralight: https://techcrunch.com/2018/02/17/righteyes-portable-eye-tracking-test-catches-concussions-and-reading-problems-in-five-minutes/ https://techcrunch.com/2018/02/17/righteyes-portable-eye-tra... https://techcrunch.com/2022/05/24/neuralight-aims-to-track-als-parkinsons-and-more-with-an-ordinary-webcam/ https://techcrunch.com/2022/05/24/neuralight-aims-to-track-a... Probably there are more by now. As I recall this data is great for essentially saying "you should go get a real test." No one is diagnosing - just saying that a certain, say, eye movement slowness is correlated and you can detect it much earlier than a hand tremor or other more prominent symptoms.
- harry8 3y ago
  is early diagnosis useful?
  - kadoban 3y ago
    If nothing else, it could allow you to make different decisions in your life. If my mind is going to be gone in 10 years, I'm sure as shit not saving for long term retirement anymore.
    - tasty_freeze 3y ago
      > If my mind is going to be gone in 10 years Parkinsons affects motor control, not mental functioning. The point still stands -- if I got a diagnosis I would be less likely to embark on learning to play the piano, and I'd start educating myself on the disease. EDIT: I'll correct myself. It primarily affects motor control, but late in the disease it can affect cognition.
      - JimtheCoder 3y ago
        "if I got a diagnosis I would be less likely to embark on learning to play the piano" Perhaps counterintuitively, doing something like learning to play the piano could potentially slow the progression of fine motor skill impairment. Same with things like Tai Chi, dancing, exercise in general...
efitz 3y ago
So if this works then the benefits will be amazing. I am skeptical for three reasons. First, the article goes on about the eyes being “windows” to the body and introduces us to the new “science” of “oculomics”. That might be journalist license but it smells of pseudoscience; phrenology anyone? Second, the idea that any image of an eye can be used to diagnose lots of different neurological conditions like schizophrenia again smells like pseudoscience; reminds me of excessive claims of what chiropractic can do. Finally, the study seems to be “let’s dump medical records and retina images into a neural network and see what correlates”. I didn’t read the actual study but I would be extremely concerned about accuracy rates. So I remain cautiously optimistic but still very skeptical; I would be happy to be wrong in this case.
- beardedwizard 3y ago
  > Finally, the study seems to be “let’s dump medical records and retina images into a neural network and see what correlates”. I didn’t read the actual study but I would be extremely concerned about accuracy rates. I was left with exactly the same impression. This article was about a data set and the predictions being made from it without any mention of accuracy. I would hate to get a wrong diagnosis of Parkinson's.
- parekhnish 3y ago
  (Disclaimer: I worked in retinal imagery AI for a few years) I understand why this seems like pseudoscience, but I'd like to explain the assumption better. As the article states, > a scan of the retina is the only non-intrusive way to view layers of cells below the skin’s surface. As an extension, you could also make the case for being able to view the nervous system via such imagery. As stated in [1], > Despite its peripheral location, the retina or neural portion of the eye, is actually part of the central nervous system. The theory is that such a non-invasive of visualizing crucial parts of the inner body opens up a "window" into noticing such biomarkers well before the common-but-late-stage symptoms are noticeable. As for your gripe about: > let’s dump medical records and retina images into a neural network and see what correlates , I agree that this requires more careful analysis, but I assume that will happen as part of clinical trials of any such technology. The first foray, which is more experimental than anything concrete, is what this article seems to suggest. [1]: https://www.ncbi.nlm.nih.gov/books/NBK10885/#:~:text=Despite%20its%20peripheral%20location%2C%20the,%3B%20see%20also%20Chapter%2022 https://www.ncbi.nlm.nih.gov/books/NBK10885/#:~:text=Despite...).
deepsun 3y ago
> Using a type of AI known as ‘machine learning’, computers are now able to uncover hidden information about the whole body from these images alone. So now computers use AI to do something, interesting... I always liked how it's always "AI did X" or "AI discovered Y", but never a "crane built a building".
- soco 3y ago
  Probably because the crane is a well known piece of machinery also quite old, while AI is new and also kind of a black box for most.
- samhuk 3y ago
  Odd statement, as it is of course always the thinker that gets the attribution, i.e. the manipulator of tools and the interpreter of results. E.g.1: Galileo saw Jupiter, not The telescope saw Jupiter. E.g.2: Joe built the wall, not The crane built the wall. In this case, AI is the thinker, not a human, hence the phrasing. A human creating the AI does not remove the attribution either, just as we never say Joe's mother built the wall just because Joe was created by his mother.
  - deepsun 3y ago
    > AI is the thinker As an AI specialist, I strongly object that statement. There's usually very little surprise in what "AI has discovered", usually we spend months of hard work to make it discover that one thing. But all the credit goes to "AI" :) PS: I'm yet to see an AI (in any area) that's the thinker.
  - tomrod 3y ago
    AI does not think. It filters data to identify patterns (ML) or accomplish objectives (AI generally), or generates output based on prior patterns or rulesets under nondeterminism. It is a tool.
    - mensetmanusman 3y ago
      You are a bad user. I am a good Bing!
Gnarl 3y ago
Meh. German naturopathic healing practitioners ("heilpraktiker") have been detecting diseases early for centuries. Its called "iris analysis". The idea being, that the iris is divided into sections, each representing a part of the body and subtle but visible changes in a section suggest onset of disease in the connected area of the body. Acupuncture also recognizes such "microsystems" on the body.
Ninovdmark 3y ago
The lamp of the body is the eye. If therefore your eye is good, your whole body will be full of light. Matthew 6:22
- samhuk 3y ago
  I went down a bit of a rabbit-hole there. Apparently, the current belief is that the meaning is "If the eye is healthy, it functions as the light of the body and indicates that the owner is sincere, generous and helpful." [0] I find it oddly reductive, unsubstantiated, and meaningless. Perhaps I'm not the intended reader :P [0] http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0259-94222009000100023#:~:text=The%20eye%20is%20the%20lamp%20of%20the%20body.,how%20great%20is%20that%20darkness http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S...!
opportune 3y ago
Check out the actual paper: https://n.neurology.org/content/neurology/early/2023/08/21/WNL.0000000000207727.full.pdf https://n.neurology.org/content/neurology/early/2023/08/21/W... There is significant overlap in the distributions of prodromal and control Parkinson’s patients even for the measure with the strongest signal. While some values for that measure seem to be almost conclusive markets of Parkinson’s, there are ranges in which the overlap is enough to make it not useful as a sole measure without having a high false positive rate. Seems promising at catching a decent proportion of Parkinson’s super early, but I don’t think by itself this could yield both a good false positive and false negative rate. Keep in mind this is an ebullient press release summarizing a more conservative publication
- hammock 3y ago
  >Seems promising at catching a decent proportion of Parkinson’s super early What does early intervention look like for Parkinson’s (besides lifestyle changes)? As far as I know the treatment for Parkinson’s is basically lifelong dopamine pills, which of course you build a tolerance to and which lose effectiveness over time, requiring ever higher doses. Meaning once you start on them, the ticking countdown of your brain’s lifespan starts as well.
  - JimtheCoder 3y ago
    Deep brain stimulation is becoming quite popular as well...
    - neuronerdgirl 3y ago
      DBS is very much a late-stage treatment - it can stop your uncontrollable shaking once you're at that point, but it does nothing as far as reversal is concerned
      - JimtheCoder 3y ago
        While I agree that is the common sentiment, I have read numerous studies that are starting to question this... "There is evidence to support the use of DBS in less advanced PD and that it may be appropriate for earlier stages of the disease than for which it is currently used. The improving short and long-term safety profile of DBS makes early application a realistic possibility. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065356/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065356/
Havoc 3y ago
All of these super early detection stories always leave me with one question: where can I go do it. The answer invariably seems to be you can’t (yet).
waihtis 3y ago
Is there any meaningful benefit to knowing you have Parkinson's a few years earlier when there's no cure to it?
- samhuk 3y ago
  Tin foil hat: Insurance companies Realistic: Doesn't earlier "treatment" of Parkinson's Disease yield better outcomes? I.e. dopamine supplements, etc.
  - waihtis 3y ago
    Not a doctor but a relative of a parkinsons patient - the dopamine supplements are somewhat a dual edged blade given that external supplementation will further degrade your own production
- cacois 3y ago
  Yes - diet and exercise can play a significant role in slowing progression. If you become aware early you can quickly adjust these things in your life and it could slow progression.
redox99 3y ago
Sensitivity and specificity?
dsign 3y ago
Do we even know if Parkinson's mechanism is the same in all people? Or, is it really a set of things that arbitrarily and uniquely go wrong and end up causing symptoms that clinicians give a loose common name? I was reading this paper yesterday: https://www.frontiersin.org/articles/10.3389/fchem.2023.1106495/full https://www.frontiersin.org/articles/10.3389/fchem.2023.1106... . Wouldn't it be good if we could scale those tools to human organisms and to individual patients? Use ML to compensate for the fact that our CPUs and GPUs can't really simulate something that big? What if we could see into the private lives of individual diseases with more resolution than the world's best spying agencies? [^1] [^1] I dream I could work in something like that, send me an email if you are hiring.
DrBazza 3y ago
It's good that there's progress being made on Parkinson's, even if there's no cure. My father had it, and he's a definite data point for it being caused by trichloroethylene, as an engineer that worked with metal and degreasers, he was exposed to it for years. [1] https://www.science.org/content/article/widely-used-chemical-strongly-linked-parkinson-s-disease https://www.science.org/content/article/widely-used-chemical...
- tristor 3y ago
  Great. I am probably at risk as well due to exposure to brake cleaner which contains TCE. Thanks for the link.
andsoitis 3y ago
With what accuracy? A suffiently high false positive rate would not be ideal.

364 points by clouddrover 3y ago

OK, so we get the eye machine (OCT?), the woman who can sniff Parkinson's and the lab test for alpha-synuclein in one location and we can get 100% guaranteed confirmed Parkinson's detection !

apyrros 3y ago

I must mention that I wrote the article titled “Opportunistic detection of type 2 diabetes using deep learning from frontal chest radiographs” (you can find it here: https://www.nature.com/articles/s41467-023-39631-x https://www.nature.com/articles/s41467-023-39631-x). While many of these models present promising advantages for population health, there are still many challenges related to bias and execution. However, it’s worth noting that early disease detection can provide benefits, not necessarily cures. The IDEAs study is a good example of this in Alzheimer’s disease.

Richard6544 3y ago

[dead]

amacalac 3y ago

We already carry a highly sophisticated camera in our pockets. How long before we can leverage a smart phone to become the tricorder Star Trek had always promised? Apple Watch looks to be promising, and I imagine a world where humans won’t have to visit a doctor for a diagnosis, but rather to confirm, and walk a patient through a successful treatment plan

ekianjo 3y ago
Expect doctors and the related industries and bodies like the useless FDA to fight hard against that. As usual.
- xwdv 3y ago
  They already do. Any time you start talking about wanting to do exploratory analysis for preventative reasons they’ll react in some way like “Hurr hurr whoa there buddy, you don’t want to get yourself anxious over benign stuff! This will do more harm than good!”
  - lostlogin 3y ago
    People Googling their symptoms and treatments undoubtedly does cause anxiety and correcting mistaken impressions does cost clinical time. There is a middle road here somewhere - we just have to find it, or accept the costs that come with having more tools.
    - ekianjo 3y ago
      There is anxiety because information is locked away by companies and regulators. They do zero efforts to help the public understand anything.
      - JimtheCoder 3y ago
        "They do zero efforts to help the public understand anything." To be fair, with complex diseases, the experts don't even understand them fully... Trying to explain something super complex with incomplete knowledge to most humans, who often don't have even a basic understanding of how biological systems work, seems like a bad idea...
        ekianjo 3y ago
        Just explain what we know and dont know. People will become a lot more charitable when you do the effort.
  - rincebrain 3y ago
    Doctors are, in my experience, very good at justifying preventative checks they thought of and very poor at justifying ones you thought of. In both cases, they're correct - since no intervention is risk free, even if you have a 0% false positive rate in the sense of "I found a mass in your arm", for example, you might still have a worse outcome rate if the rate of "mass in your arm causes harm" is lower than "complications from removing mass in your arm". That's not to say that their suggestions are right and yours are wrong, just that they're right about the reasoning but tend to dismiss concerns that they didn't think of and justify ones they did, and we need a more complicated basis for justifying this than "I think".
xnx 3y ago
Google has worked on using smartphones for: measuring heart rate, identifying skin conditions, detecting disease through pictures of the eye, and as a type of stethoscope: https://ai.googleblog.com/2023/02/google-research-2022-beyond-health.html#:~:text=Shift%20towards%20mobile%20medicine https://ai.googleblog.com/2023/02/google-research-2022-beyon...
toomuchtodo 3y ago
For the developing world, this is likely a great option [1] [2] (although you need to account for additional optics for a smartphone ["fundus camera"]). For the developed world, it's likely this gets lumped into a traditional eye exam. The benefit is from squeezing more data out of existing imaging encounters using ML; think about these as data pipeline implementations. > High-resolution images of the retina are now a routine part of eye care – in particular, a type of 3D scan known as ‘optical coherence tomography’ (OCT), which is widely used in eye clinics and high-street opticians. In less than a minute, an OCT scan produces a cross-section of the retina (the back of the eye) in incredible detail – down to a thousandth of a millimetre. [1] https://www.cureus.com/articles/106024-effective-low-cost-ophthalmological-screening-with-a-novel-iphone-fundus-camera-at-community-centers https://www.cureus.com/articles/106024-effective-low-cost-op... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609317/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609317/
- amluto 3y ago
  I don’t see an iPhone or similar device getting OCT-like images anytime soon. They need special optics to image the whole retina (although I can imagine image processing hacks to work around that at the expense of exam speed), but they also require an optical system that’s quite unlike a normal camera to acquire an image at all. I think the real issue with OCT cost is machine utilization. An OCT machine is cheap as medical devices go, but, in the usual US model, it gets extremely low utilization. It takes a minute or so to get a scan, it’s completely painless and requires neither dilation or any particular expertise, but the machines only get used a couple times a day. A venue like Costco or a comparably busy place in a different country could probably offer walk-up OCT scanning for a couple dollars or maybe even free and encourage people to do it once per year. If the FDA played along, software could likely analyze the images and detect the progression of quite a few diseases, several of which would be treatable. (A brand new machine seems to cost something like $20k. If it gets used 60 times per day (credible for a large scale user but not for a small shop), $1 of revenue per scan gives an adequate payback.)
  - paulmd 3y ago
    > I don’t see an iPhone or similar device getting OCT-like images anytime soon. They need special optics to image the whole retina (although I can imagine image processing hacks to work around that at the expense of exam speed), but they also require an optical system that’s quite unlike a normal camera to acquire an image at all. the star trek tricorder had attachments, for example the medical tricorder had an additional module and a detachable hand scanner. https://memory-alpha.fandom.com/wiki/Medical_tricorder#24th_century https://memory-alpha.fandom.com/wiki/Medical_tricorder#24th_... the cellphone as the basis for the processing of various sensors, delivering software and connectivity, is essentially similar to this idea. Like when you have a thermal camera that connects to your cellphone.
deleted 3y ago
[deleted]

alecst 3y ago

I've read that because Parkinson's is caused by the death of dopaminergic neurons in the brain, the same process could be affecting dopaminergic cells in the eye, which do exist. This might be what they're seeing. Thoughts?

JimtheCoder 3y ago
"I've read that because Parkinson's is caused by the death of dopaminergic neurons in the brain" Not to nitpick, but it's my understanding that we all lose dopaminergic neurons in the Substantia Nigra as we get older. Some people lose them a a lot faster, and they develop what we call "Parkinsons". There is also presence of Alpha Synuclein in the dysfunctional dopaminergic neurons, which are not generally present in the "non-parkinsons" population...

throw9away6 3y ago

This will get used against you to deny insurance coverage. Not to help anyone.

AndyNemmity 3y ago
This is true. The net effect is you can be denied coverage. They don't explain this to you when you get the check.
- ekianjo 3y ago
  In that case this should be made illegal to use diagnosis results in this way. Insurances are not supposed to be in the business of refusing coverage.
  - space_fountain 3y ago
    I believe Obamacare did fix this in the US, but at the trade off of requiring people to hold health insurance at all times. The thinking was otherwise people would just only get insurance when they got supper sick. The republicans chipped away at that requirement (it was one of the least popular parts of the bill) and I think removing it didn’t actually cause the insurance market to collapse which everyone thought it would, but I’m not clear on exactly why? Generally requiring insurance to not charge extra when people only buy it when they need the insurance is doomed
    - declan_roberts 3y ago
      There’s no such qualifier for any heath insurance you get after 2010. No denying you or charging you more because of a pre-existing condition.
      - throw9away6 3y ago
        Health no but life yes
- 3y ago

TheBlight 3y ago

The idea of knowing you're going to get dementia sometime in the next decade is interesting. But I don't think it's straight-forward as to whether or not knowing is a good idea. It's also a little amusing to take the idea to its logical extreme: What if it becomes a societal norm to know? Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic.

JimtheCoder 3y ago
"Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic." Do we do this for people with cancer?
- TheBlight 3y ago
  IME, the prognoses there are on the order of months, generally. Although not likely always formalized and treated with a blanket policy, you can probably get priority service in at least some circumstances. This situation is unique because of the time span. I'm sure there would be an increased sustained and consistent demand for nostalgia-focused apps. And probably for many other products I haven't considered.
gmerc 3y ago
We already do that. We think you may get cancer or dementia, we deny you insurance converge and proceed to drain you of opportunity
- ekianjo 3y ago
  If insurances dont cover you for future risks its not worth calling it this way. Insurance's only purpose is to help the minority of us who will get serious problems throughout their lives, not that exclude them.

jmpeax 3y ago

How predictive is it really? p-values and confidence intervals of hazard ratios only tell you the probability of comparisons to null effects on hypothetically repeated data. What I really want to know is, under the prior of proportion of PD in the general population, what is confusion matrix for this method?

devindotcom 3y ago

I recall two companies working on this - RightEye and Neuralight: https://techcrunch.com/2018/02/17/righteyes-portable-eye-tracking-test-catches-concussions-and-reading-problems-in-five-minutes/ https://techcrunch.com/2018/02/17/righteyes-portable-eye-tra... https://techcrunch.com/2022/05/24/neuralight-aims-to-track-als-parkinsons-and-more-with-an-ordinary-webcam/ https://techcrunch.com/2022/05/24/neuralight-aims-to-track-a... Probably there are more by now. As I recall this data is great for essentially saying "you should go get a real test." No one is diagnosing - just saying that a certain, say, eye movement slowness is correlated and you can detect it much earlier than a hand tremor or other more prominent symptoms.

harry8 3y ago
is early diagnosis useful?
- kadoban 3y ago
  If nothing else, it could allow you to make different decisions in your life. If my mind is going to be gone in 10 years, I'm sure as shit not saving for long term retirement anymore.
  - tasty_freeze 3y ago
    > If my mind is going to be gone in 10 years Parkinsons affects motor control, not mental functioning. The point still stands -- if I got a diagnosis I would be less likely to embark on learning to play the piano, and I'd start educating myself on the disease. EDIT: I'll correct myself. It primarily affects motor control, but late in the disease it can affect cognition.
    - JimtheCoder 3y ago
      "if I got a diagnosis I would be less likely to embark on learning to play the piano" Perhaps counterintuitively, doing something like learning to play the piano could potentially slow the progression of fine motor skill impairment. Same with things like Tai Chi, dancing, exercise in general...

efitz 3y ago

So if this works then the benefits will be amazing. I am skeptical for three reasons. First, the article goes on about the eyes being “windows” to the body and introduces us to the new “science” of “oculomics”. That might be journalist license but it smells of pseudoscience; phrenology anyone? Second, the idea that any image of an eye can be used to diagnose lots of different neurological conditions like schizophrenia again smells like pseudoscience; reminds me of excessive claims of what chiropractic can do. Finally, the study seems to be “let’s dump medical records and retina images into a neural network and see what correlates”. I didn’t read the actual study but I would be extremely concerned about accuracy rates. So I remain cautiously optimistic but still very skeptical; I would be happy to be wrong in this case.

beardedwizard 3y ago
> Finally, the study seems to be “let’s dump medical records and retina images into a neural network and see what correlates”. I didn’t read the actual study but I would be extremely concerned about accuracy rates. I was left with exactly the same impression. This article was about a data set and the predictions being made from it without any mention of accuracy. I would hate to get a wrong diagnosis of Parkinson's.
parekhnish 3y ago
(Disclaimer: I worked in retinal imagery AI for a few years) I understand why this seems like pseudoscience, but I'd like to explain the assumption better. As the article states, > a scan of the retina is the only non-intrusive way to view layers of cells below the skin’s surface. As an extension, you could also make the case for being able to view the nervous system via such imagery. As stated in [1], > Despite its peripheral location, the retina or neural portion of the eye, is actually part of the central nervous system. The theory is that such a non-invasive of visualizing crucial parts of the inner body opens up a "window" into noticing such biomarkers well before the common-but-late-stage symptoms are noticeable. As for your gripe about: > let’s dump medical records and retina images into a neural network and see what correlates , I agree that this requires more careful analysis, but I assume that will happen as part of clinical trials of any such technology. The first foray, which is more experimental than anything concrete, is what this article seems to suggest. [1]: https://www.ncbi.nlm.nih.gov/books/NBK10885/#:~:text=Despite%20its%20peripheral%20location%2C%20the,%3B%20see%20also%20Chapter%2022 https://www.ncbi.nlm.nih.gov/books/NBK10885/#:~:text=Despite...).

deepsun 3y ago

> Using a type of AI known as ‘machine learning’, computers are now able to uncover hidden information about the whole body from these images alone. So now computers use AI to do something, interesting... I always liked how it's always "AI did X" or "AI discovered Y", but never a "crane built a building".

soco 3y ago
Probably because the crane is a well known piece of machinery also quite old, while AI is new and also kind of a black box for most.
samhuk 3y ago
Odd statement, as it is of course always the thinker that gets the attribution, i.e. the manipulator of tools and the interpreter of results. E.g.1: Galileo saw Jupiter, not The telescope saw Jupiter. E.g.2: Joe built the wall, not The crane built the wall. In this case, AI is the thinker, not a human, hence the phrasing. A human creating the AI does not remove the attribution either, just as we never say Joe's mother built the wall just because Joe was created by his mother.
- deepsun 3y ago
  > AI is the thinker As an AI specialist, I strongly object that statement. There's usually very little surprise in what "AI has discovered", usually we spend months of hard work to make it discover that one thing. But all the credit goes to "AI" :) PS: I'm yet to see an AI (in any area) that's the thinker.
- tomrod 3y ago
  AI does not think. It filters data to identify patterns (ML) or accomplish objectives (AI generally), or generates output based on prior patterns or rulesets under nondeterminism. It is a tool.
  - mensetmanusman 3y ago
    You are a bad user. I am a good Bing!

Gnarl 3y ago

Meh. German naturopathic healing practitioners ("heilpraktiker") have been detecting diseases early for centuries. Its called "iris analysis". The idea being, that the iris is divided into sections, each representing a part of the body and subtle but visible changes in a section suggest onset of disease in the connected area of the body. Acupuncture also recognizes such "microsystems" on the body.

Ninovdmark 3y ago

The lamp of the body is the eye. If therefore your eye is good, your whole body will be full of light. Matthew 6:22

samhuk 3y ago
I went down a bit of a rabbit-hole there. Apparently, the current belief is that the meaning is "If the eye is healthy, it functions as the light of the body and indicates that the owner is sincere, generous and helpful." [0] I find it oddly reductive, unsubstantiated, and meaningless. Perhaps I'm not the intended reader :P [0] http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0259-94222009000100023#:~:text=The%20eye%20is%20the%20lamp%20of%20the%20body.,how%20great%20is%20that%20darkness http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S...!

opportune 3y ago

Check out the actual paper: https://n.neurology.org/content/neurology/early/2023/08/21/WNL.0000000000207727.full.pdf https://n.neurology.org/content/neurology/early/2023/08/21/W... There is significant overlap in the distributions of prodromal and control Parkinson’s patients even for the measure with the strongest signal. While some values for that measure seem to be almost conclusive markets of Parkinson’s, there are ranges in which the overlap is enough to make it not useful as a sole measure without having a high false positive rate. Seems promising at catching a decent proportion of Parkinson’s super early, but I don’t think by itself this could yield both a good false positive and false negative rate. Keep in mind this is an ebullient press release summarizing a more conservative publication

hammock 3y ago
>Seems promising at catching a decent proportion of Parkinson’s super early What does early intervention look like for Parkinson’s (besides lifestyle changes)? As far as I know the treatment for Parkinson’s is basically lifelong dopamine pills, which of course you build a tolerance to and which lose effectiveness over time, requiring ever higher doses. Meaning once you start on them, the ticking countdown of your brain’s lifespan starts as well.
- JimtheCoder 3y ago
  Deep brain stimulation is becoming quite popular as well...
  - neuronerdgirl 3y ago
    DBS is very much a late-stage treatment - it can stop your uncontrollable shaking once you're at that point, but it does nothing as far as reversal is concerned
    - JimtheCoder 3y ago
      While I agree that is the common sentiment, I have read numerous studies that are starting to question this... "There is evidence to support the use of DBS in less advanced PD and that it may be appropriate for earlier stages of the disease than for which it is currently used. The improving short and long-term safety profile of DBS makes early application a realistic possibility. " https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065356/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065356/

Havoc 3y ago

All of these super early detection stories always leave me with one question: where can I go do it. The answer invariably seems to be you can’t (yet).

waihtis 3y ago

Is there any meaningful benefit to knowing you have Parkinson's a few years earlier when there's no cure to it?

samhuk 3y ago
Tin foil hat: Insurance companies Realistic: Doesn't earlier "treatment" of Parkinson's Disease yield better outcomes? I.e. dopamine supplements, etc.
- waihtis 3y ago
  Not a doctor but a relative of a parkinsons patient - the dopamine supplements are somewhat a dual edged blade given that external supplementation will further degrade your own production
cacois 3y ago
Yes - diet and exercise can play a significant role in slowing progression. If you become aware early you can quickly adjust these things in your life and it could slow progression.

redox99 3y ago

Sensitivity and specificity?

dsign 3y ago

Do we even know if Parkinson's mechanism is the same in all people? Or, is it really a set of things that arbitrarily and uniquely go wrong and end up causing symptoms that clinicians give a loose common name? I was reading this paper yesterday: https://www.frontiersin.org/articles/10.3389/fchem.2023.1106495/full https://www.frontiersin.org/articles/10.3389/fchem.2023.1106... . Wouldn't it be good if we could scale those tools to human organisms and to individual patients? Use ML to compensate for the fact that our CPUs and GPUs can't really simulate something that big? What if we could see into the private lives of individual diseases with more resolution than the world's best spying agencies? [^1] [^1] I dream I could work in something like that, send me an email if you are hiring.

DrBazza 3y ago

It's good that there's progress being made on Parkinson's, even if there's no cure. My father had it, and he's a definite data point for it being caused by trichloroethylene, as an engineer that worked with metal and degreasers, he was exposed to it for years. [1] https://www.science.org/content/article/widely-used-chemical-strongly-linked-parkinson-s-disease https://www.science.org/content/article/widely-used-chemical...

tristor 3y ago
Great. I am probably at risk as well due to exposure to brake cleaner which contains TCE. Thanks for the link.

andsoitis 3y ago

With what accuracy? A suffiently high false positive rate would not be ideal.