An Interview with Dr. Paul Thompson of Enigma-PD: Part 1

This interview contains 2 parts. Continue reading about Enigma-PD in part 2 of this interview with Dr. Paul Thompson.

I recently had the opportunity to sit down and chat with Dr. Paul Thompson, who is the Associate Director of the USC Mark and Mary Stevens Neuroimaging and Informatics Institute.

Dr. Paul Thompson is also a key player of the USC sector of the Enigma-PD program, which is a massive database that collects images of Parkinson’s disease (PD) brains in order to facilitate more in-depth, global research initiatives. This was our conversation.

About the program

Mary Beth: Can you tell me a little bit about the work that you’re doing with Enigma-PD?

Dr. Thompson: Enigma is an international brain study where people compile brain images and clinical data to answer questions. Maybe 12 years ago, people were constantly finding genetic risks for different diseases. There would be variants in the disease that effect the disease.

The first challenge was to see how these genetic differences effect the brain. We formed this alliance. Now it has over 500 sites, and over 2,000 scientists that work together. It was a little bit unusual for brain imaging - this sort of notion that we could work together to do more was what motivated it.

We were funded (the PD branch) to set up a big data center of excellence at centers at USC. We received 12 million dollars to bring groups together at Enigma to study different diseases. There were disorders that would be a little bit of a puzzle.

[We wanted to answer questions like:] can we predict if they’ll do well on a treatment or not? There were a lot of projects from 45 different countries. And anyone at Enigma can come up with a question.

What makes this different

Mary Beth: Has anything been done like this study before?

Dr. Thompson: The closest thing, and it’s a huge landmark study, was PPMI (Parkinson’s Progression Markers Initiative), [for which] data was collected primarily in America. PPMI was launched maybe a decade ago. And again, there are obviously some limits in the breadth of people that can be assessed. I think they’re adding sites.

PPMI would be 1 of the 20 cohorts in Enigma. That was a very useful set of data with scans, genetics, and ongoing clinical assessments. The difference with Enigma Parkinson’s would be this enormous breadth of involvement, as we mentioned Australia, New Zealand, South Africa, China, Taiwan. I think the biggest cohort is from Taiwan. I think they’re contributing 600-700 scans. As you can imagine, with 20 centers collecting several hundred, the overall samples are reaching 10,000.

Enigma studies a number of other disorders that are related to PD, and that sometimes occur at the same time (issues such as depression and anxiety or other types of anxiety). If you have PD you may or may not have signs of Alzheimer’s, dementia, vascular disease.

Some of these processes are refractory and will go away without treatment. You could begin to disentangle the subgroups of patients that might respond better to different treatments [with the help of this data].

It’s a lot faster than doing a random clinical trial. You would still want a randomized trial. But if there were features that were overlooked or someone has a lead to explore, all of these experts could pitch in with their own data.

How to get involved

Mary Beth: Are you currently recruiting patients?

Dr. Thompson: We are. Here’s how to get involved: If you’re a patient or a caregiver, we accept typical brain scan data from any research center. Go to a medical research center. You can usually enroll in a study where you can contribute your scans or primary care of neurologist can [submit them].

If you’re at a center that isn’t currently in ENIGMA-PD, we would be able to use that data as a secondary study. Normally they volunteer for a study that’s going on at their site. But then they could just encourage their neurologist to join in.

Because we work with anonymous data, if there’s some other study we could ask to use your data. Its relatively easy for us to use their brain scans. Nearly all of these sites are still recruiting.