The PDS Tissue Bank at Imperial aims to help understand what causes Parkinson's and assist in the development of better drug treatments by providing high quality brain tissue to researchers working in the field of Parkinson's and related neurological disorders. The Tissue Bank also aims to enhance the public's awareness of Parkinson's, promote the work of the Tissue Bank and increase the numbers of volunteers who are willing to sign up to the donor scheme. The Tissue Bank also aims to collect the tissue so that it is suitable for all research needs and that it is collected in the most ethical manner.

The Tissue Bank have recently sent out two questionnaires to our prospective donors. The first concerns the medical history, including all drug treatments, acute and chronic conditions and further details relating to dietary, occupational and family background. The second questionnaire, which is to be sent out at regular intervals to those enrolled in our donorship scheme, contains 100 questions which address symptoms that can arise while living with a diagnosis of Parkinson’s. You might wish to know why we are putting more post through your door!

The Biography of the Brain
When a pathologist looks at any tissue sample, be it from the liver, kidney or the brain itself, it is essential a clear and accurate record of the medical history is provided and also, in many contexts, of the wider social background and lifestyle of the individual. For example, for a liver biopsy, it would be of utmost importance to know about alcohol intake and drug exposure as well as the travel history which may involve exposure to infections such as viral hepatitis. In the case of the kidney, a biopsy report will not prove fully helpful without details concerning drug exposure, blood pressure and the Presence of conditions such as rheumatological disorders which are known to involve the kidney. Without this information, the pathologist may be able to give only a vague and incomplete diagnosis and will not know which specialised tests are indicated upon the tissue in question. The nervous system and brain have so much more complexity than organs such as the liver and kidney and chronic disorders such as Parkinson's develop over decades with both genetic and environmental influences. Hence, it is easy to understand why detailed and accurate medical and other biographical facts must accompany each brain at the time of pathological examination and then into the realm of scientific research.

The Devil is in the Detail!
What sort of facts are needed to make a brain donation more important? It would be desirable to have an accurate family history since some genetic influences can increase the risk of having Parkinson's. If we can obtain information from individuals as far back as possible on family members who have had problems with tremor or with movement and memory, then researchers may be able to trace back the specific genetic influences. When we do not have the family history then a brain might be analysed erroneously as a case of 'sporadic' Parkinson's and thus the genetic story will be lost!

Leaping from genes to the environment, we know that certain occupations with chemical exposure and rural living carry a slightly higher risk for Parkinson’s later in life. Smoking seems to be protective (but is not recommended for many other health reasons!) and there may be further risks associated with high blood pressure, diabetes, elevated cholesterol, head injuries a history of depression or anxiety and other factors. Simple facts such as caffeine intake, fruit and vegetable consumption can all prove helpful information for the research scientist.

Since Parkinson’s affects many parts of the nervous system seemingly unrelated health facts can be of great value. For example sleep disorders, smell and taste function and bowel habit (with lifelong constipation implying a higher risk) are all pieces of information that point to involvement of specific areas of the peripheral and central nervous system in Parkinson's. These ‘non-motor’ features of the illness that exist alongside tremor, slowness and stiffness are finally receiving the attention that they deserve for arriving at better treatments and promoting more wide-ranging research that will address what are often very serious and troubling symptoms.

The pathologist and scientist also both need to know about complications of treatment because when these occur they may indicate changes in the brain secondary to the treatment or making the individual more vulnerable to develop complications.