421late-onset AD, suggesting a potentially new way to treat or even prevent the disease
(Dreses- Werringloer et al. 2008 ). Genome-wide scans have been used to screen
the brain’s connectivity pattern and the SPON1 variant at rs2618516 on chromo-
some 11 (Jahanshad et al. 2013 ). Older persons who carry the connectivity variant
rs2618516 have signifi cantly milder clinical dementia scores.
Prospects for the Future Management of AD
The New York Genome Center, in collaboration with Illumina, started a project in
2012 to conduct whole genome sequencing (WGS) of 1,000AD patients over a
period of 4 years in order to understand the genetic basis of susceptibility to AD,
which will help to assess an individual’s lifetime risk of developing the disease, and
better defi ne the molecular pathways responsible for neuronal degeneration. This
project is a massive undertaking that involves sequencing 30 billion bases per person
for 1,000 patient samples and then comparing these sequences to those from normal
elderly individuals. Understanding the molecular basis of neuronal degeneration
will enable development of effective strategies for early detection and targeted treat-
ment. Functional genomics, proteomics, pharmacogenomics, high-throughput meth-
ods, combinatorial chemistry and modern bioinformatics will greatly contribute to
accelerate drug development for AD.
Personalized Management of Parkinson Disease
Parkinson’s disease (PD) is characterized by progressive degradation of dopaminer-
gic neurons, which results in both cognitive as well as movement disorders. The
drug most commonly prescribed for PD, levodopa is a precursor of dopamine. With
use of levodopa, a physician titrates dopamine up to an optimal level for movement
and some aspects of cognition. However, the part of the nervous system, which is
relatively normal, is overdosed making the drug perform aberrantly. That is why
some patients react psychotically to levodopa. Knowing the neural bases of these
differential effects will enable clinicians to modify the drug dose, or combine
levodopa with other drugs, to produce the best outcome for individual patients and
avoid such reactions. There is a trend now towards incorporating genetics into clini-
cal studies of therapy for PD to investigate how a person’s genetic make-up infl u-
ences effect of drugs that work by neurochemical intervention.
Genomic Basis of Personalized Approach to Parkinson Disease
Entacapone, a drug used for the treatment of PD, inhibits catechol-O-
methyltransferase (COMT) in a dose-dependent, reversible, and tight-binding man-
ner but does not affect other catechol metabolizing enzymes. It enables the reduction
Personalized Management of Parkinson Disease