AOS Regional Partners
Taiwan Movement Disorder Society
Contributed by Yih-Ru Wu
Taipei, Taiwan
The Taiwan Movement Disorder Society (TMDS) was officially founded on April 7, 2007. The aim of TMDS is to integrate the neurology in Taiwan, boost the research and education of movement disorders, as well as provide world standard medical care for patients with movement disorders through organization of a patient society in Taiwan. The same effort is also intended to set up the Parkinson's disease medical treatment networks to make comprehensive care for the patients possible. The successful founding of the TMDS should be attributed to the persistent leadership of Dr. Ruey-Meei Wu, the Director of Centre of Parkinson's and Movement Disorder and Professor of National Taiwan University Hospital, alongside a number of senior neurologists in Taiwan. Read Story
"Centre for Parkinson and Movement Disorders" at National Taiwan University Hospital, Taipei, Taiwan
Contributed by Ruey-Meei Wu
Taipei, Taiwan
The centre for Parkinson and Movement disorders at NTUH was inaugurated on 15th December 2007. The mission of the center is to provide the finest quality of care for patients with Parkinson's disease (PD) and Movement disorders in Taiwan by a team work of experts who integrate a comprehensive program for disease management, and a myriad of ancillary services. Services include initial diagnosis, comprehensive evaluation and ongoing treatment management as well as evaluation of complex cases as a second opinion. The patients undergo a complete medical history, physical examination and functional nuclear medicine examination (SPECT and PET study for evaluation of the dopaminergic system), and receive an individualized treatment plan. Depending on the need, patients also have easy access to a special trained PD nurse, a variety of additional services including physical therapy, occupational therapy, swallowing and speech evaluations, surgical treatments(deep brain stimulation) and intraduodenal infusion therapy of levodopa in advanced stage. In 2010, the center had 18,196 outpatient visits with the diagnosis of parkinsonism and other movement disorders. Read Story
The Biannual Movement Disorder Society of Australia Conference
Melbourne, Australia - September 8-10, 2011
Contributed by Victor Fung, Carolyn Sue and David Williams
The Biannual Movement Disorder Society of Australia Conference was held in Melbourne, Australia from September 8-10, 2011 (http://www.mdsaconference.com.au/) and was endorsed by The Movement Disorder Society. Read Story
Deep Brain Stimulation Outreach Program to PD Patients from Laos
Contributed by Roongroj Bhidayasiri and Natlada Limotai
Thailand
Deep brain stimulation (DBS) is accepted as one of the therapeutic options for advanced Parkinson's disease (PD) because of its documented efficacy. Even though DBS has been performed in Europe and United States for several years, it is regarded as innovative in Thailand. Since it was introduced in Thailand during the last decade, this procedure has been limited exclusively to a few university hospitals given a lack of budget allocation and few neurologists and neurosurgeons trained in this procedure. Read Story
5th Annual meeting of Movement Disorder Society of Japan
October 6-8, 2011 Tokyo, Japan
Contributed by Ryosuke Takahashi and Yoshikazu Ugawa
The Movement Disorder Society of Japan (MDSJ) has been established in 2001 and became an affiliated member of MDS in 2009. MDSJ has currently 694 regular members, consisting of neurologists, neurosurgeons and other healthcare professionals. The current President is Professor Sadako Kuno at Kyoto Shijo Hospital and the President-elect, Professor Fumihito Yoshii at Tokai University, will assume office from November, 2011. Read Story
World Parkinson Day
Mumbai, India, April 2011
Contributed by Maria Barretto
Coordinator, PDMDS, Mumbai, India
Parkinson’s Disease & The Movement Disorder Society (PDMDS), an all India 'Registered Charitable Organization', got over 350 people with Parkinson’s (PWP’s) and their families, medical and allied health professionals, philanthropists, students and well-wishers together to celebrate World Parkinson’s Day on the 10th of April, 2011 at the S.P. Jain Auditorium in Mumbai.
The PDMDS was founded 10 years ago by Prof. B.S. Singhal to improve the life of people with Parkinson’s disease. Over the last 10 years the PDMDS has touched the lives of many PWPs. The theme of this year's celebration ‘Let’s Do It Together’ symbolized the ethos of the PDMDS and the belief that through collaboration much is possible. Read Story
Boxing and Parkinsonism: A Link or a Myth?
Bankok, Thailand, February 2011
Contributed by Roongroj Bhidayasiri, MD, FRCP, FRCPI
Chulalongkorn Movement Disorders Centre
Chulalongkorn University Hospital
Bangkok, Thailand
Boxing is often believed to be a frequent cause for parkinsonism caused by chronic repetitive head injury, with Muhammad Ali frequently cited as an example. However, the relationship between head trauma and Parkinson’s disease (PD) is still a subject of debate.
To answer this dilemma, we recently conducted a study to determine the prevalence of PD in retired Thai traditional boxers (Lolekha P, Phanthumchinda K, Bhidayasiri R. Mov Disord 2010;25:1895-901). Among 704 boxers, 8 boxers (1.14%) had parkinsonism: 5 with PD, 1 with progressive supranuclear palsy and 2 with vascular parkinsonism, resulting in age-adjusted to the USA 1970 census of 0.17% (95% CI:0.15-0.20), which is comparable to the general population. Boxers with PD were noted to have an older mean age than those without PD (p=0.003). Further analysis revealed that the number of professional bouts is a risk factor among these boxers, supporting the notion that repetitive head trauma may pose an additional risk factor to certain individuals who are already susceptible to PD.
To explore if PD in boxers is identical to idiopathic PD, we studied three retired professional Thai boxers with PD who fought more than 100 contests with several knockouts with 18F-FDOPA PET and compared their findings with those of sex-, Hoehn & Yahr-, and disease duration-matched controls with idiopathic PD. The Kiref value representing the uptake of 18F-FDOPA was calculated by use of graphical analysis method with data from 15 to 90 min (Patlak method) using occipital cortex as the reference region, and striatal-to-occipital ratio (SOR) with data from 75 to 90 min, which both have been shown suitable detecting striatal changes seen in Parkinson’s disease.
Comparison between the boxers with PD and PD control groups showed that the mean caudate (p=0.22) and putamen (p=0.037) uptake was lower in PD control group. Further comparison yielded a significant difference in the anterior putamen (p=0.046), ipsilateral anterior putamen (p=0.048), and most pronounced in the contralateral posterior putamen group (p=0.021). The mean caudate: putamen Ki ratio was lower in boxers with PD than PD controls (p=0.36). These results suggest that boxers with PD are etiologically distinct from idiopathic PD. However, these boxers probably represent a group of patients who are susceptible to PD but cumulative chronic head trauma from boxing poses an additional risk factor to the boxers who are already at risk (Manuscript in preparation).
Deep Brain Stimulation: A Path to Treat Parkinson's Disease
Bankok, Thailand, February 2011
Contributed by Apichart Pisarnpong, MD
Bangkok Hospital, Bangkok, Thailand
Parkinson's disease (PD) was first described in 1817 by James Parkinson, a British physician, as the "shaking palsy." Research shows that an increasing number of elderly Thais suffer from advanced stages of age-related illnesses, especially neurological disorders. One of the most common neurodegenerative disorders found among elderly people is PD. The disease usually begins at around age 60 to 65, but it can start much earlier. More commonly found in men than in women, the disease is chronic and progressive. Currently, there is no cure for PD despite extensive research.
The risk of having PD increases with age. What exactly triggers PD is not known. However, it is proven that a lack of dopamine in the brain leads to the motor manifestations of PD.
At the beginning, patients experience a combination of at least three motor dysfunctions: 1) tremors of hands, arms, legs, jaw and tongue (found in 70% of patients), 2) bradykinesia or slowness of movement, and 3) rigidity or stiffness of the arms, legs and torso, usually accompanied by pain in various parts of the body. The pain increases as the disease progresses. Symptoms will progress, usually after a period of at least three to five years. In advanced stages, the disease will spread from one side to another, and completely take control of motor stability of both sides of the body.
Although PD is not fatal by itself, complications such as choking, pneumonia, and falls, especially at the advanced stages of the disease, can lead to death.
Studies in the past few decades have led to great improvement in surgical techniques, and surgery is again being used in patients with advanced symptoms. A widely used surgical technique to date is Deep Brain Stimulation or DBS. In Thailand, almost 200 patients received DBS surgery with great results.
Prior to resorting to surgery, physicians will consider drug treatment to directly or indirectly increase the level of dopamine in the brain, to regulate neurotransmitters in the body in order to ease some of the symptoms of the disease, including the non-motor manifestations. Physical therapy is also conducted in conjunction with drug treatment to correct and improve patients’ balance and movement.
As the disease progresses, patients may experience "wearing-off" phenomenon, meaning that the therapeutic window of the medication is getting shorter. In such cases, as well as in advanced stages of PD with complications, we may consider DBS surgery on a case-by-case basis.
Approved by the U.S. Food and Drug Administration, DBS uses an electrode which is surgically implanted into part of the brain. The electrodes are connected by a wire to a pulse generator; a small battery-operated electrical device that is implanted in the chest beneath the collarbone. The pulse generator and electrodes painlessly stimulate the brain in a way that stops many of the symptoms of PD soon after surgery.
The pulse generator can be adjusted or reprogrammed for best results after surgery via remote control. After surgery, doctors will supervise reductions in medication. The number of medical visits usually decreases significantly with time, although patients may occasionally need to return to have their stimulators checked. About 5% of DBS patients are able to stop medications that they have been taking for a long time. Complications such as infection, lead migration, hemorrhage and confusion can occur in about 3% of DBS patients. These side effects are minor and transient, and can be minimized. Most of the DBS patients have improvement in their quality of life in terms of decreased severity of tremor, stiffness and muscle rigidity in almost 70-80%. The reduction of medications results in a decrease in dyskinesia rates. Patients enjoy more “ON” time and less “OFF” time. They gain independence and more freedom to do things on their own.
Patient selection is the key to success for DBS operation. The candidate should have typical PD and good response to medications for at least 5 years, but development of motor complications such as wearing-off and dyskinesia. Patients who have atypical parkinsonism, profound dementia or depression, or bleeding tendency are contraindicated for DBS operation.
World Parkinson Day
Taiwan, April 2010
On April 10, 2010, more than 10 Parkinson’s disease (PD) Patient Groups gathered in Jhongsing Village, Nantou County, to participate in the Walk for Parkinson’s event organized by the Taiwan Movement Disorders Society. Read Story.
Mumbai, April 2010
The Parkinson’s Disease and Movement Disorders Society (PDMDS) was registered in Mumbai in 2001, and organized its first World Parkinson’s Day (WPD) event in 2003. In that year, an international symposium was organized, with 40 international Movement Disorders Experts as faculty, together with Mrs. Mary Baker, the then Chairperson of the WHO workgroup on Parkinson’s disease (PD). Read Story.
Singapore, April 2010
It was a Red Tulip Day on 9 April 2010. The Parkinson’s Disease Society (Singapore) launched a major public awareness programme to celebrate World Parkinson’s Day. About 45 volunteers went out to the seven major hospitals in Singapore to help Singaporeans learn more about Parkinson’s disease (PD) and where to seek help. They set up public education booths on PD, and distributed nearly 2000 Red Tulip collar pins for a small donation. Read Story.
PDMDS Partners With WPC
India, September 2010
Contributed by Maria Barretto
PDMDS Coordinator
The Parkinson’s Disease & Movement Disorder Society (PDMDS) is an all-India 'Registered Charity Society', founded Dr. B.S.Singhal in 2001 with the objective of improving the quality of life of people with Parkinson’s and their caregivers.
The Society hosted the 7th World Parkinson’s Day international symposium in December 2003. The Global Declaration was launched for the first time by Mrs. Mary Baker and the WHO working group on PD at this symposium and signed by prominent industrialists, celebrities and film personalities.
The PDMDS is an organizational partner of the WPC. Dr. Maria Barretto will represent the PDMDS at the Congress. PDMDS will participate in the ‘non medical exhibition’ and showcase the work of the PDMDS through audiovisuals, posters and publications.
Dr. Maria Barretto has two poster presentations in the scientific section. The posters are on the research studies conducted by the PDMDS. The research study ‘Yoga Improves the Quality of Life of Parkinson’s Disease Patients’ examines the efficacy of the ancient Indian science of yoga in improving the quality of life of individuals with Parkinson ’s disease. The second poster is a Qualitative Study and presents "An Analysis of the Needs of Homebound patients with Parkinson’s disease and their caregivers."