Yoshikuni Mizuno Lectureship Award

Old problems, new solutions: Harnessing technology and innovation in movement disorders for the decades of the new normal

The Yoshikuni Mizuno Lectureship Award was created to recognize an outstanding scholar and inspiring neuroscientist from the AOS region in the field of Movement Disorders. Therefore, I am particularly honored to have been invited to presented this lectureship award during the 8th AOPMC in Kolkata, India. I am overwhelmed to have received this appreciation for my work from the community who are such an important part of my life, and without whom I would not have been able to achieve what I have.

I was fortunate to have had the opportunity to get to know Prof. Mizuno in 2005 when I returned to Thailand from UCLA to establish the Chulalongkorn Centre of Excellence for Parkinson’s Disease and Related Disorders, the same year that Prof. Mizuno (with Prof. Philip Thompson) established the Asian-Oceanian Section (AOS) of the MDS. His vision was to foster research collaboration and education in Movement Disorders within the region, especially in the field of basic science. I am in debt to Prof. Mizuno for all excellent opportunities he has given me to be involved in his educational activities in the AOS and for introducing me to several prominent colleagues in Japan and the rest of the AOS who have all supported me to get my research started in Thailand and beyond.

My research in Thailand started with the development of a national registry of Parkinson’s disease (PD) in order to understand the epidemiology and challenges of care in the region. This revealed specific risk factors in the area from pesticides and those with chronic traumatic encephalopathy (Thai boxers). With the mismatch of a limited number of neurologists but a growing PD population within the country, I realized that a passive approach of ‘waiting for patients with advanced disease to be referred to us’ was not going to be an optimal strategy to promote better care of movement disorders in Thailand. So, in order to overcome this, we need to investigate and embrace new ways of working.

Technology provides significant advantages for care provision, as patients’ symptoms can be measured quantitatively and remotely, presenting efficient solutions for many of the regional care challenges. With this in mind, several wearable devices are now being developed for tremor, finger dexterity, gait, electronic diary, and nocturnal symptoms for the purposes of improving diagnostic accuracy and monitoring treatments. Further developments have expanded to therapeutic indications, including laser-guided walking sticks, PD gloves for tremor, and PD shoes for freezing of gait, where machine learning has been adopted to improve better prediction and accurate detection of those symptoms. In addition, national implementation of the laser-guided walking stick has demonstrated the cost effectiveness of such technologies for patients and their families. Our next step is to implement a national screening program for PD using digital platforms to identify patients in earlier stages of the disease and at-risk individuals for future preventive trials. Our research is made possible through the ongoing support of several collaborators within the AOS and, most importantly, our patients and their families.

I believe that I made the right decision to return home to Thailand, and am sincerely grateful to have had the opportunity to be part of the MDS-AOS community, which I very much value. It is a true privilege and honor to be the 2023 recipient of the Yoshikuni Mizuno Lectureship Award following many esteemed colleagues, including Nobutaka Hattori (2014), Eng-King Tan (2016), Ruey-Meei Wu (2019), and Ryosuke Takahashi (2021).