MDS Blog

Controversies and Hot Topics in Parkinson's Disease and Movement Disorders

Welcome to the MDS Scientific Issues Committee Blog. This is a forum for visitors to obtain the latest in scientific advances, new developments, and trends in the field of Movement Disorders. Comments are welcome; please return monthly to read about new topics and follow the discussion.


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MDS Blog: Parkinson's Disease or Diseases: Are PD Subtypes Useful in Predicting Disease Progression?

Date: November 2019
Prepared by SIC Member: Alvaro Sanchez-Ferro, MD.
Authors: Eduardo De Pablo-Fernández, MD; Ron Postuma, MD, MSc
Blog Editor: Un Jung Kang, MD

Imagine the following scenario: The first patient of today’s clinic walks into your office and presents with the typical symptoms and signs of Parkinson’s disease. Will this patient progress like the next “textbook” patient exhibiting similar symptoms? 
Go to Discussion

MDS Blog: Sleep Problems in MSA

Date: August 2019
Prepared by SIC Member: Han-Joon Kim, MD, PhD
Authors: Pietro Cortelli, MD, PhD, IRCCS-ISNB, University of Bologna, Italy, and Tetsutaro Ozawa, MD, Department of Neurology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
Blog Editors: Stella M. Papa, MD, and Un Jung Kang

Sleep Problems in MSAThe clinical presentation of multiple system atrophy (MSA) is characterized by progressive autonomic failure, parkinsonism, cerebellar dysfunction, and pyramidal features in various combinations. However, most patients with MSA have sleep problems as well.  Go to Discussion

MDS Blog: Sleep Problems for Seniors

Date: August 2019
Prepared by SIC Member: Han-Joon Kim, MD, PhD
Authors: Pietro Cortelli, MD, PhD, IRCCS-ISNB, University of Bologna, Italy, and Tetsutaro Ozawa, MD, Department of Neurology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
Blog Editors: Stella M. Papa, MD, and Un Jung Kang

Sleep Problems in MSAThe clinical presentation of multiple system atrophy (MSA) is characterized by progressive autonomic failure, parkinsonism, cerebellar dysfunction, and pyramidal features in various combinations. However, most patients with MSA have sleep problems as well.  Go to Discussion

Normal Pressure Hydrocephalus

Date: July 2019
Authors: Alfonso Fasano, MD, PhD, Sokratis Papageorgiou
Commentators: Anthony Lang, OC, MD, FRCPC, and Joachim Krauss, MD
Blog Editor: Stella M. Papa, MD

MDS Blog: Normal Pressure HydrocephalusNormal Pressure Hydrocephalus (NPH) has remained a contested entity since its inception more than 5 decades ago.  Recent articles have added fuel to the controversy surrounding this condition, including the coining of new terms such as “neurodegenerative NPH”.  Go to Discussion 

 

 


MDS Blog: Rehabilitation as a Therapeutic Approach for Dystonia

Date: June 2019
Prepared by SIC Member: Aparna Wagle Shukla, MD
Authors: Amit Batla, MBBS, MD DM, Lynley Bradnam, PhD, and Teresa Kimberley, PhD
Blog Editors: Stella Papa, MD

MDS Blog: Rehabilitation as a Therapeutic Approach for Dystonia. Dystonia is the third most common movement disorder characterized by excessive involuntary muscle contractions leading to abnormal postures and movements. There are various clinical forms of dystonia, and the current available treatments remain mostly symptomatic.  Go to Discussion.

MDS Blog: Nutrition-Based Therapy for Parkinson’s Disease

Date: May 2019

Blog Prepared by SIC Member: Praween Lolekha, MD, MSc
Authors: Maria Stamelou, MD, PhD, FEAN; Xiang Gao, MD, PhD
Blog Editors: Stella Papa, MD, and Un Jung Kang, MD

Nutrition-based therapy for Parkinson’s disease.Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the aging population. Environmental factors are believed to be important in the etiology of PD, and a handful of studies suggest that diet may be such a factor. 

Go to Discussion

Apathy in Parkinson's Disease

Date: April 2019
Prepared by SIC Member: Jau-Shin Lou, MD, PhD, MBA
Authors: Javier Pagonabarraga, MD, PhD; Tanya Harlow, MD; Jau-Shin Lou, MD, PhD, MBA
Blog Editor: Stella M. Papa, MD

Apathy in Parkinson's DiseaseApathy is a common non-motor symptom in Parkinson’s disease (PD), but is often under-recognized. Apathy is defined as a lack of motivation characterized by reduced emotional expression and diminished goal-oriented behavior.  Go to Discussion 

 

 


LRRK2 in Idiopathic Parkinson’s Disease

Date: March 2019
Prepared by SIC Member: Lorraine V. Kalia, MD, PhD
Authors: J. Timothy Greenamyre, MD, PhD; Andrew West, PhD; Connie Marras, MD, PhD
Blog Editor: Stella M. Papa, MD

LRRK in Idiopathic Parkinson's DiseaseAbout 10% of Parkinson’s disease (PD) cases are caused by single gene mutations. Of these, the most common cause of autosomal dominant PD is mutation of Leucine-Rich Repeat Kinase 2 (LRRK2), which accounts for about 3% of PD cases.  Go to Discussion 

Early-stage predictors of Parkinson’s disease evolution – what do we know about REM Sleep Behavior disorder (RBD) and the link to PD?

Date: February 2019
Prepared by SIC member: Susanne A. Schneider, MD
Authors:  Susanne Schneider, MD; Ron Postuma, MD; Daniela Berg, MD
Blog Editor: Stella Papa, MD

Early-stage predictors of Parkinson’s disease evolution – what do we know about REM Sleep Behavior disorder (RBD) and the link to PD?Parkinson’s disease is a neurodegenerative disease with variable clinical presentation - including slowly and more rapidly progressing variants. Go to Discussion

β2-Adrenoreceptor Agonists and Antagonists and Parkinson’s Disease

Date: January 2019
Prepared by SIC member: Connie Marras, MD
Authors:  Lorraine V. Kalia, MD, PhD, FRCPC; Raymond Y. Lo, MD, PhD
Blog Editor: Stella Papa, MD

MDS Blog: β2-adrenoreceptor agonists and antagonists and Parkinson’s diseaseIn 2017, a study by Scherzer and colleagues suggested that β2-adrenoreceptor agonists had the ability to reduce alpha-synuclein levels and to protect against MPTP toxicity.   These findings were accompanied by epidemiological data that found an inverse relationship between β2-adrenoreceptor agonists and PD risk. Go to Discussion

 

Hey Siri, Do I Have Parkinson's?

Date: December 2018
Prepared by SIC member: Álvaro Sanchez-Ferro, MD
Authors:  Alberto Espay, MD, MSc and Walter Maetzler, MD
Blog Editor: Stella Papa, MD

The technological advances of recent times make us wonder whether a question such as –Hey Siri, do I have Parkinson’s– will ever be a real alternative available to the public to diagnose that or other complex neurological diseases. We can certainly respond –not in the short term. Go to Discussion

Pitfalls in the Diagnosis of Multiple System Atrophy

Date: September 2018
Prepared by SIC Member: Han-Joon Kim, MD, PhD
Authors:  Hirohisa Watanabe, MD, PhD and Horacio Kaufmann, MD, FAAN
Blog Editor: Stella M. Papa, MD

Multiple system atrophy (MSA) is a progressive neurodegenerative disorder with a mean survival of 6-10 years. Multiple system atrophy (MSA) is a progressive neurodegenerative disorder with a mean survival of 6-10 years. Early and accurate diagnosis is crucial for patient management and for the development of disease-modifying therapies. 
Go to Discussion 

 

Off Label Prescribing of Disease-Modifying Therapies Under Investigation: Balancing Uncertain Risks and Benefits

Date: June 2018
Prepared by SIC Member: Connie Marras, MD, PhD
Authors: Roger Albin, MD; Samuel A. Frank, MD; Albert Hung, MD; Soania Mathur, MD
Blog Editor: Stella M. Papa, MD
 

Advances in high-throughput drug screening techniques and artificial intelligence technologies (e.g. Benevolent AI or IBM Watson for Drug Discovery) are speeding up the process of drug repurposing.Advances in high-throughput drug screening techniques and artificial intelligence technologies (e.g. Benevolent AI or IBM Watson for Drug Discovery) are speeding up the process of drug repurposing.  Go to Discussion

 

 

Immunotherapies in Parkinson's Disease

Date: February 2017
Authors: Howard E. Gendelman, MD, Martin Ingelsson, Vladimir Kostić, MD, PhD, Leonidas Stefanis, MD, PhD
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

The relationship of the immune system to the pathogenesis of Parkinson’s disease (PD) and in particular to alpha-synuclein (α-syn) has been the focus of intense research efforts over many years.The relationship of the immune system to the pathogenesis of Parkinson’s disease (PD) and in particular to alpha-synuclein (α-syn) has been the focus of intense research efforts over many years.  This relationship has come recently to the forefront of interest of the PD community, as the first clinical trials in PD using immunization strategies against α-syn have commenced.  Go to Discussion.

Genetic Testing for GBA and LRRK2 Mutations

Date: August 2018
Prepared by SIC Member: Roy Alcalay, MD, MS, Columbia University, New York, NY, USA
Authors:  Jill S. Goldman, MS, MPhil, CGC; David K. Simon, MD, PhD; Nir Giladi, MD

Blog Editor: Stella M. Papa, MD

Genetic testing is not a part of the routine evaluation of people with Parkinson’s disease (PD), and is rarely offered in late-onset PD. However, approximately 5% of the PD population of European descent carries either glucocerebrosidase (GBA) or LRRK2 mutations.Genetic testing is not a part of the routine evaluation of people with Parkinson’s disease (PD), and is rarely offered in late-onset PD. However, approximately 5% of the PD population of European descent carries either glucocerebrosidase (GBA) or LRRK2 mutations.  Go to Discussion

 

Biomarkers in Clinical Practice and Research in Parkinson’s Disease

Date: July 2018
Prepared by SIC Member:  Un Jung Kang, MD
Authors: Alice Chen-Plotkin, MD; Jing Zhang, MD, PhD; Brit Mollenhauer, MD
Blog Editor: Stella M. Papa, MD
 

Although clinicians sometimes remark that a diagnosis of Parkinson’s disease (PD) can be made by walking a patient from the waiting room to an examination room, we are often stymied by surprising autopsy findings and other evidences contrary to our clinical impression.Although clinicians sometimes remark that a diagnosis of Parkinson’s disease (PD) can be made by walking a patient from the waiting room to an examination room, we are often stymied by surprising autopsy findings and other evidences contrary to our clinical impression. Go to Discussion

 

Autonomic Issues in Parkinson's Disease

Date: April 2017
Authors: Nestor Galvez-Jimenez, MD, MSc, MHA; Ramon Lugo-Sanchez, MD; Tarannum Khan, MD
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

Recent advances as well as experience accrued when caring for patients with Parkinson’s’ disease (PD) has revealed that autonomic disturbances are an integral component of the evaluation of patients and that their symptoms have often become a source of disability.Recent advances as well as experience accrued when caring for patients with Parkinson’s’ disease (PD) has revealed that autonomic disturbances are an integral component of the evaluation of patients and that their symptoms have often become a source of disability.  Go to Discussion

Dance for Parkinson's Disease

Date: April 2018
Prepared by SIC member: Lorraine V. Kalia, MD, PhD, FRCPC
Authors:  Gammon Earhart, Pt, PhD; Madeleine E. Hackney, PhD; Ron Postuma, MD, MSc; Sarah Robichaud; Susan Fox, MRCP(UK), PhD
Blog Editors: Stella Papa, MD and Un Kang, MD
 

Dance for Parkinson's Disease Dance as a group-based treatment for Parkinson’s disease (PD) incorporates physical exercise, cognitive tasks, sensory experience (music), emotional expression, and social interaction. As such a multidimensional activity, dance has the potential to address many of the challenges faced by patients.
Go to Discussion

Inflammation in Parkinson's Disease

Date: March 2016
Authors: Malú Tansey, MD, David Sulzer, MD, and David Standaert, MD, PhD
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

Understanding the role of inflammation in Parkinson’s disease (PD) has attracted a large amount of interest in recent years.Understanding the role of inflammation in Parkinson’s disease (PD) has attracted a large amount of interest in recent years. Studies have identified various cellular and molecular components of the immune responses that seem to contribute to the pathology associated with α-synuclein accumulation.  Go to Discussion

Recent Advances in Deep Brain Stimulation (DBS) Technology

Date: March 2018
Prepared by SIC member: Aparna Wagle Shukla, MD
Authors: Alfonso Fasano, MD, PhD; Chandan Reddy, MD; Kelly Foote, MD
Blog Editors: Stella Papa, MD and Un Kang, MD

 

Recent Advances in DBS Technology Deep Brain Stimulation (DBS) is a widely used treatment for advanced Parkinson’s disease (PD), essential tremor, and dystonia, and its clinical applications for other debilitating neurological disorders are continuously being explored.
Go to Discussion

Multisensory Hallucinations and Delusions in Parkinson’s Disease

Date: May 2018
Prepared by SIC member: Praween Lolekha, MD, MSc
Authors:  Joseph H. Friedman, MD; Gregory Pontone, MD; Jorge L. Juncos, MD
Blog Editors: Stella Papa, MD and Un Kang, MD

 

Hallucinations and delusions are common in Parkinson’s disease (PD) whether or not they are associated with dementia. These psychotic symptoms may cause great concern for patients and caregivers. Hallucinations and delusions are common in Parkinson’s disease (PD) whether or not they are associated with dementia. These psychotic symptoms may cause great concern for patients and caregivers.
Go to Discussion

MRI-Guided Focused Ultrasound (FUS) to Treat Movement Disorders

Date: November 2018
Prepared by SIC Member: Hideki Mochizuki, MD, PhD
Authors: Takaomi Taira, MD, PhD; Andres M. Lozano, MD, PhD; José A. Obeso, MD, PhD CINAC
Blog Editor: Stella Papa, MD
 

MRI-guided focused ultrasound (FUS), which employs ultrasound waves to create a lesion in the brain without surgery has emerged as a new treatment for drug-irresponsive tremor and Parkinson’s disease.In the past three decades the resurgence of invasive surgical procedures to produce local lesions or apply DBS (Deep brain stimulation) have radically improved the quality of life of many patients with Parkinson’s disease, tremor and other movement disorders. Recently, MRI-guided focused ultrasound (FUS), which employs ultrasound waves to create a lesion in the brain without surgery has emerged as a new treatment for drug-irresponsive tremor and Parkinson’s disease. Go to Discussion

When Does Social Media, Email and Internet Use Cross the Line to a Psychiatric Disorder?

Date: August 2017
Authors: Francisco Cardoso, MD, PhD, FAAN, and Marc N. Potenza, MD, PhD
Blog Editors: Michael S. Okun, MD, Stella Papa, MD, and Daniel Weintraub, MD
 

Psychiatrists, neurologists and general practitioners commonly encounter patients who excessively use technology. However, our understanding of when the Internet and social media habits cross a line to become a psychiatric disorder remains murky. Psychiatrists, neurologists and general practitioners commonly encounter patients who excessively use technology. However, our understanding of when the Internet and social media habits cross a line to become a psychiatric disorder remains murky.  Go to Discussion

Cannabinoids in Movement Disorders

Date: October 2017
Authors: Nestor Galvez-Jimenez, MD, MSc, MHA; Camilo Garcia, MD; Ramon Rodriguez, MD; Connie Marras, MD
Blog Editor: Stella Papa, MD
 

The use of cannabis for medical disorders is a global issue, whether or not the drug is legalized for general use, only for use in some medical disorders or not legal in any setting.The use of cannabis for medical disorders is a global issue, whether or not the drug is legalized for general use, only for use in some medical disorders or not legal in any setting.  Where not legal, there is black market selling and purchasing and large scale use in many countries.  Go to Discussion

The Relationship Between Diabetes and Parkinson's Disease

Date: January 2018
Editor: Stella M. Papa, MD
Authors: Tom Foltynie, PhD, MRCP; Marios Politis, MD, PhD, FRCP, FEAN; Eduardo Tolosa, MD; and Leonidas Stefanis, MD, PhD
 

Diabetic patient receives treatment. Recent studies have highlighted the potential connection between Diabetes Mellitus (DM), a very common condition, and Parkinson’s Disease (PD).  These studies raised a number of questions about the interrelation between these disorders. Go to Discussion

'Feeling the Guts': Controversies About the Role of the Gastrointestinal System in the Development of Parkinson’s Disease

Date: February 2018
Authors: Filip Scheperjans, MD, Glenda Halliday, MD, Álvaro Sánchez-Ferro, MD
Blog Editor: Stella Papa, MD
 

Gastrointestinal systemIn recent years, the importance of non-motor features in Parkinson’s disease (PD) has become increasingly recognized, and one of them that may have a pathophysiologic role is the gastrointestinal dysfunction. Different studies have documented the relevance of the enteric system in PD. Go to Discussion

Fatigue in Parkinson's Disease

Date: December 2017
Authors: Jau-Shin Lou, MD, PhD, MBA; Joseph Friedman, MD; Benzi Kluger, MD; Kelvin Chou, MD
Blog Editor: Stella Papa, MD
 

Fatigue in Parkinson's DiseaseFatigue is one of the most common non-motor symptoms reported in Parkinson’s disease (PD).  Up to 58% of patients with PD report symptoms of fatigue, and a third of patients claim it is their most disabling symptom. Go to Discussion

'Direct to Consumer' Genetic Testing

Date: November 2017
Authors: Prof. Enza Maria Valente, Dr. Scott Roberts, and Prof. Thomas Gasser
Blog Editor: Stella Papa, MD
 

'Direct to Consumer' genetic testing.In the era of digital commerce, it is not surprising to find that even genetic testing can be sold and purchased through the Internet, television, or other marketing channels without any intermediation of health care professionals and without any specific counseling, namely “Direct-To-Consumer Genetic Testing” (DTC-GT). 
Go to Discussion

Do-It-Yourself Transcranial Direct Current Stimulation (DIY tDCS): Is It Safe?

Date: June 2017
Authors: Jau-Shin Lou, MD, PhD, MBA; Robert Chen, MA, MBBChir, MSc, FRCPC; Velijko Dubljevic, PhD, DPhil
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD

 

The scientific literature has shown that tDCS improves memory, math skills, and academic performance in normal subjects and may be beneficial for patients with depression, Alzheimer’s disease and stroke.The scientific literature has shown that tDCS improves memory, math skills, and academic performance in normal subjects and may be beneficial for patients with depression, Alzheimer’s disease and stroke.  Because tDCS is non-invasive, simple and low cost, it has gained significant media attention and public interest.

Go to Discussion

 

 

Psychogenic Movement Disorders in the News and on the Internet

Date: January 2017
Authors: Mark Edwards, MD, Mark Hallett, MD, Susan Jeffrey, Executive Editor, Medscape Neurology
Blog Editors: Susanne A. Schneider, MD, Michael S. Okun, MD, and Stella M. Papa, MD

Online medical news is becoming a go-to for those looking for answers to their health problems.The Internet serves as an incredible source of information. Almost any subject imaginable can be found on search engines. More recently, a plethora of social media tools have been developed and led to a change in our communication. These tools have transformed and morphed into the medical profession.  Go to Discussion

What Do Single Gene Mutations Really Tell Us About What Goes Wrong in Idiopathic PD?

Date: December 2016
Authors: Leonidas Stefanis, MD, PhD; Thomas Gasser, MD; Roger Barker, MBBS, MRCP, PhD
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

MDS Blog: What do single gene mutations really tell us about what goes wrong in idiopathic Parkinson’s disease?Over the last 20 years there has been considerable progress in deciphering the genetic underpinnings of Parkinson’s disease (PD).  This has led to new insights into PD pathogenesis, the generation of new animal models of the disease, the implementation of experimental therapeutics in such models, and, recently, the design and initiation of clinical trials with potentially neuroprotective agents.  Go to Discussion

Cognitive Problems in Parkinson's Disease

Date: March 2017
Author: Beth A. Vernaleo, PhD
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

In 2013, the Parkinson’s Disease Foundation (PDF) launched the Community Choice Research Award (CCRA), designed to advance research in areas that were identified as unmet needs within the PD community. People with Parkinson’s (PWP) and care partners (CP) were asked “what areas of research do you think scientists should be focusing on in order to make an impact in the PD community?”  In 2015, over 300 people from eight countries responded with ideas. Go to Discussion

Role of Physical Therapy and Exercise in Management of Parkinson's Disease

Date: October 2016
Authors: Tanya Simuni, MD, Connie Marras, MD, PhD, and Terry Ellis, PhD, PT, NCS
Blog Editors: Michael S. Okun, MD, and Stella M. Papa, MD
 

There are a growing number of randomized controlled trials and meta-analytic studies supporting the benefits of physical therapy and exercise in the treatment of Parkinson’s disease.Current pharmacological management is incompletely effective at controlling the symptoms of Parkinson’s disease and patients are often seeking complementary approaches.  Exercise is a compelling strategy since recent evidence suggests both physical and cognitive benefits and, relative to many pharmacological therapies, it is inexpensive. Go to Discussion
 

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