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International Parkinson and Movement Disorder Society
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Presidential Perspective | Congress 2023

September 18, 2023
Series:MDS Congress 2023
MDS President Francisco Cardoso shares with Dr. Sara Schaefer his important takeaways from his presidential term and his hopes for the future. 2023 Congress virtual access

2023 Congress virtual access

[00:00:00] Dr. Sara Schaefer: Hello, and welcome to this special edition of the MDS podcast, the official podcast of the International Parkinson and Movement Disorder Society. I'm Sarah Schafer from the Yale School of Medicine, and today I have the pleasure of interviewing Francisco Cardoso, who is the current president of the MDS, and almost past president of the MDS.

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Welcome. Thank you for joining us. 

[00:00:31] Prof. Francisco Cardoso: Thank you so much, Sarah. Yes, you are absolutely right because we're recording this 24 hours before the business meeting of the society, when there will be a transition of the leadership. But I, I have really to make it very clear to those of us who are listening to this podcast that it's always a great fun and pleasure to be part of this program.

So congratulations to you and [00:01:00] to the whole team, and thank you so much for this invitation. 

[00:01:04] Dr. Sara Schaefer: So, as Dr. Cardoso mentioned, we're recording at the MDS Congress in Copenhagen 2023, and this is part of the special series from the Congress. Today we're gonna talk about the presidential perspective on the year to date, and the year upcoming for the society and for the Congress.

So, Dr. Cardoso, we had spoken in the past on previous podcasts about the things that you were excited about working on with the Movement Disorder Society, the visions and goals that you've had as the president, and a lot of that has included outreach with free education worldwide. And with that globalization and diversification of the society. As well as insisting on clinical care, bringing it all back to the patient and balancing that with excellent [00:02:00] basic science collaborations.

So with all of that in mind, can you tell me what you're the most proud of from your presidential run? 

[00:02:08] Prof. Francisco Cardoso: So thanks again. This is a very good question. So let me get started first with this access to education and of course that the the COVID-19 pandemic was a major disaster in all senses. The losses of life, and the economic implications, the impact over the lifestyle of the whole world. But on one hand, I would say if there is a positive aspect of the pandemic that we have learned the role of online Working practices. And that actually includes the providing online educational content. When we compare what we used to offer before the pandemic, and now that most of the [00:03:00] educational programs that we produce are online, it's incredible how much enlarged now is our audience. And, and this enlargement is mostly in areas where access to this material used to be extremely difficult because of economic reasons. As we are talking, now here from Copenhagen. Quite frankly, it's not because of Copenhagen itself, but in general, there are many of our members who cannot afford coming to the International Congress.

And just to give you an example, it was decided by us, and I am very proud of this decision, that the whole content of the Congress is recorded and 15 days after the Congress is finished, this is made available online for free for our members. And as our members from underserved areas, they have free memberships. So we are provided [00:04:00] this whole Congress actually for free. So this is really, to me, a major progress that MDS has achieved as a result of reflecting on the impact of these online activities that we have put in place over this past three or four years. So that's really one important point.

The second point that I'm very proud of is really to somehow focus on clinical Care. And we must make it very clear, make no mistake, that we are not neglecting basic science. Basic science, as the name implies, is somehow the basis of many of the things that we actually do in clinical practice. And we have engaged with our basic scientists members of MDS. But mostly people who are part of MDS, we do have data on that, more than half of them, we are clinicians. 

So the content of [00:05:00] this Congress, and I really have to make mention of my dear colleague and friend Steve Frucht, who is the coordinator of the Scientific Committee of this Congress, who is also a clinician — a very good one, by the way.

So we have designed along with the whole CSPC A Congress which is targeting mostly the unmet needs in clinical care. Just not to make this too long, one of the aspects that I'm very proud of that we have patients participated in this Congress. There are several sessions where very generously, local patients, they are coming to interact with our audience. So this is something that it's highly unusual nowadays in medical congresses, not only movement disorders Congress, but in medical congresses in general. I really believe that these call to action in terms of [00:06:00] improvement of clinical care. This is the legacy that I am most proud of, really.

[00:06:06] Dr. Sara Schaefer: Well, that's an excellent overview. And you do mention the virtual aspect of the Congress. Here we are at the beginning of the Congress, Sunday, and I know it's hard to really speak much about the offerings at the Congress, since most of them have not yet happened. But are there any offerings that you're particularly excited about that our listeners might be able to tune into later when it becomes virtually available?

[00:06:35] Prof. Francisco Cardoso: Yeah, I would start with the sessions involving patients and two of them are of particular interest to clinicians. One of them is the grand rounds. Some of you who are listened to us, maybe familiar with what we mean, but just to briefly describe this: so in the largest auditorium of the convention center, [00:07:00] there will be four Danish patients who will be examined by experts from different corners of the world.

So the audience will be able really to understand and to witness, how these experts, they approach cases, probably cases that have difficult diagnosis. I'm not aware of the diagnosis. But this is really something that, especially for young people, has a high educational value. 

And another activity involving patients are the workshops of botulinum toxins. So there will be International experts along with local doctors who will define muscles to be injected patients with dystonia and tremor. This is also invaluable. This is something very useful for clinicians. So that that's more on a clinical side. 

But in terms of [00:08:00] science, we have received more than 1800 abstracts. And we were able to review all of them. And overall high scientific content. It's interesting that it was a bit unexpected for us. There are many of these abstracts dealing with the impact of artificial intelligence in our field, and some of the best abstracts, they were chosen by the CSPC to be presented as a sort of oral platform, which is something that we didn't use to do in the past.

So this is very nice, in my view, for two reasons. One of them is that it's almost impossible to really read these 1800 or more abstracts during the Congress, and there is a lot going on simultaneously. And second, these selected abstracts, they have been highly curated by [00:09:00] people who are experts in those fields.

So this is something really that I should call the attention of our audience to, to look for when it's available online. 

And finally, there is also a new feature, which is the keynote lecture. We do have the Presidential Lectures to honor our founding fathers, Dr. Stanley Fahn and Dr. David Marsden. But this is something different because we have invited people who do usually basic science, in this case. He's a Danish scientist, Ole Kiehn, someone who works with models of basal ganglia functioning and movement and so on, which is something very basic science. But of course it has strong implications for our field for clinicians. So he is someone who has been awarded really important recognitions, and he will give a plenary talk about his area of interest.

I [00:10:00] would also call the attention of the audience for this particular feature. So those in my view are really the most important Points of the program. But as you have said, there are so many parallel sessions going on that occasionally we'll be surprised by the content of one of them.

So we'll be able really to, to have a clear understanding by the time the Congress is over. 

[00:10:26] Dr. Sara Schaefer: Yeah. And since there are so many wonderful parallel sessions, sometimes it's actually impossible to see all of them. So 

[00:10:33] Prof. Francisco Cardoso: Physically impossible. Really. Yeah. Physically impossible possible. 

[00:10:36] Dr. Sara Schaefer: Yeah. Could you speak a bit to any exciting works in progress that the MDS as a society will be working on over the next year?

[00:10:46] Prof. Francisco Cardoso: I would like really to highlight two particular initiatives. One of them, which is an issue that dovetails with this concern about access to education, [00:11:00] which implies access to care, is to partner with other stakeholders to make sure that we can improve and enhance the access to care, to basic care, as a matter of fact, in the field of movement disorders.

I will give you concrete examples. There are many parts of the world where people with Parkinson's disease, they simply do not have access to levodopa, which is an inexpensive drugs. So it's really necessary to work together to bring together many different partners.

And we are doing this under the leadership of the World Health Organization. In fact, during the Congress, we are holding a meeting, which will bring together foundations, other medical organizations like the World Federation of Neurology, and ourselves as well. So we are counting [00:12:00] on this initiative resulting in improving access to care. 

And I gave the example of levodopa. But if we actually talk about more complex treatments, the situation is even worse. And it's not only an issue that applies to underserved areas, low to middle income countries. We do have data, Sarah, showing that in the most advanced economies, a large proportion of patients, they, for many different reasons, they do not have access to treatments. Levodopa, as I have listed. But if we speak about more sophisticated and complex management options like neurosurgery, infusion therapies, the situation can be quite worrisome. So this is something that MDS has become really recently involved. That's one point.

And, and the other, more in a [00:13:00] theoretical aspect, and this is something I'm very proud of I'm sure you are familiar with all the actions surrounding now the creation or the development of new diagnostic criteria and staging of Parkinson's disease based, not so much on clinical features, as we have been doing traditionally since at least 1817 when Parkinson's described the disease that would receive his name. But the focus of some of these proposals has been biomarkers, which is something that might represent an advancement in the field, but it raises many different questions. So, MDS has stepped into this conversation. 

So we decided Christopher Goetz, who is the chair of the committee doing the oversight of the Congress, Steve Frucht and myself, as a matter of fact, to create one additional [00:14:00] session here in Copenhagen, which will take place tomorrow to discuss these proposals. And we have, as a matter of fact a paper which represents. The MDS stance on these proposals that have been really developed quite recently.

So this is something that might sound a bit esoteric, if I may say so. So detached from the daily concerns of clinicians, but the reality is that there are many, many implications in terms of access to care and so on. This is something that, we had really to get involved because of the pace that these proposals have had.

So I, I'm really very, very proud of this initiative because it was fast and we had really to organize ourselves to answer to this new scenario. 

[00:14:51] Dr. Sara Schaefer: That all sounds like wonderful work and certainly gives me a window into all the things the MDS has a hand in other [00:15:00] than just the educational offerings and the congress.

So I listened back to my interview with Claudia Trenkwalder in 2021 when she was passing the reins to you. And she had mentioned, I asked her for a piece of advice for you as the incoming president, and she said to stay calm and trust your instincts. I wonder if you could give Victor Fung, the incoming president, some of your own advice from your own experiences as president of the MDS?

[00:15:32] Prof. Francisco Cardoso: In my country, we say that if advices were good, people would charge for them. So to provide them for free indicates that not always they can be helpful. But I, I do believe that in this particular context they are quite welcome. I actually received these recommendations from Claudia in a very humble [00:16:00] manner.

 And perhaps it's worth sharing with our listeners that MDS has a very wise and clever way of making the transition of leadership. So when I started two years ago, it was not from day scratch. So I was already being mentored and trained by Claudia during two years as President-elect. So that, that was very, very important really to prepare myself for the challenges that we face in running an organization complex and large and global and diverse as MDS is. And it has happened the same with Victor. So as past president, I made sure that he was part of all the decision making process. So it's a very smooth transition and I am 100% sure that he will deliver what we all, especially our [00:17:00] membership, our patients with movement disorders, they expect.

But in terms of two features advice, I guess, that I would mention, I would say that one of them is the need to be patient, really. Because with a global organization like ours with so many requests, it's necessary really to try to understand where people are coming from when they submit requests to us. So patience is something very, very important. 

And the second issue is to remain committed to clinical care. I do not speak about MDS itself because I, as I have said before, we are a society of clinicians mostly, but I view with great concern a sort of general trend in medicine in general, of people somehow moving away from [00:18:00] the beauty of clinical care. And this is very, very worrisome because by the time that we no longer listen to people and it's really necessary to do that, it's impossible to deliver what they expect from us and what they want from us. And that's what clinicians are for. We are here trying really to improve the lives of these people.

So that, that would be probably the most important piece of advice, or very gentle recommendation that I would make. Let's keep focused on patients, listening to patients. Technology, genetics, biomarkers — they are all very, very important, but they are important as long as they do not lose sight of the final mission that we have, which is really to provide care to people.

[00:18:55] Dr. Sara Schaefer: Wise words. Progress can't really happen when everybody is siloed.[00:19:00] Thank you for joining us today and for giving us your thoughts on the society and I appreciate your time. 

[00:19:08] Prof. Francisco Cardoso: Thank you so much, Sarah. It's always a a pleasure to do that, and congratulations again to you and the whole podcast team for the wonderful job that you have been doing. 

Special thank you to:

Prof. Francisco Cardoso
Past MDS President
Professor of Neurology in the Movement Disorders Unit, Neurology Service,
Internal Medicine Department of the Federal University of Minas Gerais,
Belo Horizonte MG, Brazil

Sara Schaefer, MD 

Yale School of Medicine

New Haven, CT, USA

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