The Luck of the Irish

This week Dublin Ireland has been the host for the Movement Disorders Society  (MDS) International Congress. Neurologists, Movement Disorders specialists and neuroscientists from all around the globe came together for this annual meeting.  The hallway that I share with the Movement Disorders Center of University Hospital has been quiet this week as Drs David Riley and Ben Walter are across the Atlantic as well.  I look forward to hearing what impressed them from what must have been a jam-packed week..Parkinson's and then more Parkinson's.  

The blog below, from The MJFF website, is an interesting place to start. When you think of PD, I would guess that tremor...or shaking...is what immediately comes to mind...and perhaps "walking funny" would hold a close second. And while yes, most of us deal with tremor and gait issues, what I came to understand during the Q & A at the recent roundtable in Cleveland was that the attention being paid to non-motor symptoms was not only appreciated by the PWP in the audience but was a relief.  Depression, constipation, sleep disorders and hypotension are just some of the non-motor problems that can greatly effect the life of a PWP but don't seem to be talked about as much in comparison.  So to see that The MDS is starting to redefine or should I say re-emphasize what Parkinson's is, brings us to a new level.  The new question is "How does PD effect the whole body?"  This is exciting stuff, if you ask me.  I had several of these non-motor symptoms in my late 30's...a good 10 years before my arm decided to clue me in. 

So let me daydream for a quick minute...Not too far beyond the horizon is a day that looks like this: A 35 yo woman has developed several non-motor symptoms that worry her physician.  A DAT-scan is ordered. She undergoes a lumbar puncture and a diagnosis is confirmed by the presence of a biomarker. With neuro-imaging and bio-specimen confirmation, she is given the approved Parkinson's vaccine.  Life is good. 

I have teased David Riley, Cindy Comella and Hubert Fernandez that they are three of the most optimistic physicians I know.  I have come to realize that much has changed since each were young fellows and indeed they have much to be optimistic about.  And so while it is good that Parkinson's is not contagious, the progress being made by the many researchers in the field, has many physicians and patients humming the same happy tune.

*******************************************************************************

Is Parkinson's Disease Just a Movement Disorder?

Posted by  Nate Herpich, June 21, 2012

Fox Meeting Notes: We report on the latest news in Parkinson's disease research, live from the Movement Disorder Society International Congress in Dublin, Ireland.

Today's morning session focused on a budding topic in the field of Parkinson's disease (PD) research: Is PD even rightly defined as a movement disorder, anymore? Here is the concept at play: By the time a person is diagnosed with Parkinson's, the disease is already well developed - typically an individual has already lost around 80 percent of their dopamine neurons. More and more, research is pointing to the fact that Parkinson's may involve other systems in the body, beyond the central nervous system.

"I am amazed to think how our vision of PD continues to evolve," explains Maurizio Facheris, MD, MSc, associate director of research programs at the Michael J. Fox Foundation (MJFF). "It has now moved way beyond the substantia nigra, even beyond the entire brain itself to include the colon and other systems. We should have no fear to change our perspectives and vision, we will still call it Parkinson's. But we do need to expand our thinking in developing treatments that could possibly target systems in the body that we never expected to target, just years earlier."

Researchers are already starting to take up this call to action. The Movement Disorder Society has formed a working group to be led by MJFF awardee Daniela Berg, MD, and Ron Postuma, MD, with the goal to better redefine PD on the whole, based on new understandings of the pre-motor signs of the disease. And as we wrote in this space last month, the landmark biomarker study the Parkinson's Progression Markers Initiative (PPMI) is pondering expansion into a pre-motor cohort.