{"id":33452,"date":"2011-06-01T12:15:29","date_gmt":"2011-06-01T16:15:29","guid":{"rendered":"http:\/\/parkinson.netfirms.com\/epp_e\/?p=387"},"modified":"2011-06-01T12:15:29","modified_gmt":"2011-06-01T16:15:29","slug":"donald-calne-lecture-individualized-treatment-best-approach-in-parkinsons","status":"publish","type":"post","link":"https:\/\/archiveparkinson.thedev.ca\/fr\/donald-calne-lecture-individualized-treatment-best-approach-in-parkinsons\/","title":{"rendered":"Donald Calne Lecture: Individualized treatment best approach in Parkinson\u2019s"},"content":{"rendered":"

Parkinson\u2019s disease is a complex disease that requires individualized treatment. \u201cNo two people are alike. You have to decide what each person needs and treat accordingly.\u201d That was the over-riding message of the 8th Donald Calne Lecture delivered by Dr. Stanley Fahn, the H. Houston Merritt Professor of Neurology and Director of the Centre for Parkinson\u2019s Disease and Other Movement Disorders at Columbia University in New York.<\/p>\n

Dr. Fahn, who is the Scientific Director of the (American) Parkinson\u2019s Disease Foundation and Past President of the American Academy of Neurology, addressed over 150 attendees at the Donald Calne Lecture on Tuesday, June 7th in Toronto at the Hyatt Regency Toronto Hotel, with his presentation titled, Misperceptions and Mistakes made by patients and doctors in treating Parkinson\u2019s disease<\/strong>. The event was hosted by Parkinson Society Canada and Parkinson Society Central & Northern Ontario.<\/p>\n

Starting with the most common misperception on the part of patients that Sinemet lasts only 5 years or levodopa loses its effectiveness after 5 years<\/em>, Dr. Fahn noted, \u201cLevodopa never loses its effectiveness. What happens is that Parkinson\u2019s disease worsens over time. The early-stage symptoms such as tremor, slowness of movement and rigidity are responsive to levodopa. However, the late-onset symptoms such as difficulty with posture, loss of balance and freezing of gait are areas that levodopa doesn\u2019t touch. Levodopa never did treat those symptoms.\u201d<\/p>\n

Dr. Fahn then proceeded to expose a variety of myths and mistakes relating to starting therapy for Parkinson\u2019s \u2013 when to start, when to delay, which drugs are effective and for which age group, whether there are relationships between Parkinson\u2019s medications and disease progression, if and when combining medications is effective \u2013 all the while backing up his assertions with findings from published studies.<\/p>\n

Dr. Fahn also addressed motor complications such as dyskinesias and \u201coff\u201d states in Parkinson\u2019s \u2013 possible causes, susceptibility, strategies for reducing them. With a show of hands from audience members with Parkinson\u2019s, he debunked the notion of many doctors that Dyskinesias are more of a problem for the patient than \u201coff\u201d states<\/em>. He said, \u201cI haven\u2019t yet had a patient who would rather be \u201coff.\u201d They all want to be \u201con\u201d and have the ability to move.\u201d<\/p>\n

In response to an audience question about non-drug therapies for Parkinson\u2019s, Dr. Fahn cited the benefits of exercise and the availability of surgery such as deep brain stimulation (DBS), explaining what it is, when and why it is used. He also discussed the potential of continuous dopaminergic stimulation, using infusion therapies such as DuodopaTM<\/sup>, to pump levodopa directly into the small intestine and deliver it evenly throughout the day, to minimize and\/or prevent motor complications. The intervention is widely used in Europe. It is approved in Canada on the condition that additional clinical trials are carried out to verify benefits. See Medication Info Sheet<\/a> at parkinson.ca.<\/p>\n

Looking ahead, Dr. Fahn anticipated there will be better drugs and better surgical techniques for Parkinson\u2019s. He said, \u201cWe\u2019ve solved most of the motor problems, with surgery and medicines. Now, we have to find ways to solve the intractable problems in Parkinson\u2019s, such as the cognitive decline that comes with age.\u201d He expressed hope that ongoing research into pathogenesis \u2013 understanding the mechanisms underlying neurodegenerative diseases like Parkinson\u2019s \u2013 will unlock the key to understanding why dopamine neurons decline and die in Parkinson\u2019s and provide a basis for finding ways to stop the process.<\/p>\n

Thanks to Abbott Canada and Rx&D who sponsored this year\u2019s Donald Calne Lecture.<\/p>\n

The Donald Calne Lecture was recorded. Look for it online at archiveparkinson.thedev.ca<\/a> by mid-July. Or order a copy, by contacting communications@parkinson.ca<\/a>.<\/p>\n

The Donald Calne Lectureship was established in 2002 to honour Dr. Donald Calne for his outstanding service to the Parkinson\u2019s community as Professor of Neuroscience, University of British Columbia and past chair and long-time member of the Scientific Advisory Board, Parkinson Society Canada. Each year, Parkinson Society Canada awards this lectureship to a distinguished neuroscientist of international reputation, whose work is primarily in the area of Parkinson\u2019s disease.<\/p>\n

\"\"<\/a><\/p>\n

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