Parkinson's Insights

EP 41 - The Parkinson Weekly Helpdesk

🎙️ In Episode 41 of Parkinson Weekly, Prof. Bas Bloem opens the Helpdesk once again to answer questions submitted by listeners.In this fourth Helpdesk episode, Bas explores three very different but important topics. He begins with women and Parkinson’s, discussing the menstrual cycle, menopause, hormone replacement therapy and pregnancy, and why women with Parkinson’s may require more individualised approaches to care.He then looks at whether infections, stressful events or even mosquito bites could trigger Parkinson’s, explaining the difference between causing the disease and potentially unmasking symptoms that were already developing.Finally, Bas discusses delayed gastric emptying in Parkinson’s, how it can affect the absorption and reliability of oral medication, signs such as bloating and unpredictable medication response, and some of the approaches that may help manage it.Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

EP 40 - A Faster Way to Find New Treatments for Parkinson’s?

In Episode 40 of Parkinson Weekly, Prof. Bas Bloem explores what he describes as one of the most exciting and encouraging developments in Parkinson’s clinical research: multi-arm, multi-stage (MAMS) clinical trial platforms.As our understanding of the biological processes underlying Parkinson’s disease continues to grow, so too does the number of potential treatments that could target these mechanisms and potentially slow disease progression. The challenge is how to test these promising therapies quickly, efficiently and reliably.Traditional clinical trials can take years, require large numbers of participants and often need a separate placebo group for every treatment being investigated. MAMS platforms offer a different approach, allowing several potential treatments to be tested simultaneously against a shared control group.Crucially, these platforms also incorporate planned interim analyses. Treatments showing little or no evidence of benefit can be stopped early and replaced by new candidates, while those showing promising signals can continue through the trial. The aim is to reduce costs, make better use of participants and, most importantly, identify promising therapies more quickly.Prof. Bloem discusses how this approach has already been successfully used in areas such as cancer and COVID-19, and looks at the growing international movement to bring the same model to neurological diseases.For Parkinson’s disease, he highlights the Edmond J. Safra Accelerating Clinical Trials in Parkinson’s Disease (EJS ACT-PD) platform in the UK, alongside similar initiatives emerging internationally. He also discusses some of the treatments being evaluated through these new trial approaches, including telmisartan, terazosin and UDCA.The episode also considers the challenges involved, from selecting appropriate placebo groups to identifying sensitive biomarkers that can provide an early indication of whether a treatment is working.While these platforms will not change clinical care tomorrow, Prof. Bloem explains why they represent genuine hope for the Parkinson’s community: a smarter, faster and more collaborative way of determining which potential treatments deserve to move forward.Could this new generation of clinical trials help accelerate the search for disease-modifying treatments in Parkinson’s?Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

Moderating the session “When Research Reaches People: Real-World Success Stories” at the National Parkinson’s Advisory Council reminded me that the true measure of scientific progress is not simply discovery or publication, but whether research actually reaches people and changes their lives. Simon Little, MD, PhD, from the University of California, San Francisco, shared the remarkable evolution of deep brain stimulation from treating motor symptoms to adaptive approaches that respond to brain circuit dysfunction, with opportunities to address nonmotor symptoms, sleep, and other challenges. Bill Martin, PhD, formerly of Johnson & Johnson, described the long journey of bringing amyloid PET imaging into clinical practice for Alzheimer’s disease, including the importance of Medicare coverage, overcoming regulatory barriers, and ensuring that diagnostic advances become accessible to patients. Claudio Soto, PhD, from the University of Texas Health Science Center at Houston, highlighted how alpha-synuclein seed amplification assays are transforming our ability to detect Parkinson’s biology earlier, potentially before symptoms emerge, while reminding us that validation and commercial sustainability are essential for translating discoveries into clinical tools. David Vaillancourt, PhD, from the University of Florida, shared the journey of NeuroPacs, an MRI-based diagnostic aid designed to improve differentiation among Parkinson’s disease and related disorders, illustrating how persistence over many years, regulatory engagement, and eventual coverage decisions can determine whether a promising technology reaches the clinic. What resonated most with me across all four presentations was that discovery is only the beginning. We must screen, measure, validate, navigate regulatory pathways, secure coverage, and ultimately deliver innovations to patients. From the early 2000's to 2026, these stories illustrated that translation often takes decades, requiring scientists, clinicians, industry, regulators, payers, and patients to work together. Our responsibility is not simply to fund discovery, but to build and sustain the entire pathway from the laboratory to the person.

What resonates most with me about this important study by McGinley and colleagues in the Journal of Parkinson’s Disease is that surviving a hip fracture and recovering from a hip fracture are two very different things. In this Australian study of 5,553 individuals with hip fractures, including 208 with Parkinson’s disease, researchers found no statistically significant differences in hospital length of stay, ICU admissions, or mortality at 30 days and one year after adjustment for clinical differences. That is encouraging, although the relatively small Parkinson’s cohort warrants caution. However, people with Parkinson’s were approximately twice as likely to be discharged to rehabilitation rather than directly home. Only 10% of those with Parkinson’s returned directly home, compared with 22% without the disease. These findings remind us that the consequences of a fall extend far beyond the broken bone. A hip fracture can threaten independence, mobility, confidence, and quality of life. We need to be much more proactive about bone health, osteoporosis screening, balance training, fall prevention, and Parkinson’s-specific rehabilitation. We also need to ensure that Parkinson’s medications are delivered on time during hospitalization and that patients are mobilized safely and early. My biggest takeaway is that we should not measure success simply by whether someone survives hospitalization. We should measure success by whether we can help them return to the life they were living before the fracture. Prevention matters, but so does the journey home. https://cutt.ly/uyUWuLjo