Parkinson's Insights

EP 35 - “What to do, if even David Marsden would not have a clue”

🎙️ We’re back with Episode 35 of Parkinson Weekly, hosted by Prof. Bas Bloem.Recorded live at the European Academy of Neurology (EAN) Congress in Geneva, this special episode sees Prof. Bas Bloem reflect on his C. David Marsden Award Lecture, entitled “What to do, if even David Marsden would not have a clue”.Prof. Bloem explores how clinicians can approach particularly challenging movement disorder presentations when the diagnosis is far from straightforward. Drawing on the themes of his lecture, he outlines the value of a structured, multistep approach to reaching a clinically based diagnosis, even in the most complex cases.The episode also highlights the importance of developing an eclectic approach to clinical practice. Prof. Bloem discusses the value of identifying your own clinical heroes, learning from the skills and qualities that make them exceptional, and incorporating the best of these into your own clinical repertoire — while combining them with your individual strengths, preferences and abilities.Recorded from EAN 2026 in Geneva, this episode offers a fascinating insight into clinical reasoning, lifelong learning and the art of becoming a better clinician.Tune in now to hear Prof. Bas Bloem share the key lessons from his C. David Marsden Award Lecture.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 34 - Pesticides Callout!

🎙️ We’re back with Episode 34 of Parkinson Weekly, hosted by Prof. Bas Bloem.In Episode 34 of Parkinson Weekly, “Pesticides Callout!”, Prof. Bas Bloem delivers a powerful call to action regarding proposed changes to European pesticide regulations.Prof. Bloem explores concerns surrounding the current omnibus proposal, particularly the possibility that real-world evidence may no longer be considered when assessing the long-term safety of pesticides once they have been approved for market use. Drawing on decades of research into Parkinson’s disease and environmental risk factors, he explains why ongoing scrutiny of pesticides and other chemicals remains essential, especially as new evidence emerges from real-world exposure.The episode examines the limitations of current testing methods, the importance of post-approval monitoring, and recent research linking environmental exposures to an increased risk of neurodegenerative disease. Prof. Bloem also discusses the need to support greener agricultural alternatives and questions proposals that could extend the use of chemicals already identified as harmful to human health.This thought-provoking episode highlights the intersection of environmental policy, public health, and Parkinson’s disease, while urging policymakers to prioritise long-term population health when making regulatory decisions.Tune-in now to hear why Prof. Bloem believes real-world evidence must remain at the heart of efforts to protect future generations from potential environmental contributors to neurodegenerative disease.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.

The academic Parkinson's and movement disorders workforce is at a crossroads. Are we under threat of losing our best clinician-researchers? What does academic medicine mean? Academic medicine refers to health care providers who care for patients while also teaching the next generation and conducting research to improve the future of medicine. Mahajan and colleagues describe in a new paper in Movement Disorders Clinical Practice the current state of the academic movement disorders workforce in the United States and the challenges threatening its future. Key points: - More than half of surveyed academic movement disorders neurologists reported considering leaving their current position or academic medicine during the previous year. - The leading reasons included pressure to see more patients, inadequate salary, poor clinical support and loss of professional autonomy. - The author argues that improving retention will require reducing administrative burden, strengthening research support, investing in faculty development and restoring balance to the missions of patient care, education and research. My take: This paper resonated deeply w/ me. Academic movement disorders has never simply been about generating revenue (term RVUs commonly used). It is about caring for the most complex patients, training future leaders and discovering tomorrow's treatments. If we lose sight of that mission, everyone loses, especially the folks living w/ Parkinson's disease, dystonia, Huntington's disease, Tourette syndrome and many other neurological disorders. Burnout is frequently a systems problem, not an individual problem. Protecting academic medicine means protecting the future of neurology. Here are 4 points that resonated w/ me: 1- We must value teaching, mentoring and discovery just as much as clinical productivity. 2- Administrative burden and inadequate support steal time from patients, research and education. 3- Recruiting and retaining talented academic neurologists will require meaningful investment in wellness, autonomy and career development. 4- As the Parkinson pandemic grows, we cannot afford to lose the next generation of movement disorders specialists.

Can we predict Alzheimer's disease by measuring when biomarkers change, instead of simply measuring how much is there? Biomarkers are measurable biological signals, such as blood proteins or brain imaging findings, that help track disease processes before symptoms become obvious. Pelkmans, Bikou, and Salvadó describe in a new Brain commentary how modeling the timing of biomarker changes may move us closer to predicting an individual's risk of future cognitive decline rather than simply describing where they are today. Key points: - The commentary highlights new work showing that the timing of changes in plasma p-tau217, amyloid PET, tau PET, and cognition may be more informative than simply comparing biomarker levels at one point in time. - Strong coupling between biomarker timing and cognitive decline was observed in the Alzheimer's Disease Neuroimaging Initiative (ADNI), while weaker coupling in the population-based Mayo Clinic Study of Aging suggests aging is influenced by multiple interacting pathologies. - The authors argue that future prediction models should integrate Alzheimer's biomarkers w/ vascular disease, inflammation, α-synuclein, TDP-43, resilience, and other biological factors to better predict who will experience cognitive decline. My take: This commentary captures an important shift in Alzheimer's disease research. We are moving beyond asking whether a biomarker is abnormal and beginning to ask when it becomes abnormal. Timing may ultimately prove just as important as the biomarker itself. The future will likely require integrating multiple biological pathways rather than relying on a single test to predict cognitive decline. Here are 3 points that resonated w/ me: 1- Alzheimer's disease does not unfold the same way in every person, and understanding individual timing may improve prediction and personalize care. 2- Blood biomarkers such as plasma p-tau217 continue to emerge as powerful tools that may help identify disease years before symptoms become disabling. 3- Aging brains frequently contain more than one disease process, so cognitive decline cannot always be explained by Alzheimer's pathology alone.