Hubert Fernandez, MD

“As the disease progresses, the medication we give 3 times a day only lasts for 1 or 2 hours, not 4 or 5 hours. These patients are then in this limbo state of waiting for their next medication dosing and then they have a good 1 hour of ON time.”

Parkinson disease (PD), like many other neurological disorders, has no cure at the moment. But, progressive advancements in treatments have helped alleviate OFF time and thus boost minimal cognitive impairments. The problems that lie within the disease are very ranged, with individuals experiencing different complications, both motor and non-motor every day.  

Hubert Fernandez, MD, understands that although the cure is the number 1 unmet need, other areas of improvement include treatments for mental issues, balance and other motor fluctuations that are associated with PD. He mentions that falling is a symptom that commonly occurs in patients with PD, but there are no therapies that can assist with the problem.

Fernandez, director of the Center for Neurological Restoration at Cleveland Clinic, sat down with 

 to unveil his top 5 greatest unmet needs for patients with PD. He also detailed some of the non-motor symptoms associated with PD that don’t garner enough attention.

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The director of the Center for Neurological Restoration at Cleveland Clinic describes the greatest unmet needs in Parkinson disease research.

Hubert Fernandez, MD: The Top Concerns for Parkinson Disease

“A decade ago, our clinical trials were to stop the tremor. Now, we’re addressing cognitive impairment, disease progression, and testing more and more devices for advanced stages of Parkinson’s.”

The focus of Parkinson disease (PD) treatment has shifted greatly over the past 2 decades. A disease often characterized by the symptoms that are associated with it, researchers have begun to gain a better understanding of the underlying causes of PD and have ramped up testing agents that can disrupt the cascade of events that lead to the disease.

Hubert Fernandez, MD, director, Center for Neurological Restoration, Cleveland Clinic, claims that researchers have identified gene mutation that is responsible for 5% to 10% of cases of PD. Fernandez told 

 that the continued development of agents that will attack those genes and prevent them from spreading will ultimately act as a cure for PD.

Fernandez also discussed deep brain stimulation (DBS), a procedure that has become safer over the years but is still not widely used, and bears caution for some. In an interview with 

, Fernandez discussed the shift in focus for therapeutic options for patients with PD, as well as the pros and cons for patients who may be eligible for DBS surgery.

The director of the Center for Neurological Restoration at Cleveland Clinic detailed the recent technological and therapeutic innovations and their advantages in treating Parkinson disease.

Hubert Fernandez, MD: Therapeutic Innovations For Parkinson Disease

“While we wait for a cure, we need to do things that can help improve the quality of life. For example, 50% of PD patients are depressed, a quarter of them are anxious and have panic attacks, and 90% of them have constipation.”

Despite the lack of a cure for Parkinson disease (PD), researchers have made significant strides in helping mitigate the effects of the disease and helping to reduce “off” time over the last feew decades. Among a treatment landscape that has been long-dominated by levodopa therapy, other agents such as opicapone (Ongentys; Neurocrine Biosciences) and istradefylline (Nourianz; Kyowa Kirin) have emerged in recent years. Amantadine, which is currently in phase 3 testing, is among the highly anticipated treatment options expected to take the next leap.

Hubert Fernandez, MD, director, Center for Neurological Restoration, Cleveland Clinic, explained to 

 that he feels as though there is an understanding between clinicians that finding a cure would be the “holy grail,” but it won’t come overnight. He added that there is a 2-pronged approach to PD treatment right now, half of which is dedicated towards a cure and slowing disease progression, and the other half is coming up with treatments that can help alleviate quality of life. 

, Fernandez also details the focus of clinical research in PD, the realities of attempting to develop a cure, and the increased attention the PD community has gained over the past 2 decades.

The director of the Center for Neurological Restoration at Cleveland Clinic details the direction of clinical research for Parkinson disease and efforts that are being made to alleviate quality of life issues for those with the disease.

Hubert Fernandez, MD: Focus of Parkinson Disease Research

“We’re still in the midst of a different and persevering pandemic, and I’m not talking about COVID-19. I am talking about Parkinson disease and neurodegenerative disorders in general.”

On July 22, 2020, neurologists and researchers around the world turned their attention to raise awareness for Parkinson disease (PD) on World Brain Day. The movement disorder affects more than 10 million people globally and is associated with direct and indirect health care costs estimated near $52 billion annually in the US alone.

As the director of the Center for Neurological Restoration at Cleveland Clinic, Hubert Fernandez, MD, understands the level of magnitude and impact that PD has on those living with it and their daily function. The treatment landscape has been long dominated by the gold standard of levodopa therapy since the turn of the century, but it has recently seen an increased number of nonpharmacological treatments make their way through the clinical pipeline.

, Fernandez shared his thoughts on what World Brain Day means to him, and why the raised awareness for PD is so important for the clinical community and those with the disease.

The director of the Center for Neurological Restoration at Cleveland Clinic discussed the importance of raising awareness of Parkinson disease on World Brain Day, highlighting the magnitude of the disease.

Hubert Fernandez, MD

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