Consultant, department of neurology, Mayo Clinic

Rodolfo Savica, MD, PhD

"Even if the patients do not have a complete mutation, the involvement of this particular pathway that is in the membrane of the cells, is relevant to the pathophysiology.”

Parkinson disease (PD) is a progressive disorder that affects nerve cells in the brain responsible for body movement. For reasons not yet understood, the dopamine-producing nerve cells of the substantia nigra begin to die off in some individuals. When dopamine-producing neurons die, symptoms such as tremor, slowness, stiffness, and balance problems occur.

It has been echoed by experts that PD is not just a single disease, but the makeup of a multitude of underlying neurological diseases. Despite this, the treatment options for individuals with PD remain few and far between. Rodolfo Savica, MD, PhD, feels as though researchers should begin to focus on mechanisms of action that are neuroprotective to PD.

Savica, a consultant in the department of neurology at 

 and researcher of early-life predictors of neurodegeneration, sat down with 

to discuss the major mechanisms of action of PD that need expanded research efforts, along with dismissing some of the previous confusions about the genetic makeup of PD.

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The consultant in the Department of Neurology at Mayo Clinic discussed the mechanisms of action researchers should key in on for patients with Parkinson disease.

Expanded Research on Targeting Mechanisms of Parkinson Disease: Rodolfo Savica, MD, PhD

"The mistake we’ve been doing over the years, even in the medication trial and neuroprotective trials, is that we lump everything together. We know that Parkinson disease is not 1 disease. If we are able to identify differences in groups, it’s possible that agents that failed in the past, may be used now.”

Although symptoms of possible Parkinson disease (PD) can be found in very early documents, the first clear medical description was written in 1817 by James Parkinson. The first treatments for PD were based on empirical observation, and anticholinergic drugs were used as early as the nineteenth century. The discovery of dopaminergic deficits in PD and the synthetic pathway of dopamine led to the first human trials of levodopa, a drug that is still considered the standard treatment today.

Since then, the knowledge of PD has grown, but unfortunately there is still no cure. Other medications doctors have prescribed for patients include carbidopa-levodopa infusion, dopamine agonists, MAO B inhibitors, Amantadine, and anticholinergics. According to Rodolfo Savica, MD, PhD, knowledge of the disease has increased the most in the sense that clinicians understand the final pathology of the accumulation of alpha synuclein Lewy bodies.

Savica, consultant in the Department of Neurology at 

, believes that we are on the verge of a revolution that will include a molecular diagnosis of PD, with the ability to identify a subgroup or many subgroups that share similar particular biological and biochemical characteristics. He recently sat down with 

to discuss the areas of PD that clinicians have gained a better understanding for.

Goetz CG. The history of Parkinson disease: early clinical descriptions and neurological therapies. 

Published online September 1, 2011. doi: 10.1101/cshperspect.a008862

The consultant in the Department of Neurology at Mayo Clinic discussed the advancements of Parkinson disease knowledge and treatment over the past 2 decades. 

Growth of Parkinson Disease Knowledge: Rodolfo Savica, MD, PhD

"The patient with Parkinson disease needs to make their neurologist aware, because the old generation of neurologists would look at you, see your tremor or stiffness, prescribe medications, and say, ‘see you later.’ The new wave is making sure that our patients are completely, holistically, totally listened to, and see what the main symptoms are.”

Parkinson disease (PD) has been characterized by both the motor and non-motor complications patients with the disease face on the daily. All persons with PD do not develop the same symptoms, and any symptoms that do develop may change over time as the disease progresses. The primary symptoms most commonly associated with PD are tremor, rigidity or stiffness, slow movement/loss of movement, and balance/walking problems.

Research has identified a number of non-motor symptoms of PD that might be experienced up to 10 years before the motor symptoms appear. They include constipation, loss of olfaction, sleep disorders, pain, seborrhea, fatigue, and depression. Rodolfo Savica, MD, PhD, compares the non-motor symptoms to a surrounding cast of characters in a movie, noting that although they are not the protagonist, they all play a significant role.

, feels as though communication between patients with PD and their neurologist is crucial to try to alleviate the symptoms they are experiencing. He recently sat down with 

to provide an overall background on the multitude of quality of life issues this patient group faces and which research efforts are needed to address these symptoms.

The consultant in the Department of Neurology at Mayo Clinic discussed the mounting number of unmet needs for patients with Parkinson disease.

The Numerous Needs for Parkinson Disease: Rodolfo Savica, MD, PhD

"In Parkinson [disease], we’re dealing with a situation where the most effective drug has been around for 40 years.”

Parkinson disease (PD) is a progressive neurodegenerative disease that causes nerve cells in the area of the brain that controls movement to weaken and/or die. More than 10 million people worldwide are currently living with PD and nearly 1 million will be living with the disease in the US this year, according to the Parkinson’s Foundation.

Common symptoms of PD often begin gradually and progress over time and can include shaking or tremor, rigid muscles, difficulty walking, unsteady balance, poor posture, and slowing of body movements. Additionally, as the disease continues to progress, other symptoms such as slurred or soft speech, trouble chewing and/or swallowing, memory loss, constipation, trouble sleeping, and loss of bladder control.

In efforts of continuing discussion and momentum within the community, 

turned to Rodolfo Savica, MD, PhD, consultant, department of neurology, 

. Savica, who also studies early-life predictors of neurodegeneration, discussed the positives these social initiatives can have on not only the PD community, but throughout the entire world.

The facts about Parkinson’s disease. Harvard Health Publishing. 

https://www.health.harvard.edu/diseases-and-conditions/the-facts-about-parkinsons-disease

. Published February 2020. Accessed April 2, 2021.

The consultant in the department of neurology at Mayo Clinic discussed Parkinson Disease Awareness Month and the benefits behind social initiatives that raise awareness. 

Rodolfo Savica, MD, PhD

Articles

Expanded Research on Targeting Mechanisms of Parkinson Disease: Rodolfo Savica, MD, PhD

Growth of Parkinson Disease Knowledge: Rodolfo Savica, MD, PhD

The Numerous Needs for Parkinson Disease: Rodolfo Savica, MD, PhD

Importance of Parkinson Disease Awareness Month: Rodolfo Savica, MD, PhD

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