Disease Spotlight: Parkinson Disease

Apart from the small pump system, which was preferred by the patients, the study found no clear advantage of levodopa-entacapone-carbidopa to levodopa-carbidopa intestinal gel.

A recent study suggests that palliative education and telehealth improve quality of life and advance care planning among patients with Parkinson disease and related disorders.

If successful, the study has potential implications for future surgical outcomes and patient experience among those with Parkinson disease.

Standardizing protocols and incorporating objective diagnostics and telemedicine can enhance care for patients with PD and alleviate the burden on healthcare systems.

The trial will feature 60 individuals with early-stage Parkinson disease who will be randomly assigned 1:1 to either daily CVN424 or placebo for a 12-week treatment period.

Carbidopa levodopa enteral suspension for Parkinson disease demonstrated cost-effectiveness compared to standard care, with an incremental cost-effectiveness ratio of $7711/QALY in a real-world study.

Test your neurology knowledge with NeurologyLive®'s weekly quiz series, featuring questions on a variety of clinical and historical neurology topics. This week's topic is Parkinson disease.

In a small-scale trial, patients with Parkinson disease on accelerated theta-burst transcranial ultrasound demonstrated higher motor evoked potentials than those on sham, with no statistically significant changes in MDS-UPDRS-III scores.

The data suggest that central nervous system-derived extracellular vesicles in the blood will likely play a key role in biomarker development, especially for patients with Parkinson disease, in the coming years.

In animal models, HL192 showed disease-modifying effects, as demonstrated through improvements in behavioral deficits.

Among football players, odds of having a parkinsonism or Parkinson disease diagnosis were greater with more seasons and higher level of football play.

PRO-PD showed good 6-month test-retest reliability, as well as good convergent validity between other widely used validated scales of PD.

During the progression of the movement disorder, older patients with Parkinson disease may see changes in their insulin-like growth factor and serum homocysteine indices but a potential therapy could improve these factors.

Jay Alberts, PhD, the Edward F. and Barbara A. Bell Endowed Chair at Cleveland Clinic, provided comment on a recently published randomized controlled trial assessing the therapeutic potential of an augmented reality program for postural instability and gait dysfunction in Parkinson disease.

After Supernus met with the FDA earlier this year, the company believes it has addressed the agency’s requests mentioned in its complete response letter delivered in October 2022.

The senior vice president and chief scientific officer of the Parkinson’s Foundation discussed a recently published Medicare claims analysis that highlighted significant issues with access to proper care for patients with Parkinson disease. [WATCH TIME: 4 minutes]

The senior vice president and chief scientific officer of the Parkinson’s Foundation provided perspective on the reasons for the lack of mental health specialists in Parkinson disease care and the complexities behind treating depression. [WATCH TIME: 4 minutes]

The professor of neurology and resident program director at MedStar Georgetown University Hospital discussed how Parkinson disease motor fluctuations are managed amid new, novel technologies incorporated in the field. [WATCH TIME: 4 minutes]

Although research supports the use of physical therapy as an effective treatment for Parkinson disease, implementation factors including type, timing, frequency, and durability of outcomes remain mainly untouched.

Virginia Gao, MD, PhD, a movement disorders fellow at Weill Cornell Medicine, discussed several topics related to the use of biomarkers in the prodromal stages of neurodegenerative disorders like Parkinson disease.

The movement disorder specialist at Cambridge University Hospitals NHS Foundation Trust talked about a patient with treatment-resistant Parkinson disease who experienced significant improvement in motor symptoms after using a vibrational therapy. [WATCH TIME: 8 minutes]

Because its gut-acting and gut-restricted, the safety profile of DGX-001 was considered advantageous in comparison to traditional neuropsychiatric therapies.

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Jill Farmer, DO, MPH. [LISTEN TIME: 28 minutes]

The fourth-generation deep brain stimulation system is designed to treat the symptoms of Parkinson disease and essential tremor by delivering targeted electrical stimulation via surgically-implanted leads in the brain connected to an implantable pulse generators.

The director of the Movement Disorders Center at Baylor University Medical Center in Dallas, a part of Baylor Scott & White Health, talked about the evolution of treatment for Parkinson disease and the new promising therapies patients may seen over the coming years. [WATCH TIME: 3 minutes]

Reasons behind the CRL were not related to efficacy and do not impact Amneal’s 2023 financial guidance, which did not include IPX203 revenues.

In patients with early Parkinson disease, results showed that UB-312 was generally safe and well-tolerated, which supports the advancement of the vaccine into further clinical development.

The assistant professor of occupational therapy at the New York Institute of Technology talked about educating patients with Parkinson disease about the importance of maintaining social participation for cognitive function at ATMRD 2023. [WATCH TIME: 5 minutes]

The nurse practitioner in the movement disorder division at Georgetown University Hospital discussed differences in available therapies for movement disorders versus multiple sclerosis and using a chronic care management model in Parkinson disease. [WATCH TIME: 5 minutes]

Patients with Parkinson disease who were inpatients had significant impacts on their length of stay, readmissions, and morbidity after hospitalization when administered contraindicated medications.

At AMTRD 2023, the graduate research assistant at Brown University talked about the prevalence of rapidly progressive dementia and cognition fluctuation in Parkinson disease as well as the effects of treatments for the condition. [WATCH TIME: 5 minutes]

Robert A. Hauser, MD, MBA, director of the Parkinson’s and Movement Disorders Center at the University of South Florida, provided insight on the therapeutic potential of IPX203, and why it adds flexibility to the treatment of Parkinson disease.

At AMTRD 2023, the movement disorder neurologist at the Parkinson’s Disease and Movement Disorder Center of Silicon Valley talked about the current care landscape for Parkinson disease and improving on-time for patients experiencing OFF periods. [WATCH TIME: 5 minutes]

In a recent survey, a group of advanced practice providers recognized the importance and considered the emotional impact of the unexpected return of symptoms on the life of a patient with Parkinson disease.

Pooled results of a post hoc analysis from phase 3 studies of amantadine (Gocovri; Supernus) suggest that the therapy offers increased good ON time, and in intervals that are more predictable for patients, compared with placebo.

Preclinical findings show the potential of samelisant, a potent and orally active Histamine H3 receptor inverse agonist, as a potential treatment for patients with Parkinson disease who experience excessive daytime sleepiness.

The companies have noted that the decision was not made because of safety or efficacy data, but to refocus efforts on the ongoing phase 2b LUMA trial of BIIB122.

The clinical professor in the department of neurology at the University of California, San Francisco, emphasized the need to restrict trichloroethylene availability and the challenges in studying environmental factors associated with Parkinson disease. [WATCH TIME: 4 minutes]

The clinical professor in the Department of Neurology at the University of California, San Francisco, talked about the association between contaminated water and Parkinson disease. [WATCH TIME: 6 minutes]

The director of the Memory & Cognitive Disorders Clinic at Hoag Neuroscience Institute provided perspective on the difficulties with testing agents for Parkinson disease psychosis, and the future outlook of treating the symptom. [WATCH TIME: 4 minutes]

Study shows that digital devices can provide objective and real-world measures of Parkinson disease, capturing key motor and nonmotor features of for early diagnosis of the neurodegenerative disorder.

The director of the James J. and Joan A. Gardner Family Center discussed data from the phase 3 BouNDlesstrial assessing a continuous, subcutaneous levodopa/carbidopa delivery system for patients with Parkinson disease experiencing motor fluctuations. [WATCH TIME: 3 minutes]

The director of the Memory & Cognitive Disorders Clinic at Hoag Neuroscience Institute discussed the future of treating Parkinson disease psychosis, and potential ways to lower risk of poor long-term outcomes. [WATCH TIME: 3 minutes]

A recent published study highlighted the importance of environmental risk factors for Parkinson disease, such as exposure to trichloroethylene and other volatile organic compounds.

Marcelo Bigal, MD, PhD, chief executive officer of Ventus Therapeutics, talked about the relationship between inflammation and neurodegeneration in Parkinson disease, and the importance of targeting NLRP3.

Differences in personal experience of dyskinesias in Parkinson disease were observed across multiple cultures, which could be attributable to intrinsic cultural peculiarities.

Timothy A. Leichliter, MD, a neurologist at Allegheny Health Network, provided context on the institution’s boxing program for Parkinson disease, and the need for patients to remain active.

Participants with rheumatoid arthritis had a 1.74-fold higher risk of PD compared with those without, raising importance of an elevated risk.

Jean-Cosme Dodart, PhD, senior vice president of research at Vaxxinity, discussed the progress of the UB-312 Parkinson disease vaccine, highlighting its findings from a phase 1 clinical trial, and plans for a phase 2 trial.

The CEO and cofounder of Amprion spoke about additional diagnostic uses of the αSyn seed amplification assay and its validation in the Parkinson's Progression Markers Initiative study at the 2023 AAN Annual Meeting. [WATCH TIME: 6 minutes]

Poor higher order vision at baseline was associated with worsening cognition and increased probability of death, dementia, or frailty over 3 years.

Over 48 weeks of treatment, ALXN1480 was found to be generally well-tolerated, with improvements seen in Clinical Global Impression-Improvement scores and UWDRS Parts II and III.

The medical director of the Center for Neurological Disorders at the University of Toledo discussed positive phase 3 findings assessing P2B001, and how the agent would potentially fit in the Parkinson treatment landscape. [WATCH TIME: 4 minutes]

The chief medical officer and cofounder of CND Life Sciences, who served as principal investigator of the study, offered insight into the Syn-ONe Test's clinical utility.

The pump, attached to a wearable retainer, continuously delivers the liquid medication with little to no adverse effects.

CND Life Sciences’ α-synuclein skin biopsy test showed sensitivity rates ranging from 92.7% to 100% across a number of assessed and clinically confirmed synucleinopathies, including Parkinson disease and dementia with Lewy bodies, among others.

Compared with immediate-release levodopa/carbidopa, NeuroDerm’s 24-hour subcutaneous liquid infusion improved ON time without dyskinesia and with nontroublesome dyskinesia.

The majority of treatment-emergent adverse events from IPX203 were mild or moderate in nature, and occurred within the first 90 days of treatment.

Andrew Siderowf, MD, director of the Parkinson disease and movement center at the University of Pennsylvania, talked about available therapeutics and potential future therapies in research for Parkinson disease.

Despite years of use of gold-standard therapy levodopa, therapeutic development in Parkinson disease has advanced rapidly and expanded to numerous novel pathways and targets.

The director of the Memory & Cognitive Disorders Clinic at Hoag Neuroscience Institute provided detail on an educational course that examined medication management for Parkinson disease psychosis.

As therapeutic development has advanced in Parkinson disease management, the introduction of on-demand options have extended ON time for patients and altered the paradigm of care.

Psychosis is estimated to affect more than half of patients with Parkinson disease, and there is a growing need for improved management and therapeutic development.

The holy grail of neurodegenerative disorders would be to alter or halt the progression of the disease. For years, the discussion has swirled around stem cells and gene therapy, and they remain potential options for the future.

Findings from a recent published study observed lower quality of life in Black, Hispanic, and Asian patients with Parkinson disease compared with White patients.

New research confirms a key disease pathology identified through examining spinal fluid in patients with Parkinson disease.

The neurosurgeon at Marcus Neuroscience Institute, Baptist Health, provided perspective on the advances of DBS and other invasive procedures for patients with degenerative disorders. [WATCH TIME: 4 minutes]

Positive phase 2 data on CVN424, NETSseq platforms, and CVN417, a novel treatment for Parkinson disease, were presented at AD/PD 2023 International Conference.

New data demonstrated the potential of a new class of oral, small molecule inhibitors that target the fleeting intermediates at the core of neurodegeneration in Parkinson disease.

Statistically significant improvements in several quantitative test measures of episodic memory, attentiveness, and depressive emotional bias were observed in patients treated with clenbuterol and nadolol.

Test your neurology knowledge with NeurologyLive®'s weekly quiz series, featuring questions on a variety of clinical and historical neurology topics. This week's topic is Parkinson disease (PD).

In honor of Parkinson Disease Awareness Month, Hubert Fernandez, MD, director of the Center for Neurological Restoration at Cleveland Clinic, provided perspective on the advances in the care for the neurodegenerative disorder.

Despite a pause in the trial due to the COVID-19 pandemic, patients who opted to continue treatment into the open-label extension demonstrated significant improvements in Parkinson disease dementia symptoms for up to 48 weeks.

Over a 12-week treatment period, patients with Parkinson disease on light therapy demonstrated statistically significant improvements of 58% and 40% in lower and upper limb coordination and movement.

The vice president of Health Economic and Outcomes Research at Acadia Pharmaceuticals provided perspective on the negative effects seen from quetiapine and how the knowledge of pimavanserin has improved since approval. [WATCH TIME: 5 minutes]

If approved, ABBV-951 will become the first subcutaneous delivery of carbidopa/levodopa, often considered the standard of care for symptom management for patients with Parkinson disease.

The vice president of Health Economic and Outcomes Research at Acadia Pharmaceuticals discussed the ongoing challenges with lowering mortality in Parkinson disease, and the need to improve caregiver burden. [WATCH TIME: 4 minutes]

The vice president of Health Economics and Outcomes Research at Acadia Pharmaceuticals provided perspective on the mechanistic advantages of pimavanserin over atypical antipsychotics to treat Parkinson disease psychosis. [WATCH TIME: 2 minutes]

Frailty domains such as exhaustion, slow gait speed, low grip strength, and low physical activity were all associated with incident Parkinson disease.

The director of functional neurosurgery at Baptist Health Miami Neuroscience Institute provided perspective on the growth of high intensity focused ultrasound and the lessons learned when treating essential tremor.

Findings showed that global cognition declines in the prediagnostic period in men but not women with incident Parkinson disease, further indicating cognitive heterogeneity in the prodromal period by sex.

The senior vice president and chief scientific officer of the Parkinson’s Foundation discussed the potential for new therapies that target genetically mutated forms of Parkinson disease. [WATCH TIME: 3 minutes]

The international study on genetic testing and counseling, PD GENEration, is currently at the halfway mark of its goal of 15,000 participants.

Compared with healthy controls, those with isolated RBD performed significantly worse on all cognitive assessments except in tasks of executive function.

The senior vice president and chief scientific officer of the Parkinson’s Foundation detailed some of the potential reasons for the nearly 50% increase from the previously estimated rate. [WATCH TIME: 5 minutes]

The senior vice president and chief scientific officer of the Parkinson’s Foundation provided perspective on recently published findings showing a nearly doubling of Parkinson disease incidence that previously reported. [WATCH TIME: 4 minutes]

Analysis on the EARLYSTIM trial assessing deep brain stimulation of the subthalamic nucleus in early Parkinson disease showed maintained speech intelligibility and nonspeech oral movements.

Investigators concluded that the therapeutic effectiveness of antiparkinsonian medications is short and limited for intolerable abdominal pain.

For controlling symptoms of Parkinson disease psychosis, pimavanserin had the most favorable effect size based on 2 major efficacy outcomes.

Caregivers of patients with advancing PD were more likely to spend more hours caring per day and had a higher self-perceived burden, compared with caregivers for patients with early PD.

The chief training and education officer at the Parkinson’s Foundation discussed the inclusion of various medical professionals that assist in Parkinson disease care, and the need to provide access to educational tools to inform clinicians. [WATCH TIME: 5 minutes]

Nearly two-third of all participants with REM-sleep behavior disorder had mild cognitive impairment level 2 with multi-domain MCI, but particularly attention and memory deficits.

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Robert A. Hauser, MD, MBA. [LISTEN TIME: 20 minutes]

After a follow-up of nearly 4 years, nearly half of the patients (n = 10) with baseline classification of cognitive IADL impairment and mild cognitive impairment converted to dementia.

Going forward, the company must provide safety and steady-state pharmacokinetic data on the 200 mg dose of IKT-148009, as well as continued measurement of visual acuity and examination of the cornea and lens.

Mesdopetam showed significant effects on the secondary end point of Unified Dyskinesia Rating Scale, an assessment of involuntary movements associated with long-term treatment with dopaminergic medication.

KM-819, a potent inhibitor of FAF1, a key regulatory protein in cell death pathways, is currently being assessed in a 2-part trial, with results expected to help guide a future 24-month study.

A systematic review revealed inconsistencies in the literature for assessing subjective cognitive complaints in cognitively normal patients with Parkinson disease.

Plain sulfonamide diuretics was identified as a drug chemical subgroup potentially inversely associated with Parkinson disease risk, while weaker signals included insulin and ß2-adrenergic agonists.

Not previously explored, new findings showed links between antiseizure drug prescriptions and incident PD, with trends towards increased risk in those with greater number of prescription issues and multiple AEDs.

Ryan Case, PhD, head of clinical medical affairs at NeuroDerm, spoke about the main findings from the phase 3 BouNDless trial of ND0612 for Parkinson disease.

In addition to improving ON time in patients with Parkinson disease, ND0612 was well tolerated, with only 6.3% of patients randomized to the treatment discontinuing the trial.

A population-based incident of Parkinson disease cases showed patients were more likely to develop PD dementia in 10 years with a lower level of lysosomal enzyme glucocerebrosidase activity.

After 2 months of treatment, findings showed more improvement in anxiety and mental status with acupuncture in patients with Parkinson Disease than those on sham acupuncture.

Findings from a large-scale trial of adults aged 65 and older with Parkinson disease showed that treatment with pimavanserin was associated with lower risk of mortality than other atypical antipsychotics.

The increased risk of dementia in patients showing early orthostatic hypotension was independent of the presence of concomitant supine hypertension and other factors associated with cognitive impairment.

Patients with high dysautonomia scores showed significantly slower walking speed, decreased cadence, and shorter stride but increased time than the lower scored group in backward gait.

The case-control study identified numerous motor symptoms and signals that are associated with Parkinson disease diagnosis years after they begin to occur.

Subsequent diagnosis of Parkinson disease was associated with a range of risk factors such as alcohol misuse and traumatic head injury, along with several other comorbidities and prodromal features.

Mind Moments®, a podcast from NeurologyLive®, brings you an exclusive interview with Jay Alberts, PhD. [LISTEN TIME: 27 minutes]