A Multifaceted Approach to Understanding ON and OFF Periods in Parkinson Disease: Salima Brillman, MD


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]

WATCH TIME: 5 minutes

"We still have a long way to go because a lot of patients don't really understand what their OFFs are. So, we encourage them to write down their symptoms and bring it to the attention of their healthcare providers, because we do have so many great symptomatic medications now to help them through their OFF periods and get a good ON period."

Through the years, clinical care for Parkinson disease (PD), a heterogeneous disease with rapidly and slowly progressive forms, has had challenges for both patients living with the disease and clinicians who treat them.1 Despite the challenges in the field, the present treatment options have changed the landscape of care with offering patients the opportunity to have more control over their symptoms and their lives. The available treatments cater to control the motor symptoms of the disease, including treating the OFF periods in the patient when motor symptoms return.2

Salima Brillman, MD, movement disorder neurologist, Parkinson’s Disease and Movement Disorder Center of Silicon Valley, presented a talk titled, “In search of ‘Good On’ time: current approaches to Parkinson’s treatments” at the 2nd Annual Advanced Therapeutics in Movement and Related Disorders (ATMRD) Congress, held by the PMD Alliance from June 8 to 11, 2023, in Washington, DC.3 In her presentation, she explored the dynamics of ON and OFF periods as well as discussed how clinicians can help their patients claim the therapeutic advancements available for them to have more control on their independence and quality of life.

At the congress, Brillman sat down in an interview with NeurologyLive® to describe clinicians' current ability to provide patients with PD with good ON time. She also talked about the aspects that helped to get to a better point with patients and the challenges in helping them to understand their OFF periods. Additionally, Brillman discussed the factors the contribute to the underutilization of the available medications for PD OFF periods. She spoke about how patient education and healthcare provider awareness of OFF periods can be improved to empower patients.

Click here for more coverage of ATMRD 2023.

1. Armstrong MJ, Okun MS. Diagnosis and Treatment of Parkinson Disease: A Review. JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360
2. Tanner CM. Exploring the clinical burden of OFF periods in Parkinson disease. Am J Manag Care. 2020;26(12 Suppl):S255-S264. doi:10.37765/ajmc.2020.88517
3. Brillman, S. In search of “Good On” time: current approaches to Parkinson’s treatments. Presented at: ATMRD; June 9-11, 2023; Washington, DC.
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