Update Course – Review and Summary

The VCU PD Center sponsored an Update Course on Saturday,

April 23, 2011.  Over 130 people attended
the course, which featured presentations on mood disorders and mild cognitive
impairment in Parkinson’s, as well as the drug development process and a review
of drugs currently in development for PD.
Following a break for lunch, the speakers participated in a question and
answer panel facilitated by Dr. Jim Bennett.

Dr. Laura Marsh’s presentation on mood disorders highlighted
the impact of depression and depressive disorders on Parkinson’s symptoms.  She reviewed new research findings that
depression appears to be an early symptom of PD, before the motor signs are
present.  Research has also shown that
depression and depressive disorders are under recognized and/or
undertreated.  Dr. Marsh encouraged
people with PD and physicians to better communicate with each other to
recognize and treat these problems.
Treatments can include adjustment of PD medications, psychotherapy,
rehabilitation therapy (occupational, physical, speech, exercise), relaxation
training, and social supports.  Of great
importance is the fact that Dr. Marsh shared research that has demonstrated
that treating depression and depressive disorders in PD effectively can help not
only improve mood and overall quality of life for individuals with PD but also
reduce their motor symptoms of PD and level of PD-related disability. 

Dr. Alexander Tröster reviewed current research that
indicates that cognitive changes occur earlier and more frequently than
previously thought in PD.  About
one-third of recently diagnosed patients have cognitive impairments on one or
more cognitive tests, but these may not be obvious in day-to-day functioning. Executive
functions, or complex higher-level problem solving skills, are most likely to
be impacted early in the disease. He noted that more research studies are
needed to validate the criteria clinicians use to diagnose mild cognitive
impairment. Dr. Tröster emphasized that early assessment and detection of these
impairments is important in order to offer individuals with PD various
cognitive enhancement strategies, such as pharmacological interventions,
exercise, or cognitive training, which may work best when difficulties are
mild. He reviewed several strategies to help people with PD and mild cognitive
impairment, including prompting recognition rather than expecting recall, cuing
attention, pacing a conversation by questioning, implementing routines, and
placing reminder notes in prominent places.

Dr. Kathleen Clarence-Smith presented information on the
drug discovery and development process.
This process, starting with the discovery of a compound, through to
clinical trials and FDA approval, can take up to 16 years to complete and the
costs can be in the billions of dollars.
There are many factors to consider in this process, especially the
medical need.  She noted that if a newly
discovered drug is not going to better than an existing drug or if it treats
the same symptoms of a drug already on the market, it will often be determined
to not be worth developing.  At the
conclusion of her presentation, Dr. Clarence-Smith reviewed examples of drugs
currently in development for PD. 

This course was videorecorded and will be posted in the
event video archive in the coming weeks.