Dr. Alberto Espay is a Professor and Chair of the Gardner Center for Parkinson’s disease at the University of Cincinnati. He has published over 300 research articles and 8 books on neurodegenerative diseases.

The models used to define certain neurodegenerative conditions (such as "Parkinson’s") have largely remained the same for over a century.

The presence of certain pathological markers or the loss of specific populations of cells in the brain have been used to explain the clinical features patients experience. And technological advances have been used to validate rather than question these models.

As a result, each neurodegenerative disorder has become defined as complex, and the wide range of variability between cases has been difficult to explain.

We have come to know a lot about our model of the disease we call Parkinson’s, but next to nothing about each individual affected. And this is important when it comes to developing novel treatments.

Promising new therapies have been tested in large clinical trials, but these studies have involved a broad mix of people with Parkinson's, each bringing their own version of "Parkinson's". Many of these experiments have been started without a clear bioassay to determine the suitability of each participant at the start of the study, which has often led to much difficulty in interpreting the final results.

If we can change this latter aspect, and start matching these therapies to people with the appropriate biology to benefit from them, then and only then can we achieve a first success in disease modification.

Follow Dr. Espay on Twitter https://twitter.com/AlbertoEspay

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