In Season 2, Episode 3, our Professors investigate the letter F, focusing on Fluctuations and Fatigue.

In this latest episode of the S2: ABC of Parkinson's Disease, both Prof. look into the letter E where they discuss Early Morning Off, Evidence, Exercise, Early PD.

In this new season, Prof. Poewe and Prof. Bloem will be discussing the ABC of Parkinson’s Disease - each episode will have a certain letter attributed to the many different avenues within PD. 

The letter for this episode is C: COMT Inhibitors, Continuous Dopaminergic Delivery.

In this episode of Reflections On Parkinson's Disease, both professors dive into the history of Apomorphine, the role of the drug within each of their hospitals/for their patients and how the drug impacts non-motor symptoms. 

In episode 6, both Prof’s address the different experiences that they have encountered with their patients during their many years as PD specialists. 

They discuss ways in which Dr’s communicate with patients on how medication problems may lead to fluctuating responses, what mechanisms can lead to changes in symptom severity and what their take is on the value of aids for communication i.e., wearing off questionnaires, home diaries and other techniques.

In this latest Episode of Reflections on Parkinson’s Disease, Prof’s Bloem and Poewe discuss what is meant by ‘on/off’ fluctuations and what it entails. 

They evaluate the ‘good on and the bad on’ and consider that when a patient is turned ‘on’, medication can sometimes overshoot its target, which means patients develop involuntary movements which are called Dyskinesia’s. 

The Prof’s then explore the different types of Dyskenisia’s, what problems can arise for patients who are suffering them and also how it can affect their loved ones in everyday life.

In the anticipation of Euro 2020, both Professor’s share their thoughts on who they will be supporting at this years tournament, before delving into the topic of Response Fluctuations in Parkinson’s Disease and why they can be missed. 

They discuss how a patients education on the disease is vital to explain what response fluctuations are, the current ways in which patients are recording their experiences and finally whether the use of technology sensors could help patients detect their response fluctuations.

In Episode 3, Profs. Poewe and Bloem discuss why Parkinsons Disease patients develop fluctuations, how they can be treated & what mechanisms effect this. They also explore the practical elements of combining treatments and whether there are wiser ways of starting treatment.

In this episode, Bas and Werner delve into the term ‘motor fluctuations’ which is linked to the long-term experience patients have with Levodopa. They discuss a study by George Cotzias regarding the ‘intermittency in the action of the drug’, what the term ‘wearing off’ stands for and the differences between a short-duration/long-duration response. 

In this episode both Professors dispel the myths and misconceptions of a drug that's been used for over 50 years. They discuss the idea of a "honeymoon period" for those using Levodopa and Prof. Bloem also reveals some interesting results from a study he carried out as well as addressing how Levodopa responds to tremors.

Special thanks to BIAL for sponsoring this podcast.

BIAL is an innovative pharmaceutical company. Dedicated to discovering, developing and commercializing medicines, we are committed to improve people's lives worldwide. Keeping life in mind.