Every year the International Parkinson and Movement Disorder Society (MDS) holds a conference and every year APDA is there, learning about the newest research and sharing our resources with the wider Parkinson’s disease (PD) community. The MDS Congress is the preeminent gathering of medical professionals from around the world who are dedicated to PD and other movement disorders.  So much fascinating information is shared at the Congress that each year we report back to our readers about what we have learned. In 2020, we reported from the first virtual conference. You can also read our recaps from 2018 and 2019 to learn more.

Once again, the conference presented cutting-edge research that is moving our understanding of Parkinson’s disease treatments forward. You will recognize themes in the research that we have been discussing with you over the past year. The following are some of the highlights of the MDS Virtual Congress 2021, the key takeaway from each one, and the APDA information and resources that correlate to it.

The GI tract and Parkinson’s Disease

Comparison of gastrointestinal transit times in typical and erratic levodopa-responders in patients with Parkinson’s disease. (Safarpour D, et al)

In this study, people with PD who had a typical response to Levodopa (predictable motor fluctuations, with onset of benefit from a Levodopa dose within 60 minutes of ingestion) were compared with those who had an erratic response (unpredictable fluctuations, delayed time to benefit from Levodopa dose, dose failures). Results showed that:

• Erratic responders demonstrated an erratic pattern in serum levodopa levels over time as compared to typical responders.
• 50% of erratic responders showed the presence of small intestinal bacterial overgrowth (SIBO, a condition in which there is excessive bacteria in the small intestine), a rate much higher than seen in typical responders.
• Erratic and typical responders were investigated with SmartPill, a wireless, ingestible capsule that travels through the GI tract and can measure transit time through the gut. Both groups showed variability in transit time in different segments of the GI tract, with more variability in the erratic responders.

Takeaway:  Variable gut transit times and SIBO may play a role in why some people have erratic and variable responses to Levodopa doses.

APDA resources:  There are many APDA resources that can help you learn more about the gut, GI symptoms, and PD. Or, you can review our presentation on motor fluctuations and the influence of the GI tract on motor fluctuations.

 

The Microbiome and Parkinson’s

Gut microbiota and nutritional profiles of Parkinson’s disease patients. (Lubomski M, et al)

This study looked at the association between gut microbiome, clinical features of PD, and nutritional profiles of people with PD. Based on validated nutritional surveys, people with PD tended to consume higher amounts of carbohydrates and increased total sugars as compared to healthy controls. Microbiome profiles were also different between PD and control patients, with people with PD showing an over-representation of bacteria in the Lactobacillaceae and Enterobacteriaceae families and under-representation of bacteria in the Pasteurellaceae family, validating trends identified in prior studies. Whether the difference in dietary profile is a cause of the difference in microbiome profile cannot be determined from this study.

Takeaway: The PD microbiome may be used in the future as a biomarker for disease. Manipulating the microbiome, possibly with dietary changes, may be a method to manage PD.

APDA resources:  Learn more about the intersection between the microbiome and PD on our blog. You can also explore the fascinating research APDA has sponsored into the microbiome and PD, such as studies on the oral microbiome in Parkinson’s disease and microbial-brain interactions in Parkinson’s disease neurodegeneration.

 

Genetics and Parkinson’s

Building a Global Parkinson’s Genetics Program (GP2): Clinical Cohorts Integration Working Group (Joubert J et al)

Lack of diversity in Parkinson’s disease genetic research: current landscape and future directions
(Schumacher-Schuh AF et al)

This first research paper presents the infrastructure of the Global Parkinson’s Genetics Program or GP2, an international collaboration aimed at understanding the genetic and clinical characteristics of people with PD, by studying data from 150,000 people with PD from 80 locations worldwide. As this data is collected, it will be made available to researchers for analysis.

In the second paper, GP2 investigated the lack of diversity in current PD genetic research. A literature search identified all the current medical papers that examined genetic data in non-European populations. Of these papers, most focused on Chinese populations. Other groups including South and East Asian (non-Chinese), North African, Middle Eastern, Latin American, and Black populations worldwide were under-represented. GP2 is set to change this equation by recruiting cohorts worldwide.

Takeaway:  There is worldwide focus on understanding the genetics of Parkinson’s and including genetic populations from around the globe in this effort.

APDA resources:  APDA is committed to funding the genetics of diverse PD populations. You can read more about the research that we fund, including a study on Parkinson’s disease in the Mexican population and in this interview with Dr. Karen Nuytemans.

 

Parkinson’s and post-COVID syndrome

Parkinson’s disease and Post-COVID-19 syndrome: The Parkinson’s Long-COVID Spectrum (Leta V, et al)

This study reported a case series of 27 people with PD who contracted COVID-19 and followed them for long-term sequelae, defined as symptoms present for more than 12 weeks after COVID-19 infection. About 85% of people with PD and COVID-19 had long-term effects. About half reported worsening of motor function and increased levodopa daily requirements. Forty percent reported fatigue and about 20% reported cognitive disturbances and sleep disturbances. Severity of the original COVID infection did not correlate with the development of long-term symptoms.

Takeaway:  Long-term symptoms after COVID are common among people with PD.

APDA resources:  APDA has been closely monitoring COVID-19 information as it relates to people with PD since the start of the pandemic. You can read general information about COVID-19 and PD, a COVID-19 and PD Q+A, a discussion of a post-COVID world with PD, and a summary of the research that relates to COVID-19 and PD.

 

Parkinson’s and virtual programming 

Feasibility of dance therapy through synchrony videoconference in Parkinson’s disease and elderly people. (Pinto C, et al)

Remote Art Therapy is feasible and may benefit individuals with Parkinson’s disease (Rieders J, et al)

 The first study investigated the safety and efficacy of an online dance class for people with PD. A group of 13 people with PD took an online 16-week dance class together, twice a week over two months. They were followed for adherence to the classes and whether any falls or safety issues occurred. They were also assessed before and after the 16-week session, using scales for anxiety, depression, balance, and functional mobility. The study concluded that online PD dance classes were safe, and adherence was very high. Functional mobility improved over the course of the study.

The second study investigated the feasibility of remote art therapy for people with PD. In the setting of the COVID-19 pandemic, a virtual extension of an art therapy clinical trial was developed. Thirteen participants attended ten weekly sessions led by art therapists. Baseline and follow-up psychosocial assessments were performed, along with data on adherence, retention, and safety. Adherence and safety data were excellent and a trend towards improved quality of life scores was noted despite the COVID-19 restrictions at the time.

Takeaway:  Online dance and art therapy classes may be a way of engaging in creative activities in a safe and effective manner for people with PD in the absence of in-person classes.

APDA resources:  You can watch this conversation with David Leventhal, founder of Dance for PD^®, as he discusses the benefits of dance for people with Parkinson’s. Check out our virtual calendar where you can sign up for online classes of all types specifically tailored for people with PD. 

Tips and Takeaways

• The Movement Disorder Society Congress is a yearly meeting that allows clinicians and researchers to learn and exchange ideas. This year’s event once again took place virtually and APDA was there.
• Each of the studies mentioned above is helping to uncover important aspects of the disease.
• You can check out the research that APDA is funding. Donate to be part of the efforts to find new treatments, and eventually a cure.