A Window Into Our Evolving Understanding of Parkinson Disease (Podcast)

Is Parkinson disease (PD) truly a single illness or rather a collection of several variants with different manifestations? That’s one of the questions explored in a probing discussion of our evolving understanding of PD with international expert Hubert Fernandez, MD, in a new episode of Cleveland Clinic’s “Neuro Pathways” podcast for healthcare professionals.

In the 20-minute episode, podcast host Alex Rae-Grant, MD, engages Dr. Fernandez, Director of Cleveland Clinic’s Center for Neurological Restoration, on a number of timely topics in the field, including:

• How the definition of PD has been changing in recent years
• The emergence of targeted therapies for PD, including gene-targeted therapies and human monoclonal antibodies
• The role of exercise in PD management
• The quest for markers to assess disease progression

Click the player below to listen to the podcast now, or read on below for a short excerpt — in edited transcript form — of the discussion that’s in store. You can check out more “Neuro Pathways” episodes at clevelandclinic.org/neuropodcast or wherever you get your podcasts.

Excerpt from the podcast

Dr. Fernandez: What we have come to really appreciate in the last decade or so is how much more there is to Parkinson disease than just the motor symptoms associated with the condition. What is moving the needle earlier and earlier in the diagnosis of Parkinson disease is a recognition of what are called the premotor symptoms of Parkinson disease. They can occur decades before the onset of the first shaking of a pinky finger or the softening of a patient’s voice. These nonmotor symptoms — we call them premotor symptoms or the prodromal stage of Parkinson disease — include constipation, REM behavior disorder (where patients act out their dreams involuntarily), depression and anxiety. Identifying these early symptoms is relevant because in our quest to find disease-modifying therapies, we have to really try to attack the disease as early as possible to give us the best chance of slowing disease progression or even stopping it altogether.