Monday 20 th July 2009 Parkinson’s Summerschool A Personal Perspective On Parkinson’s Tom Isaacs

1. Monday 20th July 2009 Parkinson’s Summerschool A Personal Perspective On Parkinson’s Tom Isaacs Co-Founder – Cure Parkinson’s Trust Board Member – European PD Association Steering Group – World Parkinson’s Congress

2. Tom’s Tiny (but tasty) Two-minute Turkey Teach-in4 slides 30 seconds each • Parkinson’s can affect anyone at age • It is idiopathic – of unknown cause • Increasingly it is being linked to genetics and environmental factors • The shaking and immobility are caused by a deficit of dopamine in the brain • Dopamine is the chemical messenger which controls movement • You do not need an electric toothbrush if you have Parkinson’s

3. Tom’s 2-minute Turkey Teach-in. • Treatment for Parkinson’s is usually with a combination of the following medications: • L-dopa • Agonists – patch or pill • COMT Inhibitors • MAOB Inhibitors • Amantadine • After a 2-10 years of using L-dopa-induced dyskinesia is common • In later stage Parkinson’s the following further treatments are available • Apomorphine – rapid response agonist by injection • Duodopa – continuous dopaminergic stimulation via pump from duodenum • Deep brain stimulation (DBS) – electrical implant (pacemaker for the brain) • No treatment yet said to be “disease modifying” except arguably Azilect (MAOB) • All Parkinson’s medicines sound like they are from an Italian restaurant menu • E.g. Ropinorole, rotigotone, tolcapone, duadopa, selegeline, cabergoline, stalevo.

4. Tom’s 2-minute Turkey Teach-in. • Current Avenues of Parkinson’s Research • Genetic profiling and biomarkers • Gene Therapy • Neurotrophic factors and neurotrophic factor inducers • Alpha–synuclein disaggregation • Calcium channels/Anti-inflammatories • Delivery Mechanisms: Viral vectors, nanotechnology, novel peptides • Stem cell therapy • Drugs for other indications e.g. Hypertension and Diabetes

5. Tom’s 2-minute Turkey Teach-in. COMMON SYMPTOMS INABILITY TO COMMUNICATE e.g. Parkinson’s Mask DEPRESSION BEHAVIOURAL PROBLEMS COGNITIVE ISSUES/DEMENTIA FREEZING / RIGIDITY / INABILITY TO MOVE DROOLING / DRIBBLING SEXUAL PROBLEMS – (hyper or low drive) CONSTIPATION / INCONTINENCE SPASM DYSTONIA DYSKINESIA INSOMNIA TREMOR LOSS OF SENSE OF SMELL AND TASTE DYSPHAGIA / DIFFICULTIES WITH SWALLOWING PARANOIA ON/OFF FLUCTUATIONS .......and lots more!!!

6. CARLOS

8. HUGO

10. BARRY

12. Monday 20th July 2009 Parkinson’s Summerschool A Personal Perspective On Parkinson’s Tom Isaacs Co-Founder – Cure Parkinson’s Trust Board Member – European PD Association Steering Group – World Parkinson’s Congress

13. “The greater part of our happiness or sadness is not dependant on our circumstances but on our disposition”

14. PD CURE ISSUES • Communication • Multi-disciplinary teamwork • Rigidity, inflexibility and an inability to move forward • Flamboyant gestures -achieve nothing • Focus • Leaving it too long before next medication PD CARE ISSUES • Communication • Multi-disciplinary teamwork • Rigidity, inflexibility and an inability to move forward • Flamboyant gestures -achieve nothing • Focus • Leaving it too long before next medication

15. CARE CURE U CURE