The BGS Parkinson’s Disease Section Specialist Meeting was held on 1 - 2 March.

Seventy delegates assembled on the evening on the 1st March at the Forest of Arden Hotel in Warwickshire for the British Geriatrics Society Parkinson’s Disease Section Specialist Meeting kindly sponsored by GSK and GE Healthcare.

The evening began with Dr David Nicoll, Consultant Neurologist from City Hospital, Birmingham outlining the development of a new teaching aid “The Clinical Atlas of Parkinson’s Disease”. This interactive CD Rom was named one of the BMA’s books of the year and won the award in the electronic media category last year. The CD Rom includes video clips of patients and also an historical perspective of the development of the management of Parkinson’ Disease.

The following morning Dr Donald Grosset, Consultant Neurologist, Glasgow conducted an interactive tremor disorders workshop. Again using video technology he was able to clearly demonstrate the differences in tremor types followed by a video quiz. He covered particularly the tremor of Parkinson’s disease, orthostatic tremor, the tremor of Wilson’s disease, psychological tremor, psychogenic tremor, essential tremor, dystonic head tremor and rubral / mid-brain tremor.

After coffee a ‘balloon debate’ was held for the rest of the morning on the topic of “Which of the following areas should have highest priority for funding in the NHS?”

1. Imaging
2. Treatment of motor symptoms
3. Treatment of cognitive disorders in PD

Three pairs of protagonists entered into this with great gusto. Dr Donald Grosset and Dr Paul Kemp, Consultant in Nuclear Medicine, Southampton spoke eloquently on the benefits of obtaining a clear diagnosis through imaging and Dr Grosset showed compelling evidence on how savings made through stopping medication in patients with no evidence of dopamine depletion on imaging can result in more cost effective care.

Then Dr Richard Walker, Consultant Physician, North Tyneside offered an historical and global perspective on why it is important to treat motor symptoms. Dr Carl Clarke, Reader in Neurology, Birmingham discussed the importance of treating motor complications in terms of quality of life.

Dr Richard Brown, Consultant Psychologist, Kings College London speaking for the management of cognitive disorders felt that PD should be called a neuro psychiatric syndrome rather than a movement disorder. He outlined the high number of patients who have dementia and the impact that has on their carers.

Finally Dr David Burn, Consultant Neurologist, Newcastle outlined the general management principles of dementia, discussing the use of anti-cholinesterase inhibitors.

A lively debate ensued and after further voting the consensus vote was that the management of cognitive disorders has the highest priority, whilst recognising that this is an artificial debate and in practice we would support all three areas.

After lunch Dr Carl Clarke provided an update on the PD Med trial which has now recruited 1100 patients in total although it is still looking particularly to recruit to the late PD arm. Dr Dorothy Robertson advertised the ‘Multi-disciplinary care in Parkinson’s disease and Parkinsonism – from science to practice’ to be held on the 11 July 2006 at the Royal College of Physicians. The meeting this year will focus on parkinsonism.

Then Dr Mark Lee, SpR in Palliative Care, North Tyneside presented work from his MD looking at palliative care in Parkinson’s Disease. He outlined the differences in tools pertaining to measure quality of life and the impact on quality of life of domains outside of Parkinson’s disease. He has also surveyed pain in patients with Parkinson’s disease and again identified a median of at least two different pains in most of his Parkinson’s patients, about half of which was due to the Parkinson’s disease (either muscle spasms or muscle cramps) and half of which were due to other diseases such as osteoarthritis.

Finally Dr Sarah Savage from Kings College London talked about new developments in pharmacology and therapeutics. Her talk ranged from novel means of delivering existing medication, such as depot apomorphine, through novel dopaminergic agents such as the rotigotine patch, to the development of non-dopaminergic agents. Finally she discussed evidence for the mechanisms of cell death in Parkinson’s disease and the difficulties of identifying neuro-protective agents for Parkinson’s disease.

Helen Roberts
Senior Lecturer
Southampton