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BGS Movement Disorders |
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| Email your comments On the gathering evening, participants heard a lively pre-dinner talk on the PD GEN study with an overview of future developments in genetic testing in PD from Prof Karen Morrison. Karen graciously stayed behind after dinner to network and discuss genetics with the delegates. One of the more senior committee members took her at her word and interrogated her on her Celtic lineage! The next morning opened with an old friend of the Section, Prof David Brooks who gave a state of the art talk on imaging in PD past, present and future which was a model of clarity. This encompassed aspects of non motor function such as depression as well as the role of imaging such as SPECT and transcranial sonography in early diagnosis. He also highlighted less familiar roles in detecting and quantifying inflammatory aspects to neuro-degeneration. Jane Liddle then expertly led us in a session on audit with the participation of Steve Ford, Chief Executive of the PD Society. This session helped to develop and build on the Section’s ongoing work with PDS on NICE guideline audit - keep checking the Section website for more details of this and other ongoing audit activity.
Our own neurocognitive expert Dr John Hindle then gave us a valuable overview of current concepts of depression in PD and the exciting research going on in the PD PROMS study, supported by the Section. The Northumbrian hard hitter Richard Walker then appeared in a double header with a thought provoking presentation on ‘information prescriptions’ and then an update on the work of DENDRON. Richard was honest enough to ascribe the initial cynicism of some of his team to the introduction of further paperwork on ‘information’ provision. Our next guest speaker, Dr Huw Morris gave us a masterclass in dementia and parkinsonism with extensive video footage and reference to his own genetic work in Cardiff. This was Huw’s first visit to the Section but we will try and ensure a speedy return! Roger Barker from Cambridge presented on the future of cell therapies in PD in a fascinating talk which dispelled many of the myths and clarified concepts and misconceptions in this area which clearly still has significant potential therapeutic efficacy. The meeting finished with a debate on the ‘hot topic’ of early drug treatment. The proposition was that ‘this house believes that treatment should be initiated in all patients from the time of diagnosis’. Before the debate began 19.4 % of the audience supported the proposition while 80.6 % refuted it. Dr Graeme Macphee entered into a passionate defence of the proposition once the debate proper was underway. He highlighted quality of life issues and also the putative effects of treatment on disease modification and mortality. He was countered by Dr David Stewart who pointed out the complications of early medication and illustrated the small print from some of the studies that have been previously put forward in support of the hypothesis. Following the debate and the summing up, the percentage in support of the hypothesis had fallen to 16.7% while those refuting the proposition had risen to 83.3%. However, these figures do not tell the whole story. Asked whether members of the audience if diagnosed with Parkinson’s disease tomorrow (in other words as active working individuals) would wish to start treatment, those in favour of the hypothesis rose to 28.7% while those against fell to 71.4%. Specifically asked if they would wish to initiate therapy with rasagiline, (being studied with regard to neuroprotection or neuro-modulation) the figures rose further to 31.4% in favour while the figure against fell further to 68.6%. Draw your own conclusions! Graeme MacPhee BGS Newsletter, March 2008 |
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