Improving Care for Parkinson’s: An Update from the International Congress of Parkinson's Disease and Movement Disorders
The International Parkinson’s Disease and Movement Disorders Congress gathered specialists in Honolulu, Hawaii, October 5-9 for discussions on the latest advances in research and care. The largest annual event dedicated to the field of Parkinson’s disease (PD) and other movement disorders, the conference was themed “Toward Disease Modification in Movement Disorders,” reflecting the growing momentum in treatments that move beyond symptom management and toward impacting the disease trajectory.
Presentations focused on ways to better manage PD’s wide-ranging symptoms and weighed in on the growing pipeline of therapies to slow the worsening of the disease. Key takeaways include the following.
Treatment to Slow, Stop and Prevent PD is Getting Closer
A featured session on disease-modifying trials for PD previewed the record number of these therapies in clinical testing. Over half of the over the 170 treatments in active or soon-to-be-active clinical testing are designed to be disease-modifying, which means they hold the potential to halt, slow or even prevent the disease process itself.
Tanya Simuni, MD, a movement disorders specialist who serves on leadership team for the Parkinson’s Progression Markers Initiative (PPMI), hailed the fact that a drug to stop the buildup of alpha-synuclein moved into Phase III clinical trials recently — a first for the field. (When misfolded alpha-synuclein builds up in the brain, it is thought to become toxic to dopamine neurons.) She also expressed enthusiasm for the diversity of the therapeutic pipeline, which beyond alpha-synuclein includes drugs targeting a range of other biological mechanisms linked to PD. For instance, there are disease-modifying therapies being tested to improve how cells handle, recycle and get rid of old proteins and therapies targeting mutations in certain genes that disrupt this system. Other disease-modifying therapies aim to reduce inflammation, which may contribute to the loss of dopamine neurons in PD.
Many of these therapies have advanced in human trials thanks either to direct funding from MJFF or to Foundation-provided research, tools and resources — enabling support that helps drug makers advance testing.
While there aren’t yet any disease-modifying therapies approved for PD, a number of emerging studies hint that exercise not only improves PD symptoms but also, potentially, has disease-modifying effects. Studies — such as one published in npj Parkinson’s Disease in 2024 — particularly point to the benefits of rigorous, high-intensity exercise.
A session on lifestyle approaches to treating PD included a recommendation for clinicians to prescribe exercise to their patients in the same way that they might prescribe medications. MJFF’s guidebook on exercise in Parkinson’s provides useful tips for people at any stage of the disease.
Comprehensive PD Care is Critical for Quality of Life
As anyone with the disease knows, Parkinson’s can affect more than just movement. The disease commonly disrupts sleep, results in sudden drops in blood pressure, and causes constipation, depression, pain and a range of other nonmotor symptoms. But these nonmotor symptoms can be less outwardly apparent and less well-known as being part of the disease process, and in many cases, treatment options are frustratingly limited.
But in multiple sessions, speakers cited evidence that efforts to take a comprehensive treatment approach — one that factors in both motor and nonmotor symptoms — improves quality of life for people with PD and possibly impacts the disease process itself. They noted simple approaches can sometimes go a long way to relieving symptoms, such as when clinicians check for exacerbating factors like infections and anemia, assess the side effects of medications and encourage helpful behavioral practices, such as moving the feet and clenching the fists to boost circulation, consuming adequate fluids and salt and a high-fiber diet, and maintaining good sleep habits.
Newer Treatment Options Can Meaningfully Reduce “Off” Time
Since 2024, the U.S. Food and Drug Administration (FDA) has approved three new drugs focused on lessening the symptom fluctuations that people tend to experience more frequently as the disease advances:
- Crexont is a long-acting pill that combines an extended-release formulation of levodopa/carbidopa with immediate-release levodopa/carbidopa.
- Vyalev delivers levodopa/carbidopa continuously under the skin through a pump like the one used to deliver insulin for diabetes.
- Onapgo similarly uses a continuous infusion pump to deliver a constant supply of apomorphine, a medication (called a dopamine agonist) that looks and acts like dopamine, the brain chemical that decreases in Parkinson’s.
At a session focused on the use of medications to manage PD, speakers shared lessons learned from the growing use of these new longer-acting therapies to reduce “off” time, when medication wears off and Parkinson’s symptoms return. They presented experiences indicating that these therapies can meaningfully impact quality of life by reducing the amount of “off” time for some patients — and noted that “off” time can mean both a reduction in motor symptoms, like tremors and walking and balance, and non-motor symptoms, like fatigue, pain and anxiety. The infusion therapies also circumvent the gut, which can be helpful for people with digestive issues that delay absorption of oral medications.
Deep brain stimulation and focused ultrasound also received callouts for their improved capacity for reducing “off” time in appropriate candidates: In early 2025, the FDA approved the first “adaptive,” or self-adjusting, deep brain stimulation, which automatically tailors stimulation, in real time, to address symptoms and both-sided, “bilateral,” focused ultrasound, a surgical treatment using concentrated sound waves to target and destroy tiny, specific brain areas that contribute to movement symptoms and complications (previously, focused ultrasound was approved for use on one side of the brain and therefore eased symptoms on one side of the body only).
MJFF’s role in PD care advances was threaded throughout the conference, including in mentions of the Foundation’s support for therapeutic development, such as for research leading to medication and device advances — and more broadly, for the Foundation’s sponsorship and funding of PPMI. The 15-year natural history study follows thousands of people with and without Parkinson’s over time, collecting information that researchers use to fill gaps in understanding how the disease starts and progresses, reveal information about biological mechanisms underlying the disease, and inform and accelerate clinical trials.
PPMI is expanding to further fuel disease insights and therapeutic progress. To learn about participating, visit www.michaeljfox.org/ppmi.