Research on new Parkinson’s medications, strategies for managing Parkinson’s symptoms and insights on the role of sleep and nutrition were some of the highlights of this year’s American Academy of Neurology conference, which took place April 5-9 in San Diego.
With attendance topping 14,500, the conference serves as a key annual event for information sharing and networking among neurology researchers, movement disorder specialists, general neurologists and other clinicians who study and provide care for people with brain diseases, including Parkinson’s and other neurodegenerative diseases.
The conference featured updates on research and clinical care in Parkinson’s disease (PD). Below are some key takeaways.
Nutrition and Parkinson’s Management
MJFF’s principal medical advisor, Rachel Dolhun, MD, DipABLM, spoke at a symposium about the role of diet and nutrition in managing Parkinson’s symptoms.
Dr. Dolhun, a double-board-certified neurology and lifestyle medicine physician and fellowship-trained movement disorder specialist, presented evidence supporting the Mediterranean and MIND diets. She discussed their nutritional content, potential for easing symptoms and role in reducing the risk of malnutrition. For people experiencing motor fluctuations, she presented a strategy for eating that shifts protein intake to dinner while limiting it at breakfast and lunch, so that Parkinson’s medicine is better absorbed during the day.
To reduce constipation, a common symptom of Parkinson’s, she recommended drinking enough water and consuming a high-fiber diet. Drinking enough water also helps reduce orthostatic hypotension that can occur in PD, especially as the disease advances. Smaller, more frequent meals is another strategy for lowering hypotension risk, she said.
“The conference offers a welcome opportunity to bring this lifestyle content directly to not just movement disorders specialists but also general neurologists, who may then bring it to their patients. It’s so important to share widely the role that nutrition can play in helping manage the symptoms of the disease,” Dr. Dolhun said.
Sleep as an Avenue for Parkinson’s Prevention
In a much-discussed presentation, Isabella Montano, from the VA Portland Health Care System in Oregon, reported that treating obstructive sleep apnea appears to slow the progression of Parkinson’s. Montano and her colleagues analyzed 20 years of data from millions of veterans to learn about obstructive sleep apnea as a potential risk factor for Parkinson’s. They looked at rates of Parkinson’s five year after a sleep apnea diagnosis. Rates were significantly lower among those who started treatment with a continuous positive airway pressure (CPAP) machine within two years of being diagnosed with sleep apnea compared to people who waited two years or more to treat the sleep disorder.
The novel findings add to the list of reasons for proactively diagnosing and treating this common condition that disrupts sleep, lowers oxygen levels and increases the risk not only for PD but also for heart attack and stroke.
Emerging Treatments for Parkinson’s
The conference included noteworthy updates on emerging treatments targeting Parkinson’s motor symptoms, including tavapadon, a new dopamine agonist, and bemdaneprocel, a cellular therapy for motor impairments.
Tavapadon
Researchers reported that two Phase III trials of tavapadon, an oral once-daily dopamine agonist, showed that it was safe and eased motor symptoms when taken alone in people with recently diagnosed Parkinson’s. In addition, researchers reported a third Phase III trial, investigating tavapadon as an add-on to levodopa in people with more advanced PD, that showed the drug increased total daily “on” time by about an hour without increasing dyskinesias and other side effects. The drug’s manufacturer has said it plans to submit the drug for regulatory approval.
Bemdaneprocel
Researchers provided an update on a Phase I trial of bemdaneprocel, a cellular therapy engineered to replace the brain cells lost due to Parkinson’s with dopamine-producing neurons. They noted that 24 months after being surgically placed into the brain, bemdaneprocel posed no safety concerns and there were positive trends related to the treatment of motor impairments in people with PD. Based on the encouraging findings, the U.S. Food and Drug Administration granted BlueRock Therapeutics the ability to skip Phase II trials and move directly to Phase III for further evaluation of the effectiveness of bemdaneprocel.
The conference’s sessions also addressed emerging fieldwide themes, including a growing focus on the future of precision medicine, the role of climate change and the environment in brain disease, and neurostimulation as an increasingly adaptable treatment tool.