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Shifting the Paradigm: A New Era for Parkinson’s Care

In this episode of “Hear From Her:” Hear from two leaders at the forefront of a much-needed change in how Parkinson’s is understood, diagnosed, and treated.

- PMLiVE

Padma Mahant, MD, was working in a clinic as a movement disorder specialist when she noticed a disturbing trend. Patients eventually diagnosed with Parkinson’s disease “took several years to find their way to me,” she says. There were many misdiagnoses and multiple medication trials before finally getting correctly diagnosed.  And during that elapsed time, their Parkinson’s had progressed quite a bit. “It seemed like such a lost opportunity for early intervention,” Mahant says, “because we know from studies that starting treatment early can improve quality of life and slow the disease’s progression significantly.”

That realization was a turning point in Mahant’s career. She decided she wanted to become involved in educating clinicians about Parkinson’s symptoms during the “significant prodromal state prior to developing motor symptoms” and researching and creating a diagnostic tool for clinicians to use.

Mahant still sees patients, but now she’s also Director of Medical Affairs at CND Life Sciences, a company leading the way in advancing the care of patients facing a potential diagnosis of a neurodegenerative disease. And they have made breakthroughs: CND recently presented a sleep study that revealed a particular protein detected in 75% of Parkinson’s patients with Rapid Eye Movement Sleep Behavior Disorder but no motor symptoms. Manant says she believes “this is an opportunity to really move the needle” in terms of early intervention and towards disease modification.

Before her big career pivot, Mahant says, “one of the first people I called to say, ‘Hey, I’m thinking about making this shift and what do you think?’ Was Indu.”

Indu is Dr. Indu Subramanian, clinical professor of neurology at UCLA and director of the South West Parkinson Disease Research, Education and Clinical Care Center of Excellence. She is also board certified in Integrative medicine and co-chair of the Wellness Task Force at the Movement Disorders Society.  “As a young neurologist, I found that classic Western medicine wasn’t really serving my patients that well. So I became curious about other things,” she says.

Subramanian started her own yoga and mindfulness practices and ended up training to teach both. She also became interested in integrative medicine and alternative practices like Ayurveda and traditional Chinese medicine, and started really leaning into those things for her Parkinson’s patients, to help with the emotional distress that Parkinson’s can cause.

The image most people have of Parkinson’s, Subramanian says, is an older Caucasian man with a tremor. However, a growing body of evidence, and the stories of countless patients, challenges this outdated view.  Changing the Parkinson’s narrative, especially for women, requires not just better science, but also raising awareness about prodromal symptoms and the need for clinicians to be more proactive about early diagnosing. 

Women in a prodromal stage, for instance, often experience anxiety and constipation, but are often told their symptoms are stress-related.  Once patients understand that they are experiencing Parkinson’s type symptoms, we can teach them wellness strategies and lifestyle changes to help them live better, they say.  “Hopefully, developing those strategies early can help prevent progression.”

“I think we all went into medicine to help make other people’s lives better,” says Subramanian. “What fills my teacup time and time again is helping a patient and hearing that they’re doing better because of something that I was able to bring, uniquely as a woman perhaps. Who was able to slow down and take the time and connect, offer them something to help them feel better other than a pill or surgery.”

Hosted by Sara Thorpe, Director of Clinical Strategy at Medscape Education

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