"I think we can look broadly to research across the neurodegenerative diseases to assess how co-morbid pathologies might influence the rate of progression and the severity of expression of the disease. How does cerebrovascular disease affect PD disease course? How does sarcopenia and sedentary lifestyle affect disease progression, and can they be improved? Our patients are complex individuals not just with many organ systems but also multiple social/environmental influences." ~ Dr. Ludy Shih
This month, ANA spoke to Associate Professor at Boston University School of Medicine/Boston Medical Center, Ludy Shih, MD, MMSc. She discusses the wide range of treatment options for Parkinson’s disease (PD), the public’s understanding of the disease, and her lab’s current work focusing on PD.
What does the public need to understand about PD that it often doesn’t?
I think the public doesn’t grasp how complex PD is, in the way it affects people so differently from person to person. While it’s important that we keep working at understanding the biology of the disease, we also need innovative treatments to alleviate some of the burden for people who have it now.
How are treatment options for PD different today from 10 years ago?
We have many pharmacologic options for improving dopaminergic tone, but now the landscape has more options both for motor and non-motor symptoms. Clinicians and patients are also managing the complexity of choosing the right regimen, not just of pharmacotherapy, but rehabilitation strategies, neuromodulation, and other advanced therapies, as well as proper recognition and management of non-motor symptoms including sleep, pain, anxiety, GI symptoms, etc.
This requires a mastery of new and emerging information in the literature, as well as recognition of knowledge gaps that need to be filled in order to improve overall treatment of PD.
What promising research is poised to change the standard of treatment for PD?
I think we can look broadly to research across the neurodegenerative diseases to assess how co-morbid pathologies might influence the rate of progression and the severity of expression of the disease. How does cerebrovascular disease affect PD disease course? How does sarcopenia and sedentary lifestyle affect disease progression, and can they be improved? Our patients are complex individuals not just with many organ systems but also multiple social/environmental influences.
What work is your lab undertaking to move understanding or treatment for PD forward?
Right now, my group is taking an interdisciplinary approach and focusing on understanding gait and functional mobility and its relationships to non-motor aspects, including cognition, but also to everyday navigation of life with the disease.
We are interested in developing methods that can help clinicians assess and understand how their patients are affected and how they can use this information to deliver care in a tailored fashion, whether it’s through remote care, use of digital technologies, or targeting the right rehabilitation strategy for the problem at hand.
How has the ANA supported your career and/or work in this area?
The ANA is an organization that is committed to supporting physicians who have a keen interest in critically appraising the way we currently diagnose, treat and manage our patients with neurological disease and in pushing the boundaries of what we currently have available. I think this gets to the heart of the motivation driving most neurologists who want to spend their time making an impact on the field and leaving it different than when they came into it.
I’ve had the opportunity to present my work at the ANA Annual Meeting and to create a career development panel on how academic physicians can collaborate with non-academic partners, like industry research and development teams, to tackle some of our biggest problems. When we can have conversations like these about working together, we can begin to feel that path is less lonely and difficult than we might be inclined to think.
Want to learn about more of the groundbreaking research being conducted by ANA members? Read past editions of The ANA Q&A.