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Parkinson Disease: HELP
Articles by Roongroj Bhidayasiri
Based on 66 articles published since 2010
(Why 66 articles?)
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Between 2010 and 2020, R. Bhidayasiri wrote the following 66 articles about Parkinson Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Editorial Editorial and introduction: Behavioral aspects of Parkinson's disease. 2017

Friedman, Joseph H / Bhidayasiri, Roongroj / Truong, Daniel D. ·Butler Hospital, Department of Neurology, Alpert Medical School of Brown University, RI, USA. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Truong Neuroscience Institute, Parkinson's and Movement Disorders Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA, USA. ·J Neurol Sci · Pubmed #28087061.

ABSTRACT: -- No abstract --

2 Editorial Nonmotor symptoms in Parkinson's disease: are we still waiting for the honeymoon? 2016

Colosimo, C / Bhidayasiri, R. ·Department of Neurology, Santa Maria University Hospital, Terni, Italy. carlo.colosimo@uniroma1.it. · Department of Medicine, Faculty of Medicine, Chulalongkorn Center of Excellence for Parkinson's Disease and Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. ·Eur J Neurol · Pubmed #27611181.

ABSTRACT: -- No abstract --

3 Review Mastering nocturnal jigsaws in Parkinson's disease: a dusk-to-dawn review of night-time symptoms. 2020

Bhidayasiri, Roongroj / Sringean, Jirada / Trenkwalder, Claudia. ·Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand. rbh@chulapd.org. · Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330, Thailand. · Department of Neurosurgery, University Medical Centre Goettingen, Paracelsus-Elena Hospital, Kassel, Germany. ·J Neural Transm (Vienna) · Pubmed #32172472.

ABSTRACT: Finding out about night-time symptoms from Parkinson's disease (PD) patients can be a challenge as many patients and their carers cannot recall many symptoms that occur during the night, resulting in an under-recognition or a large variability of responses from clinical interviews and scales. Moreover, technology-based assessments for most night-time symptoms are still not universally available for use in a patient's home environment. Therefore, most physicians rely on their clinical acumen to capture these night-time symptoms based on pieces of patients' history, bedpartner's reports, clinical features, associated symptoms or conditions. To capture more night-time symptoms, the authors identified common nocturnal symptoms based on how they manifest from dusk to dawn with selected features relevant to PD. While some symptoms occur in healthy individuals, in PD patients, they may impact differently. The authors intend this narrative review to provide a practical guide on how these common night-time symptoms manifest and highlight pertinent issues by focusing on prevalence, clinical symptomatology, and specific relationships to PD. It is also important to recognise that PD-specific sleep disturbances increase with advancing disease with additional contributions from ageing, comorbidities, and medication side effects. However, the relative contribution of each factor to individual symptom may be different in individual patient, necessitating clinical expertise for individual interpretation. While there are debatable issues in certain areas, they underlie the complexity of night-time symptoms. Understanding night-time symptoms in PD is like re-arranging jigsaw pieces of clinical information to create, but never complete, a picture for physicians to instigate appropriate management.

4 Review Exploring bedside clinical features of parkinsonism: A focus on differential diagnosis. 2019

Bhidayasiri, Roongroj / Rattanachaisit, Watchara / Phokaewvarangkul, Onanong / Lim, Thien Thien / Fernandez, Hubert H. ·Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Neurology, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. · Department of Neurology, Island Hospital, Penang, Malaysia. · Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA. ·Parkinsonism Relat Disord · Pubmed #30502095.

ABSTRACT: The proper diagnosis of parkinsonian disorders usually involves three steps: identifying core features of parkinsonism; excluding other causes; and collating supportive evidence based on clinical signs or investigations. While the recognition of cardinal parkinsonian features is usually straightforward, the appreciation of clinical features suggestive of specific parkinsonian disorders can be challenging, and often requires greater experience and skills. In this review, we outline the clinical features that are relevant to the differential diagnosis of common neurodegenerative parkinsonian disorders, including Parkinson's disease, multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration. We aim to make this process relatable to clinicians-in-practice, therefore, have categorised the list of clinical features into groups according to the typical sequence on how clinicians would elicit them during the examination, starting with observation of facial expression and clinical signs of the face, spotting eye movement abnormalities, examination of tremors and jerky limb movements, and finally, examination of posture and gait dysfunction. This review is not intended to be comprehensive. Rather, we have focused on the most common clinical signs that are potentially key to making the correct diagnosis and those that do not require special skills or training for interpretation. Evidence is also provided, where available, such as diagnostic criteria, consensus statements, clinicopathological studies or large multi-centre registries. Pitfalls are also discussed when relevant to the diagnosis. While no clinical signs are pathognomonic for certain parkinsonian disorders, certain clinical clues may assist in narrowing a differential diagnosis and tailoring focused investigations for the individual patient.

5 Review Getting a good night sleep? The importance of recognizing and treating nocturnal hypokinesia in Parkinson's disease. 2018

Bhidayasiri, Roongroj / Trenkwalder, Claudia. ·Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Department of Neurosurgery, University Medical Center Gottingen, Paracelsus Elena Hospital, Kassel, Germany. ·Parkinsonism Relat Disord · Pubmed #29336905.

ABSTRACT: When Parkinson's disease (PD) patients are asked about the quality of their sleep, their answers are dominated by difficulties associated with impaired mobility in bed, medically referred to as nocturnal hypokinesia. Nocturnal hypokinesia is symptomatic from the mid-stage of the disease, affecting up to 70% of PD patients, and contributes to poor sleep quality, and increased carer burden. Here we explore four areas of nocturnal hypokinesia that are relevant to clinical practice, namely: manifestations and definition; clinical assessment and objective monitoring; etiologies and contributing factors; and evidence-based therapeutic approaches. In addition, we provide an operational definition of what constitutes nocturnal hypokinesia and outline different methods of assessment, ranging from clinical interviews and rating scales to objective night-time monitoring with inertial sensors. Optimal management of nocturnal hypokinesia in PD begins with recognizing its manifestation by inquiring about cardinal symptoms and contributing factors from, not only patients, but also carers, followed by formal assessment, and the application of individualized evidence-based treatment. Night-time dopaminergic treatment is the primary therapy; however, careful clinical judgment is required to balance the benefits with the potential adverse events related to nocturnal dopaminergic stimulation. Future studies are needed to explore the practicality of home-based objective assessment of nocturnal hypokinesia, new therapeutic options not limited to dopaminergic medications, and non-pharmacologic approaches, including training on compensatory strategies and bedroom adaptations.

6 Review Non-Motor Symptoms Assessed by Non-Motor Symptoms Questionnaire and Non-Motor Symptoms Scale in Parkinson's Disease in Selected Asian Populations. 2017

Sauerbier, Anna / Jitkritsadakul, Onanong / Titova, Nataliya / Klingelhoefer, Lisa / Tsuboi, Yoshio / Carr, Harry / Kumar, Hrishikesh / Banerjee, Rebecca / Erro, Roberto / Bhidayasiri, Roongroj / Schrag, Anette / Zis, Panagiotis / Lim, Shen-Yang / Al-Hashel, J Y / Kamel, Walaa A / Martinez-Martin, Pablo / Ray Chaudhuri, K. ·Neurology, King's College Hospital, London, UK. ·Neuroepidemiology · Pubmed #28803229.

ABSTRACT: BACKGROUND: Ethnic variations have been described in medical conditions, such as hypertension, diabetes, and multiple sclerosis. Whether ethnicity plays a role in Parkinson's disease (PD), particularly with regard to non-motor symptoms (NMS), remains unclear. Existing literature is diverse, controversial, and inadequately documented. This review aims to analyse and report the currently available literature on NMS, specifically in Asian PD patients. SUMMARY: We conducted a literature review using PubMed, searching for articles and currently available publications that reference and assess NMS in PD patients living in Asia using the validated NMS Questionnaire (NMS Quest) and NMS Scale (NMSS). In total, 24 articles were included: 12 using the NMS Quest and 12 using the NMSS. Symptoms of constipation, memory impairment, and nocturia were the most frequently self-reported symptoms (NMS Quest) in selected Asian populations, while symptoms within the domains sleep/fatigue, attention/memory, and mood/apathy were most prevalent when applying the health-professional completed NMSS. Key Messages: NMS are generally prevalent and highly burdensome within selected Asian PD populations living in countries included in this review. Our review suggests that NMS-driven phenotypic heterogeneity is present in Asian patients, and compared to Western PD populations there might be variations in assessed NMS.

7 Review Objective Measurement and Monitoring of Nonmotor Symptoms in Parkinson's Disease. 2017

Klingelhoefer, Lisa / Jitkritsadakul, Onanong / Bhidayasiri, Roongroj. ·Technical University Dresden, Dresden, Germany. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. ·Int Rev Neurobiol · Pubmed #28802925.

ABSTRACT: The comprehensive evaluation of nonmotor symptoms (NMS) in Parkinson's disease (PD) starts with the awareness of physicians, patients, and caregivers on their nature, clinical presentation, and effect on patient's daily activities and quality of life. This awareness can be better achieved if the symptoms can be visualized, measured, and monitored. As NMS are largely subjective in nature, a majority of them cannot be visualized (unlike tremor, which is easily seen), making their identification and quantification difficult. While symptoms are nonmotor, it does not mean that they are not measurable, as many NMS are integral to motor symptoms of Parkinson's, yet often neglected. In this review, we attempt to provide the most up-to-date and comprehensive literature review on the objective measurement and monitoring of NMS in PD. The aim is to make it clinically relevant by approaching NMS by domains as identified in the NMS Questionnaire. A section on the assessment of nonmotor fluctuations is also included, providing prospects for future objective monitoring. With the advances of technology, it is likely that many NMS will have objective outcomes, thus making these symptoms easily measurable and hopefully lead to future clinical trials that incorporate nonmotor outcomes. Nevertheless, it still requires a physician's judgment to determine which method, scales, objective measures, or monitoring devices or a combination of these is most appropriate to the individual patient in order to answer a particular clinical question.

8 Review Systematic review of hardware-related complications of Deep Brain Stimulation: Do new indications pose an increased risk? 2017

Jitkritsadakul, Onanong / Bhidayasiri, Roongroj / Kalia, Suneil K / Hodaie, Mojgan / Lozano, Andres M / Fasano, Alfonso. ·Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Toronto, Ontario, Canada; Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. · Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University of Toronto, Canada; Krembil Research Institute, Toronto, Ontario, Canada. · Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Toronto, Ontario, Canada; Krembil Research Institute, Toronto, Ontario, Canada; Division of Neurology, University of Toronto, Toronto, Ontario, Canada. Electronic address: alfonso.fasano@uhn.ca. ·Brain Stimul · Pubmed #28739219.

ABSTRACT: INTRODUCTION: Deep Brain Stimulation (DBS) is an effective treatment extended broadly to many neurological and psychiatric disorders. Nevertheless, complications may arise during DBS procedures or following implantation due to implanted hardware. This may result in both minor and major adverse events that may necessitate hardware removal and/or compromise maximal therapeutic benefit for the patient. OBJECTIVES AND METHODS: To identify relevant literature on hardware-related complications from DBS procedures by performing a systematic review, and propose how to identify at-risk group and possible preventive approaches. RESULTS: Of 4592 abstract screened, 96 articles fulfilled the selection criteria and were reviewed. Overall, the most common hardware-related complications were infections (5.12% of patients), followed by lead migration (1.60%), fracture or failure of the lead or other parts of the implant (1.46% and 0.73%, respectively), IPG malfunctions (1.06% of patients), and skin erosions without infections (0.48% of patients). New indications for DBS, including Tourette's syndrome, cluster headache, and refractory partial epilepsy, were found to bear a higher incidence of hardware-related infections than established indications such as Parkinson's disease. The highest rate of lead fracture or failure was found in dystonia patients (4.22%). Ultimately, the highest rate of pain at the implantation sites was found in refractory partial epilepsy patients (16.55%). CONCLUSION: Our analysis identified a variety of potential hardware-related complications among patients who underwent DBS procedures. Patients who were at risk of complications, such as patients with dystonia and off-label indications (e.g. Tourette's syndrome) should be informed prior to surgery and closely followed thereafter.

9 Review RimabotulinumtoxinB in sialorrhea: systematic review of clinical trials. 2017

Dashtipour, Khashayar / Bhidayasiri, Roongroj / Chen, Jack J / Jabbari, Bahman / Lew, Mark / Torres-Russotto, Diego. ·Division of Movement Disorders, Department of Neurology/Movement Disorders, Loma Linda University School of Medicine, Faculty of Medical Offices, 11370 Anderson, Suite B-100, Loma Linda, CA USA. · 0000 0000 9852 649X · grid.43582.38 · Department of Medicine, Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330 Thailand. · 0000 0001 1018 2627 · grid.419934.2 · Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. · 0000 0004 1762 2738 · grid.258269.2 · Department of Neurology, Loma Linda University School of Medicine, Loma Linda, CA USA. · Loma Linda University, School of Pharmacy, Loma Linda, CA USA. · Department of Neurology, Yale University School of Medicine, New Haven, CT USA. · 0000000419368710 · grid.47100.32 · Department of Neurology, Keck School of Medicine at the University of Southern California, Los Angeles, CA USA. · 0000 0001 2156 6853 · grid.42505.36 · Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, USA. · 0000 0001 0666 4105 · grid.266813.8 ·J Clin Mov Disord · Pubmed #28593050.

ABSTRACT: OBJECTIVE: The aim of this study was to examine the efficacy, safety and dosing practices of rimabotulinumtoxinB (BoNT-B) for the treatment of patients with sialorrhea based on a systematic review of clinical trials. METHODS: A systematic literature review was performed to identify randomized controlled trials and other comparative clinical studies of BoNT-B for the treatment of sialorrhea published in English between January 1999 and December 2015. Medical literature databases (PubMed, Cochrane Library, and EMBASE) were searched and a total of 41 records were identified. Of these, six primary publications that evaluated BoNT-B for the treatment of sialorrhea met criteria and were included in the final data report. SYNTHESIS: Total BoNT-B doses ranged from 1500 to 4000 units for sialorrhea. Most of the studies in sialorrhea showed statistically significant benefits of BoNT-B versus placebo (range 4-19.2 weeks). BoNT-B was generally well tolerated across the individual studies; most adverse events reported were considered unrelated to treatment. Adverse events considered potentially associated with BoNT-B included: dry mouth, change in saliva thickness, mild transient dysphagia, mild weakness of chewing and diarrhea. CONCLUSIONS: BoNT-B significantly reduces sialorrhea at doses between 1500 and 4000 units. The relatively mild dose-dependent adverse events suggest both direct and remote toxin effects.

10 Review Clinical Assessments in Parkinson's Disease: Scales and Monitoring. 2017

Bhidayasiri, Roongroj / Martinez-Martin, Pablo. ·Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain. ·Int Rev Neurobiol · Pubmed #28554406.

ABSTRACT: Measurement of disease state is essential in both clinical practice and research in order to assess the severity and progression of a patient's disease status, effect of treatment, and alterations in other relevant factors. Parkinson's disease (PD) is a complex disorder expressed through many motor and nonmotor manifestations, which cause disabilities that can vary both gradually over time or come on suddenly. In addition, there is a wide interpatient variability making the appraisal of the many facets of this disease difficult. Two kinds of measure are used for the evaluation of PD. The first is subjective, inferential, based on rater-based interview and examination or patient self-assessment, and consist of rating scales and questionnaires. These evaluations provide estimations of conceptual, nonobservable factors (e.g., symptoms), usually scored on an ordinal scale. The second type of measure is objective, factual, based on technology-based devices capturing physical characteristics of the pathological phenomena (e.g., sensors to measure the frequency and amplitude of tremor). These instrumental evaluations furnish appraisals with real numbers on an interval scale for which a unit exists. In both categories of measures, a broad variety of tools exist. This chapter aims to present an up-to-date summary of the most relevant characteristics of the most widely used scales, questionnaires, and technological resources currently applied to the assessment of PD. The review concludes that, in our opinion: (1) no assessment methods can substitute the clinical judgment and (2) subjective and objective measures in PD complement each other, each method having strengths and weaknesses.

11 Review The sleeping brain in Parkinson's disease: A focus on REM sleep behaviour disorder and related parasomnias for practicing neurologists. 2017

Bhidayasiri, Roongroj / Sringean, Jirada / Rattanachaisit, Watchara / Truong, Daniel D. ·Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital and Thai Red Cross Society, Bangkok, Thailand. · Parkinson's and Movement Disorders Institute, Fountain Valley, CA, USA. ·J Neurol Sci · Pubmed #28126342.

ABSTRACT: Sleep disorders are identified as common non-motor symptoms of Parkinson's disease (PD) and recently this recognition has been expanded to include parasomnias, encompassing not only REM sleep behaviour disorder (RBD), but also other non-REM forms. RBD, a prototypical parasomnia in PD, exists even in the prodromal stage of the disease, and is characterized by the presence of dream enactment behaviours occurring alongside a loss of normal skeletal muscle atonia during REM sleep. In contrast, non-REM parasomnias are more frequently observed in the late stage PD. However, the development of these disorders often overlaps and it is not uncommon for PD patients to meet the criteria for more than one type of parasomnias, thus making a clinical distinction challenging for practicing neurologists who are not sleep specialists. Indeed, clinical recognition of the predominant form of parasomnia does not just depend on video-polysomnography, but also on an individual physician's clinical acumen in delineating pertinent clinical history to determine the most likely diagnosis and proceed accordingly. In this review article, we highlight the various forms of parasomnias that have been reported in PD, including, but not limited to, RBD, with a focus on clinical symptomatology and implications for clinical practice. In addition, we review the differences in PD-related parasomnias compared to those seen in general populations. With advances in sleep research and better technology for ambulatory home monitoring, it is likely that many unanswered questions on PD-related parasomnias will soon be resolved resulting in better management of this nocturnal challenge in PD.

12 Review Understanding the role of the Parkinson's disease nurse specialist in the delivery of apomorphine therpy. 2016

Bhidayasiri, Roongroj / Boonpang, Kamolwan / Jitkritsadakul, Onanong / Calne, Susan M / Henriksen, Tove / Trump, Sally / Chaiwong, Suchapit / Susang, Phenprapa / Boonrod, Nonglak / Sringean, Jirada / van Laar, Teus / Drent, Martje / Chaudhuri, K Ray. ·Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. · Pacific Parkinson's Research Center, University of British Columbia, Vancouver, (1982-2007), Canada. · Movement Disorder Clinic, University Hospital of Bispebjerg, Copenhagen, Denmark. · National Parkinson Foundation Centre of Excellence, King's College Hospital, London, United Kingdom. · Department of Neurology, University of Groningen, Groningen, The Netherlands. ·Parkinsonism Relat Disord · Pubmed #27939324.

ABSTRACT: Optimal care of Parkinson's disease (PD) patients should involve a multidisciplinary team (MDT) of which a PD nurse specialist (PDNS) is a key member. The role of a PDNS is particularly prominent in the care of advanced PD patients suitable for apomorphine because, in addition to nursing skills, apomorphine treatment requires liaison, training, interaction and coordination with patients, caregivers and other members of the MDT as well as the interface with primary care physicians. The therapeutic success of apomorphine therapy depends not only upon the pharmacologic drug response, but also on how well the patient understands his/her disease and how to handle the therapy. In this respect, a PDNS is a vital member of the MDT who provides education and training, support, and is available for consultation when problems arise. In this article, we review the literature on the contribution of PDNSs in both continuous subcutaneous apomorphine infusion and intermittent subcutaneous apomorphine injection and highlight the various beneficial aspects of PDNS care, supported by scientific evidence when available. Despite a low level of published evidence, there is strong clinical evidence that the impact of PDNSs on the management of apomorphine therapy is vital and indispensable for the success of this treatment.

13 Review Unmet needs in Parkinson's disease: New horizons in a changing landscape. 2016

Chaudhuri, K Ray / Bhidayasiri, Roongroj / van Laar, Teus. ·The Maurice Wohl Clinical Neuroscience Institute, King's College London and National Parkinson Foundation Centre of Excellence, King's College Hospital London, UK. · Chulalongkorn Center of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Department of Neurology, University of Groningen, Groningen, The Netherlands. ·Parkinsonism Relat Disord · Pubmed #27932224.

ABSTRACT: The success of levodopa and other classes of drugs have meant that most people with Parkinson's disease enjoy a good quality of life for many years. However, despite the availability of several drugs and formulations that can be used as monotherapy and in combination, there are a number of disease features that the current therapies are unable to address. The disease continues to progress despite treatment, patients suffer from a myriad of motor and non-motor symptoms, and a neuroprotective therapy is urgently required. To move forward with medical and surgical management, it is important to consider new insights that recent research offers and in this review we examine how a better understanding of the disease pathology and progression might improve and enrich our daily clinical practice. It is also timely to consider the service provision changes that will increasingly be needed to effectively manage the needs of the aging population.

14 Review Practical management of adverse events related to apomorphine therapy. 2016

Bhidayasiri, Roongroj / Garcia Ruiz, Pedro J / Henriksen, Tove. ·Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Movement Disorders Unit, Department of Neurology, Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain. · Movement Disorder Clinic, University Hospital of Bispebjerg, Bispebjerg Bakke 23 2400 Copenhagen, NV, Denmark. ·Parkinsonism Relat Disord · Pubmed #27919586.

ABSTRACT: The potential for adverse events is often cited as a barrier to the use of subcutaneous apomorphine therapy (intermittent injections and continuous infusion) in the management of Parkinson's disease. However, with proactive management most adverse effects are manageable if reported and tackled early enough. As such, proper clinician and patient awareness of the potential adverse effects is important to minimize their impact on the overall clinical utility of this efficacious antiparkinsonian agent. In this paper, we review the key local and systemic adverse effects reported during apomorphine titration, initiation and long-term treatment, and discuss practical management strategies.

15 Review Physicians' role in the determination of fitness to drive in patients with Parkinson's disease: systematic review of the assessment tools and a call for national guidelines. 2016

Jitkritsadakul, Onanong / Bhidayasiri, Roongroj. ·Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330 Thailand. · Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama 4 Road, Bangkok, 10330 Thailand ; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. ·J Clin Mov Disord · Pubmed #27729986.

ABSTRACT: BACKGROUND: Physicians are usually at the forefront when the issue of driving ability is raised by Parkinson's disease (PD) patients or their family members, even though few have been formally trained in this area. OBJECTIVES AND METHODS: To identify relevant literature on driving assessment tools in patients with PD by performing a systematic review on this subject in order to provide background information for physicians on what types of driving assessment are available, and to delineate the role of physicians in providing fitness to drive recommendations. RESULTS: Of 1,490 abstracts screened, 55 articles fulfilled the selection criteria that investigated assessment of driving ability in PD patients with questionnaires, off-road testing battery, driving simulators, and driving skill tests (on-road tests and naturalistic driving test). Despite different methodology across studies, PD patients were observed to commit more driving errors than controls. Poor driving performance correlated with motor, visual, and cognitive severity. Excessive daytime somnolence was common in PD drivers and the presence of falling asleep while driving was identified to be a significant predictor of car accidents. CONCLUSION: Although the evidence indicated more driving errors among PD drivers as identified by various assessment tools, the extent on how physicians should be involved in the evaluation process and make related recommendations remain unclear. Driving safety is an important public health issue in PD that needs better-defined specific legal and medical guidelines. National guidelines that establish risk assessment protocols involving multidisciplinary assessments are needed to assist physicians in making appropriate referrals for additional evaluations and recommendations when patients are deemed to be unsafe drivers.

16 Review Sensor-based evaluation and treatment of nocturnal hypokinesia in Parkinson's disease: An evidence-based review. 2016

Bhidayasiri, Roongroj / Sringean, Jirada / Thanawattano, Chusak. ·Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand. · Biomedical Signal Processing Laboratory, National Electronics and Computer Technology Center (NECTEC) and National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand. ·Parkinsonism Relat Disord · Pubmed #26453387.

ABSTRACT: The manifestations of nocturnal movements in Parkinson's disease (PD) are protean, with major disabilities related to nocturnal hypokinesia. While it can be assessed by clinical interviews and screening instruments, these are often inaccurate and prone to recall bias. In light of advances in sensor technology, we explored the use of sensors in the study of nocturnal hypokinesia, by performing a systematic review of the professional literature on this topic. Evidence suggests that nocturnal hypokinesia exists even in patients in the early stages, and PD patients turned significantly less and with much slower speed and acceleration than controls, partly related to low nocturnal dopamine level. We conducted another systematic review to evaluate the evidence of the efficacy of dopaminergic agents in the treatment of nocturnal hypokinesia. Several lines of evidence support the use of long-acting drugs or by continuous administration of short-acting agents to control symptoms. Sensor parameters could be considered as one of the important objective outcomes in future clinical trials investigating potential drugs to treat nocturnal hypokinesia. Physicians should be aware of this technology as it can aid the clinical assessment of nocturnal hypokinesia and enhance the quality of patient care. In addition, the use of sensors currently is being considered for various aspects of research on early diagnosis, treatment, and rehabilitation of PD patients.

17 Review Asian perspectives on the recognition and management of levodopa 'wearing-off' in Parkinson's disease. 2015

Bhidayasiri, Roongroj / Hattori, Nobutaka / Jeon, Beomseok / Chen, Rou-Shayn / Lee, Moon Keen / Bajwa, Jawad A / Mok, Vincent C T / Zhang, Baorong / Syamsudin, Thamrin / Tan, Louis Chew Seng / Jamora, Roland Dominic G / Pisarnpong, Apichart / Poewe, Werner. ·a 1 Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · b 2 Juntendo University School of Medicine, Tokyo, Japan. · c 3 Seoul National University, Seoul, South Korea. · d 4 Chang Gung Memorial Hospital, Lingkou, Taiwan. · e 5 Sunway Medical Centre, Jalan Lagoon Selatan, Bandar Sunway, 46150 Petaling Jaya, Selangor, Malaysia. · f 6 National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. · g 7 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China. · h 8 Department of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. · i 9 National Brain Centre Hospital, Jakarta, Indonesia. · j 10 National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore. · k 11 Department of Neurosciences, College of Medicine-Philippine General Hospital, University of the Philippines Manila, Manila, Philippines. · l 12 Movement Disorder Service and Section of Neurology, Institute for Neurosciences, St. Luke's Medical Center-Quezon City and Global City, Philippines. · m 13 Department of Neurology, Bangkok Hospital, Bangkok, Thailand. · n 14 Innsbruck Medical University, Innsbruck, Austria. ·Expert Rev Neurother · Pubmed #26390066.

ABSTRACT: Most Parkinson's disease patients will receive levodopa therapy, and of these, the majority will develop some levodopa-induced complications. For many patients, the first complication to develop is the decline in the duration of therapeutic benefit of each levodopa dose, a phenomenon commonly termed 'wearing-off'. There is already extensive literature documenting the epidemiology and management of wearing-off in Parkinson's disease patients of western descent. However, data derived from these studies might not always apply to patients of Asian descent due to genetic variations, differences in co-morbidities or non-availability of certain drugs. This review summarizes the current literature regarding the epidemiology of wearing-off in Asian (including Arab) patients and discusses the management issues in the context of drug availability in Asia.

18 Review What is the evidence to support home environmental adaptation in Parkinson's disease? A call for multidisciplinary interventions. 2015

Bhidayasiri, Roongroj / Jitkritsadakul, Onanong / Boonrod, Nonglak / Sringean, Jirada / Calne, Susan M / Hattori, Nobutaka / Hayashi, Akito. ·Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org. · Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. · Pacific Parkinson's Research Center, University of British Columbia, Vancouver, Canada. · Department of Neurology, Juntendo University, Tokyo, Japan. · Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. ·Parkinsonism Relat Disord · Pubmed #26365779.

ABSTRACT: "Home" is where one has a sense of belonging and feels secure, but it can also be a risky place for people with Parkinson's disease (PD). PD patients need assistance making adjustments to their physical environment to maintain appropriate care and provide a safe environment. This relationship is called the "person-environmental fit" (P-E fit). While most PD patients remain in their own homes, little is known about the specific challenges that PD patients and their caregivers encounter in the routine activities of daily living. The aim of our study was to identify the existing evidence on the issue of housing environmental adaptation in PD by performing a systematic review with a proposal of development strategies to integrate a multidisciplinary team into a home environmental research. MEDLINE, and life science journals were searched by querying appropriate key words, but revealed very few publications in this area. However, early evidence suggested that PD patients do not enjoy an adequate P-E fit in their own homes and face more functional limitations compared to matched controls. We concluded that we need to develop research-based evaluation strategies that can provide us with a theoretical and conceptual basis as well as tools for analysis of the P-E fit for PD patients and caregivers. We recommend that individual members of the multidisciplinary team including patients, caregivers, physicians, rehabilitation specialists, and social workers use a team approach to identify the key indicators and solutions for the development of PD-specific solutions for improving the P-E fit.

19 Review Effective delivery of apomorphine in the management of Parkinson disease: practical considerations for clinicians and Parkinson nurses. 2015

Bhidayasiri, Roongroj / Chaudhuri, K Ray / LeWitt, Peter / Martin, Anne / Boonpang, Kamolwan / van Laar, Teus. ·*Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; †Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA; ‡National Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill Campus, London, United Kingdom; §Wayne State University School of Medicine, Parkinson's Disease and Movement Disorders Program, Henry Ford West Bloomfield Hospital, West Bloomfield, MI; ║King's College Hospital, Denmark Hill Campus, London, United Kingdom; ¶Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Bangkok, Thailand; and #Department of Neurology, Movement Disorder Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. ·Clin Neuropharmacol · Pubmed #25970277.

ABSTRACT: The clinical utility of long-term oral levodopa therapy in Parkinson disease (PD) is often limited by the emergence of motor complications. Over time, many patients with PD experience regular and/or unpredictable "off" periods, despite taking optimized oral medication regimens, with a major negative impact on their ability to undertake routine activities of daily living and consequently on their overall quality of life. One established approach for treating patients experiencing off periods and controlling motor fluctuations refractory to conventional oral drug therapy is the subcutaneous administration of the dopaminergic agonist apomorphine. This article outlines how the pharmacokinetic properties of apomorphine underpin its efficacy for the treatment of PD and provides practical guidance for the 3 main approaches in which it is used: subcutaneous intermittent apomorphine injection as a "rescue" therapy for off states, subcutaneous continuous apomorphine infusion for PD patients with intractable motor fluctuations as an alternative to other dopaminergic treatment, and in the apomorphine response (or challenge) test for assessment of dopamine-induced motor response in patients thought to have PD, or in establishing the optimal tolerated dose of apomorphine in patients already known to have PD. Also discussed is the management of potential adverse events with subcutaneous administration of apomorphine, the majority of which are mild and easily managed in practice. The importance of a multidisciplinary PD team in the optimal management of PD patients is now recognized, in particular the role of the specialist PD nurse.

20 Review Different diagnostic criteria for Parkinson disease: what are the pitfalls? 2013

Bhidayasiri, Roongroj / Reichmann, Heinz. ·Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. rbh1@ucla.edu ·J Neural Transm (Vienna) · Pubmed #23494196.

ABSTRACT: As there are no definite diagnostic tests or reliable biomarkers for Parkinson disease (PD), its diagnosis still relies on the presence of a combination of cardinal motor features, along with the exclusion of other causes of Parkinsonism and the presence of some of supportive features. To date, several diagnostic criteria have been developed for different purposes through expert opinions or comprehensive review of the literature. However, none of them are without limitations. In this article, we review different diagnostic criteria for PD which have been published in the English medical literature, highlighting specific limitations and pitfalls. With considerable progress in the understanding of PD, particularly in a view of diverse clinical symptomatology and its evolution, it will be difficult to establish a single criterion that is capable of capturing all cases at different disease stages. Rather, we should aim to develop a set of criteria which include a consensus on clinical gold standard or reliable biomarkers at different levels of diagnostic certainty for different purposes. Despite a more refined set of criteria that may aid in the recognition of PD, the accuracy of its diagnosis still largely depends on the observational skills and clinical sensitivity of the treating physician.

21 Review Synucleinopathies from bench to bedside. 2012

Puschmann, Andreas / Bhidayasiri, Roongroj / Weiner, William J. ·Department for Geriatric Psychiatry, Lund University, Sweden. andreas.puschmann@med.lu.se ·Parkinsonism Relat Disord · Pubmed #22166445.

ABSTRACT: Accumulation of alpha-synuclein is a pathological feature in several neurological diseases. Its characterization has allowed for a re-grouping of diseases according to the expected pathology. The clinical syndrome of PD can now be classified into forms with and without alpha-synuclein pathology. DLB and PDD are synucleinopathies, and MSA shows alpha-synuclein pathology with glial inclusions. ADHD symptoms commonly occur in persons that will subsequently develop DLB. A similar phenomenon may be the early personality changes and frontotemporal atrophy in patients with SNCA multiplication. RLS is not known to have alpha-synuclein pathology, but as PD and ADHD, involves a hypodopaminergic state. Furthermore, PD and RLS co-occur in families in a way that suggests common inheritance. A proportion of patients with ET have brainstem Lewy body pathology. Gaucher disease and other lysosomal storage disorders also have alpha-synuclein pathology. Alpha-synuclein is a naturally unfolded protein. Non-fibrillar oligomeres may be the toxic species, and Lewy body formation may in fact be protective. Inhibiting alpha-synuclein toxicity seems to be an attractive novel treatment strategy and several approaches are being developed. When such treatments become available, clinicians will need to be familiar with the clinical features that distinguish the synucleinopathies from their look-alikes.

22 Review Therapeutic strategies for nonmotor symptoms in early Parkinson's disease: the case for a higher priority and stronger evidence. 2012

Bhidayasiri, Roongroj / Truong, Daniel D. ·Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. rbh1@ucla.edu ·Parkinsonism Relat Disord · Pubmed #22166405.

ABSTRACT: It is now recognized that the neuropathology of early Parkinson's disease (PD) is not limited to the nigrostriatal dopaminergic system, but also involves various brainstem nuclei, the hypothalamus, the olfactory system, and the peripheral autonomic nervous system. Given the disseminated neuropathology of early PD, the earliest clinical signs include a myriad of non-motor manifestations including sleep-wake cycle regulation, cognition, mood and motivation, olfactory and gustatory functions, autonomic functions, and sensory and pain processing. Despite this realization, there is clearly a paucity of trials that have systematically evaluated the treatment of non-motor symptoms of PD in the early stages. For example, only one large-scale, placebo-controlled randomized trial has been conducted on the treatment of depression in PD patients. There are no reports of randomized controlled trials of therapeutic agents looking at the frequently reported anxiety and fatigue in early PD patients. Based on this lack of evidence, therapy for early non-motor manifestations is often ignored and the focus remains on dopamine replacement strategies with main outcomes being restricted to motor measurements, such as the Unified Parkinson's Disease Rating Scale. This article presents the case for prioritizing well-designed, controlled clinical trials of therapeutic interventions focusing on non-motor symptoms in early PD patients.

23 Clinical Trial Compassionate trial of levodopa carbidopa intestinal gel infusion in two patients with progressive supranuclear palsy. 2014

Bhidayasiri, Roongroj / Jitkritsadakul, Onanong / Boonrod, Nonglak / Rerknimitr, Rungsun. ·Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Neurology, Geffen School of Medicine at UCLA, Los Angeles 90095, USA. Electronic address: rbh1@ucla.edu. · Chulalongkorn Center of Excellence on Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand. · Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand. ·Clin Neurol Neurosurg · Pubmed #24388506.

ABSTRACT: -- No abstract --

24 Article COVID-19: An Early Review of Its Global Impact and Considerations for Parkinson's Disease Patient Care. 2020

Bhidayasiri, Roongroj / Virameteekul, Sasivimol / Kim, Jong-Min / Pal, Pramod Kr / Chung, Sun-Ju. ·Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. · Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. · Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India. · Department of Neurology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea. ·J Mov Disord · Pubmed #32344993.

ABSTRACT: While many infectious disorders are unknown to most neurologists, COVID-19 is very different. It has impacted neurologists and other health care workers, not only in our professional lives but also through the fear and panic within our own families, colleagues, patients and their families, and even in the wider public. COVID-19 affects all sorts of individuals, but the elderly with underlying chronic conditions are particularly at risk of severe disease, or even death. Parkinson's disease (PD) shares a common profile as an age-dependent degenerative disorder, frequently associated with comorbidities, particularly cardiovascular diseases, so PD patients will almost certainly fall into the high-risk group. Therefore, the aim of this review is to explore the risk of COVID-19 in PD based on the susceptibility to severe disease, its impact on PD disease severity, potential long-term sequelae, and difficulties of PD management during this outbreak, where neurologists face various challenges on how we can maintain effective care for PD patients without exposing them, or ourselves, to the risk of infection. It is less than six months since the identification of the original COVID-19 case on New Year's Eve 2019, so it is still too early to fully understand the natural history of COVID-19 and the evidence on COVID-19-related PD is scant. Though the possibilities presented are speculative, they are theory-based, and supported by prior evidence from other neurotrophic viruses closely related to SARS-CoV-2. Neurologists should be on high alert and vigilant for potential acute and chronic complications when encountering PD patients who are suspected of having COVID-19.

25 Article Delivering patient-centered care in Parkinson's disease: Challenges and consensus from an international panel. 2020

Bhidayasiri, Roongroj / Panyakaew, Pattamon / Trenkwalder, Claudia / Jeon, Beomseok / Hattori, Nobutaka / Jagota, Priya / Wu, Yih-Ru / Moro, Elena / Lim, Shen-Yang / Shang, Huifang / Rosales, Raymond / Lee, Jee-Young / Thit, Win Min / Tan, Eng-King / Lim, Thien Thien / Tran, Ngoc Tai / Binh, Nguyen Thanh / Phoumindr, Appasone / Boonmongkol, Thanatat / Phokaewvarangkul, Onanong / Thongchuam, Yuwadee / Vorachit, Somchit / Plengsri, Rachaneewan / Chokpatcharavate, Marisa / Fernandez, Hubert H. ·Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. Electronic address: rbh@chulapd.org. · Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand. · Department of Neurosurgery, University Medical Centre Goettingen, Paracelsus-Elena Hospital, Kassel, Germany. · Movement Disorder Centre at Seoul National University Hospital, Seoul, South Korea. · Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan. · Department of Neurology, Chang-Gung Memorial Hospital, Linkou Medical Centre and Chang-Gung University College of Medicine, Taipei, Taiwan. · Movement Disorder Centre, Centre Hospitalier Universitaire (CHU) of Grenoble, Grenoble Alpes University, INSERM U1216, France. · Division of Neurology, Department of Medicine and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. · Department of Neurology, West China Hospital, Sichuan University, China. · Neuroscience Institute, Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Manila, Philippines. · Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, Seoul, South Korea. · Department of Neurology, University of Medicine, Yangon General Hospital, Yangon, Myanmar. · National Neuroscience Institute, DUKE NUS Medical School, Singapore. · Department of Neurology, Island Hospital, Penang, Malaysia. · Movement Disorder Unit, Neurology Department, University Medical Centre, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh, Viet Nam. · Department of Neurology, Hanoi Medical University and National Geriatric Hospital, Hanoi, Viet Nam. · University of Health Science, Vientiane, Laos. · Chulalongkorn Parkinson Patients' Support Group, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Bangkok, Thailand. · Center for Neurorestoration, Cleveland Clinic, Cleveland, OH, USA. ·Parkinsonism Relat Disord · Pubmed #32146380.

ABSTRACT: An international panel of movement disorders specialists explored the views and perceptions of people with Parkinson's disease (PD) about their condition and its treatment, including the potential mismatch between the clinician's view of the patient's condition and their own view of what aspects of the disease most affect their daily lives. The initiative was focused on Asian countries, so participants comprised experts in the management of PD from key centers in Asia, with additional insight provided by European and the North American movement disorders experts. Analysis of peer-reviewed publications on patient perceptions of PD and the factors that they consider important to their wellbeing identified several contributing factors to the mismatch of views, including gaps in knowledge of PD and its treatment, an understanding of the clinical heterogeneity of PD, and the importance of a multidisciplinary approach to patient care. The faculty proposed options to bridge these gaps to ensure that PD patients receive the personalized treatment they need to achieve the best possible outcomes. It was considered essential to improve patient knowledge about PD and its treatment, as well as increasing the awareness of clinicians of PD heterogeneity in presentation and treatment response. A multidisciplinary and shared-care approach to PD was needed alongside the use of patient-centered outcome measures in clinical trials and clinical practice to better capture the patient experience and improve the delivery of individualized therapy.

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