Symposium 1: MDS-ES/EAN: The natural history of movement disorders
Main Auditorium, Saturday, June 24, 2017, 10:30-12:30
Chairperson:
Werner Poewe, Innsbruck, Austria
Evzen Ruzicka, Prague, Czech Republic
Has deep brain stimulation (DBS) changed the natural history of Parkinson’s disease?
Werner Poewe, Innsbruck, Austria
Huntington’s disease: When does it start and how does it evolve?
Jean-Marc Burgunder, Switzerland
Progressive nuclear palsy (PSP) and corticobasal degeneration (CBD): How do these two tauopathies progress?
Günter U. Höglinger, Munich, Germany
Multiple system atrophy (MSA): Does it progress differently in the Western and Asian populations?
Wassilios Meissner, Bordeaux, France
The joint symposium held by EAN and MDS painted a holistic picture, covering general knowledge combined with recent developments and current scientific publications on five important movement disorders and their natural history: Parkinson’s disease (PD), Huntington’s disease (HD), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) and multiple system atrophy (MSA).
Professor Poewe explained that deep brain stimulation (DBS) did not seem to change the underlying progression of PD, but provide a second, so-called “DBS honeymoon” following the “Levodopa honeymoon”. At the moment, there is too little evidence in favour of offering DBS very early in the course of PD, but after the introduction of Levodopa. DBS is the second biggest achievement in the treatment of PD patients and should therefore be offered if such patients meet the classical indication criteria for DBS.
Professor Burgunder pointed out that in HD patients there are several abnormalities, such as brain atrophy, especially of the basal ganglia, which can be recognised before the onset of motor symptoms. The start of HD is currently defined as the point at which such symptoms appear. The case of a young female patient formed a perfect framework for his presentation.
Professor Höglinger presented the common neuropathological and clinical aspects of PSP and CBD, and introduced the audience to the new diagnostic criteria for suggestive, possible, probable, and definite PSP. He reported that the progression of PSP was measurable with PET as well as with clinical scores like the PSPRS.
Professor Meissner informed the symposium that there was currently not enough data to conclude whether MSA symptoms progressed differently in Western and Asian populations. Although MSA-P is more common among Western populations, while MSA-C is more prevalent in Asian populations, the median survival rate is similar in both groups, at 8-10 years. To obtain more information about the natural history of PSP, CBD and MSA, the audience was informed that worldwide networks and observational studies were being set up, while other studies were already in progress, and the participation of further centres would be welcomed.
By Lisa Klingelhoefer
