Movers and Shakers

Movers and Shakers

An epidemic of age-related degenerative diseases is upon us and chief amongst these, in the neurological realm, are Alzheimer’s disease and Parkinson’s disease (PD).

On 20 July 2017, Professor Dr Lim Shen-Yang, Consultant Neurologist & Professor, University of Malaya, discussed Parkinson’s disease, the neurological specialty of “Movement Disorders”, and broader issues regarding medical care in the modern age.

He started by giving a quick introduction to his specialisation of neurology, and delving specifically on movement disorders which, when patients have problems with movements, is either too little or too much. To give a better idea of how such conditions manifest, Dr Lim showed samples of micrographia, or small handwriting done by patients with PD, as well as videos of patients before and after treatments throughout the talk.

He explains that PD is a result of a deficiency of dopamine in the brain, hence medication is used to replace it. Over the years, there has been an array of treatment available to treat PD but most of them still rely on the principle of replacing dopamine within the brain.

…but as I said, doctors are only human… as much as you can, you want to frame things to your advantage. So, ask instead [of “What would you recommend?”], “What would you do if you were in my shoes?”

Dr Lim emphasised that PD is an age-related epidemic that affects a growing number of people worldwide. Unfortunately, current treatments are not without limitations, and medication may not always be effective or may cause even more excessive movements. There have been some advances to address such problems, such as the Deep-Brain Stimulation surgery, which modulates the abnormal brain activity that occurs.

However, the accumulation of Alpha-synuclein, an abnormal protein, in the brain is the underlying reason why patients who have had successful treatment of their movement problems can still develop problems that become refractory to treatment such as dementia and psychosis.

He showed that PD is a multi-system, widespread disease affecting many parts of the brain and the spinal cord among others. Over the years there has been an interest in the study of the accumulation of the abnormal protein and the possibility of interfering the spread of this protein throughout the brain. This is especially so as the trigger for this is still unknown.

Dr Lim then explained how treatments are tested, how patient-care has developed over the years and also emphasised the importance of the patients taking responsibility for their treatment by actively monitoring their treatment and working closely with their doctor.

The talk ended with Dr Lim addressing the audience’s questions, which included the possible benefits of physical exercise to counter movement disorders and possible triggers of PD.

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