EP 38 - The Parkinson Weekly Helpdesk

🎙️ In Episode 41 of Parkinson Weekly, Prof. Bas Bloem opens the Helpdesk once again to answer questions submitted by listeners.In this fourth Helpdesk episode, Bas explores three very different but important topics. He begins with women and Parkinson’s, discussing the menstrual cycle, menopause, hormone replacement therapy and pregnancy, and why women with Parkinson’s may require more individualised approaches to care.He then looks at whether infections, stressful events or even mosquito bites could trigger Parkinson’s, explaining the difference between causing the disease and potentially unmasking symptoms that were already developing.Finally, Bas discusses delayed gastric emptying in Parkinson’s, how it can affect the absorption and reliability of oral medication, signs such as bloating and unpredictable medication response, and some of the approaches that may help manage it.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

In Episode 40 of Parkinson Weekly, Prof. Bas Bloem explores what he describes as one of the most exciting and encouraging developments in Parkinson’s clinical research: multi-arm, multi-stage (MAMS) clinical trial platforms.As our understanding of the biological processes underlying Parkinson’s disease continues to grow, so too does the number of potential treatments that could target these mechanisms and potentially slow disease progression. The challenge is how to test these promising therapies quickly, efficiently and reliably.Traditional clinical trials can take years, require large numbers of participants and often need a separate placebo group for every treatment being investigated. MAMS platforms offer a different approach, allowing several potential treatments to be tested simultaneously against a shared control group.Crucially, these platforms also incorporate planned interim analyses. Treatments showing little or no evidence of benefit can be stopped early and replaced by new candidates, while those showing promising signals can continue through the trial. The aim is to reduce costs, make better use of participants and, most importantly, identify promising therapies more quickly.Prof. Bloem discusses how this approach has already been successfully used in areas such as cancer and COVID-19, and looks at the growing international movement to bring the same model to neurological diseases.For Parkinson’s disease, he highlights the Edmond J. Safra Accelerating Clinical Trials in Parkinson’s Disease (EJS ACT-PD) platform in the UK, alongside similar initiatives emerging internationally. He also discusses some of the treatments being evaluated through these new trial approaches, including telmisartan, terazosin and UDCA.The episode also considers the challenges involved, from selecting appropriate placebo groups to identifying sensitive biomarkers that can provide an early indication of whether a treatment is working.While these platforms will not change clinical care tomorrow, Prof. Bloem explains why they represent genuine hope for the Parkinson’s community: a smarter, faster and more collaborative way of determining which potential treatments deserve to move forward.Could this new generation of clinical trials help accelerate the search for disease-modifying treatments in Parkinson’s?Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with the 39th episode of Parkinson Weekly, hosted by Prof. Bas Bloem - on this week’s episode, Prof. Bas Bloem explores an intriguing new approach to one of the most common challenges faced by people with Parkinson’s disease: poor sleep.Could something as simple as blue light therapy make a difference?Prof. Bloem discusses a recent placebo-controlled study investigating blue light delivered through specially designed glasses in people with Parkinson’s experiencing sleep problems. Participants received either blue or red light therapy for two weeks, with the results showing a significantly greater improvement in sleep quality and daytime sleepiness among those receiving blue light.In this episode, Prof. Bloem explores:Why blue light may help regulate the body’s biological clock and sleep–wake cycleThe improvements seen in sleep quality and daytime sleepinessWhy the lack of improvement in motor symptoms may actually strengthen the findingsThe potential for blue light therapy as an easy, home-based interventionWhy larger and longer Phase III studies are still needed before it can become an established treatmentWhile the study involved only 30 participants and further research is required, the findings offer an encouraging glimpse at a potentially safe, non-invasive way of improving sleep for people living with Parkinson’s disease.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with the 38th episode of Parkinson Weekly, hosted by Prof. Bas Bloem — and the third instalment of the Parkinson Weekly Helpdesk.In Episode 38 of Parkinson Weekly, Professor Bas Bloem returns with the third Helpdesk episode, answering questions submitted by listeners from around the world.This week, Bas explores the important relationship between Parkinson’s and the gut, including constipation, SIBO and how gut health can affect levodopa absorption and weight loss. He also discusses emerging research into intermittent hypoxia and its potential effects on Parkinson’s symptoms, before looking at whether Parkinson’s may be increasing among younger people and why more research into young-onset Parkinson’s disease is needed.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with Episode 37 of Parkinson Weekly, hosted by Prof. Bas Bloem.On this week’s episode of Parkinson Weekly, recorded live at the European Academy of Neurology (EAN) Congress in Geneva, Prof. Bas Bloem discusses advanced treatment options for people with Parkinson’s experiencing complex response fluctuations.Prof. Bloem explores why the term “advanced therapies” may itself create a barrier to treatment and explains why he prefers the term “smart therapies”. He discusses the range of options available, including deep brain stimulation, focused ultrasound and pump therapies, and explains how the 5-2-1 rule can help identify when it may be time to start the conversation.The episode also looks at the importance of shared decision-making, ensuring people with Parkinson’s and their loved ones are informed about all available treatment options and can work together with their clinical team to determine the most appropriate approach.Key topics include:What are “smart therapies” for Parkinson’s?Recognising complex response fluctuationsThe 5-2-1 rule and when to start the conversationDeep brain stimulation, focused ultrasound and pump therapiesWhy discussions around treatment may be happening too lateThe importance of shared decision-making and individualised careHave a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ Parkinson Weekly – Episode 36In Episode 36 of Parkinson Weekly, Prof. Bas Bloem explores one of the most overlooked reasons why oral Parkinson’s medications can become unreliable: the gut.Drawing on his presentation at the European Academy of Neurology (EAN) Congress in Geneva, Prof. Bloem explains why fluctuating symptoms are not always caused by disease progression alone. While predictable “wearing-off” episodes can often be managed by adjusting medication schedules or adding adjunctive therapies, he highlights the importance of recognising delayed ONs, dose failures and unpredictable OFF periods—all of which may point towards impaired gastrointestinal function.The episode examines how Parkinson’s disease affects the digestive tract long before diagnosis in many people, including delayed gastric emptying (gastroparesis), constipation and small intestinal bacterial overgrowth (SIBO). Prof. Bloem discusses how these conditions can prevent levodopa from reaching the small intestine for absorption or even cause the medication to be broken down before it reaches the brain, leading to inconsistent symptom control.He also reviews practical management strategies, including treating constipation, understanding the current evidence surrounding SIBO, and recognising when it may be appropriate to bypass the gut altogether using device-aided therapies such as deep brain stimulation, continuous infusion therapies, or emerging on-demand treatments like inhaled levodopa.This practical and clinically focused episode provides valuable insights into recognising gastrointestinal causes of motor fluctuations and highlights how addressing the gut can help restore more reliable symptom control, improve mobility, and ultimately enhance quality of life for people living with Parkinson’s disease.Tune in now to discover why, when Parkinson’s medications stop working as expected, the answer may lie in the gut rather than the brain.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with Episode 35 of Parkinson Weekly, hosted by Prof. Bas Bloem.Recorded live at the European Academy of Neurology (EAN) Congress in Geneva, this special episode sees Prof. Bas Bloem reflect on his C. David Marsden Award Lecture, entitled “What to do, if even David Marsden would not have a clue”.Prof. Bloem explores how clinicians can approach particularly challenging movement disorder presentations when the diagnosis is far from straightforward. Drawing on the themes of his lecture, he outlines the value of a structured, multistep approach to reaching a clinically based diagnosis, even in the most complex cases.The episode also highlights the importance of developing an eclectic approach to clinical practice. Prof. Bloem discusses the value of identifying your own clinical heroes, learning from the skills and qualities that make them exceptional, and incorporating the best of these into your own clinical repertoire — while combining them with your individual strengths, preferences and abilities.Recorded from EAN 2026 in Geneva, this episode offers a fascinating insight into clinical reasoning, lifelong learning and the art of becoming a better clinician.Tune in now to hear Prof. Bas Bloem share the key lessons from his C. David Marsden Award Lecture.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with Episode 34 of Parkinson Weekly, hosted by Prof. Bas Bloem.In Episode 34 of Parkinson Weekly, “Pesticides Callout!”, Prof. Bas Bloem delivers a powerful call to action regarding proposed changes to European pesticide regulations.Prof. Bloem explores concerns surrounding the current omnibus proposal, particularly the possibility that real-world evidence may no longer be considered when assessing the long-term safety of pesticides once they have been approved for market use. Drawing on decades of research into Parkinson’s disease and environmental risk factors, he explains why ongoing scrutiny of pesticides and other chemicals remains essential, especially as new evidence emerges from real-world exposure.The episode examines the limitations of current testing methods, the importance of post-approval monitoring, and recent research linking environmental exposures to an increased risk of neurodegenerative disease. Prof. Bloem also discusses the need to support greener agricultural alternatives and questions proposals that could extend the use of chemicals already identified as harmful to human health.This thought-provoking episode highlights the intersection of environmental policy, public health, and Parkinson’s disease, while urging policymakers to prioritise long-term population health when making regulatory decisions.Tune-in now to hear why Prof. Bloem believes real-world evidence must remain at the heart of efforts to protect future generations from potential environmental contributors to neurodegenerative disease.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with episode 33 of Parkinson Weekly, hosted by Prof. Bas Bloem.In Episode 33 of Parkinson Weekly, Prof. Bas Bloem discusses a newly published multidisciplinary allied health guideline for people living with Parkinson’s disease.Published in Parkinsonism and Related Disorders, the guideline introduces an innovative, problem-orientated approach to Parkinson’s care, moving beyond traditional single-discipline recommendations. Instead, it brings together input from physiotherapists, occupational therapists, speech-language therapists, dieticians, and other allied health professionals to address complex symptoms such as falls, fatigue, swallowing difficulties, constipation, breathing problems, and sexual health concerns.Bas highlights four key innovations: its multidisciplinary structure, decision support based on problems raised by people with Parkinson’s, full accessibility for patients themselves, and automated annual updates to ensure the guidance remains aligned with the latest evidence.This episode explores why this Dutch guideline may serve as a template for future Parkinson’s guidelines worldwide, supporting more collaborative, person-centred, and up-to-date care.A forward-looking episode on how multidisciplinary guidance could help shape the next era of Parkinson’s disease management.Read the full article here: https://pubmed.ncbi.nlm.nih.gov/42115018/Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.

🎙️ We’re back with episode 32 of Parkinson Weekly, hosted by Prof. Bas Bloem.In Episode 32 of Parkinson Weekly, Prof. Bas Bloem returns with the third Parkinson Weekly Helpdesk, answering three insightful questions from listeners.This episode explores the fascinating relationship between art, dopamine, creativity, and brain function, including how art may support wellbeing in Parkinson’s disease and why future clinical trials could help define its therapeutic potential.Bas also discusses altered perception in Parkinson’s, including hearing, vision, proprioception, posture awareness, and how practical tools such as visual feedback may help support therapy.The episode concludes with an open and thoughtful discussion on lifespan in Parkinson’s disease. Bas explains why honest conversations about prognosis, quality of life, falls, swallowing, infections, and multidisciplinary care are essential, while also highlighting the positive impact that specialist support and services such as ParkinsonNet can have on outcomes.A wide-ranging Helpdesk episode covering creativity, perception, realistic hope, and practical ways to support better living with Parkinson’s disease.Have a question you’d like Bas to answer in a future episode? Email us at [email protected] – we’d love to hear from you.