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4.001 PD: Gait and balance disorders
S192
Thursday, 13 December 2007
07.30−08.45
Rooms D, E, F, H, B
Meet the Expert Breakfast Seminars Room D 4.001 PD: Gait and balance disorders N. Giladi1° , I. Rektor2° Israel; 2 Prague, Czech Republic
1 Tel-Aviv,
Educational goals: 1. To discuss the pathophysiology of gait and balance disturbances in Parkinson’s disease with special emphasis on the role of dopaminergic and non-dopaminergic networks. In addition, the discussion will highlight the relation of gait and posture with the cognitive domain and more specifically with executive functions 2. To discuss the clinical approach to a patient with gait disturbances and falls in the different stages of the disease. More specifically, to highlight the bed side and laboratory based assessments tools available and to highlight the importance of assessment under dual tasking conditions and their contribution to the early diagnosis of gait and posture disturbances 3. To discuss the therapeutic option available in order to delay the first fall, maintain safe and independent mobilization and prevent or delay the need of a wheel chair. Medical, physical, cognitive and surgical therapeutic interventions will be discussed and demonstrated by video segments of the different options.
Room E 4.002 PD: Sleep disorders B. H¨ogl1° , D. Kaynak2° 1 Innsbruck, Austria; 2 Istanbul, Turkey Disorders of nocturnal sleep and day time sleepiness are so common in Parkinson disease, that almost all patients will be affected by one or more of them during the course of the disease. In this symposium, the attendee will learn to recognize and distinguish the different types of sleep disorders that often coexist in PD – e.g. sleep fragmentation, sleep breathing disorders, REM sleep behaviour disorder, RLS, and daytime sleepiness, and many others. If a physician only asks his patient about quality of night time sleep, this will not detect all of them reliably. Therefore, it is important to take a specific structured sleep history. Moreover, many different factors contribute to sleep disorders and daytime sleepiness in PD, which will be discussed. Educational goals: 1. To take a structured sleep history, that covers the major sleep disturbances in PD 2. To discuss the use of specific scales and tests to quantify sleep disorders and daytime sleepiness 3. To understand specific treatment strategies for disorders of sleep and daytime sleepiness.
Room F 4.003 Towards the molecular understanding of PD by applying proteomic approaches H. Meyer1° , L. Grinberg2° Germany; 2 S˜ao Paulo, Brazil
1 Bochum,
Although an increasing number of genes have been found to be associated with Parkinsonism, the underlying molecular causes for Parkinson’s disease (PD) and the exact aetiology are unknown. The spectrum of Parkinsonian syndromes range from ‘familial, monogenic’ to ‘idiopathic, sporadic’ cases, but all of them have in common a progressive degeneration of the dopaminergic neurons in the substantia nigra pars compacta. A plethora of processes have been identified to contribute to neurodegeneration in PD, including a defective protein degradation, the aggregation of proteins such as alpha-synuclein and the formation of Lewy bodies; an inhibition and disruption of the mitochondrial respiratory chain complexes I–III and an increased formation of free radicals; a severely disturbed iron metabolism; the disturbance of Ca2+ -homoeostasis; an increased NO formation; glutamate excitotoxicity; apoptosis; inflammation; and a reduced neurotrophic support. As a global approach, proteomics aims to comprehensively image these pathological pathways and to uncover new interactions at the protein level. This educational session aspires to give the audience an understanding of state-of-the-art proteomics techniques and their applicability to PD research. Recent advancements in PD research achieved by proteomic approaches ranging from differential analyses of murine model systems to the focussed investigation of sub cellular structures will be presented. Educational goals: 1. To understand the role of proteomics to image various neuropathological processes 2. To understand the techniques and applications of proteomics in PD research 3. To appreciate the results of proteomic research in PD.
Room H 4.004 Tremor P. Bain1° , M. Behari2° 1 London, United Kingdom; 2 New Delhi, India This interactive session will be based on a series of videoclips of patients with different types of pathological tremor. Our aim is to help participants to establish a paradigm for recognizing and classifying tremor on phenomenological (rest, postural, kinetic, intention, task and position specific tremors) and then on an etiological basis. So that these tremors can be identified clinically and appropriate management strategies can be deployed. The session will cover tremors that are commonly encountered in a movement disorders clinic as well as some of the rarer tremor types. In the process of observing the video-clips we intend to discuss the key points in a history and examination that help to distinguish tremors and give a brief overview of the use of selected investigations in refining a clinical diagnosis. The medical and surgical treatment issues and controversies will also be discussed in relationship to the cases that are presented. Educational goals: 1. To establish a paradigm for the phenomenological and the etiological classification of tremors 2. To appreciate the various investigations in refining clinical diagnosis 3. To overview medical and surgical treatment issues and controversies.
Thursday, 13 December 2007
07.30−08.45
Rooms D, E, F, H, B
Meet the Expert Breakfast Seminars Room D 4.001 PD: Gait and balance disorders N. Giladi1° , I. Rektor2° Israel; 2 Prague, Czech Republic
1 Tel-Aviv,
Educational goals: 1. To discuss the pathophysiology of gait and balance disturbances in Parkinson’s disease with special emphasis on the role of dopaminergic and non-dopaminergic networks. In addition, the discussion will highlight the relation of gait and posture with the cognitive domain and more specifically with executive functions 2. To discuss the clinical approach to a patient with gait disturbances and falls in the different stages of the disease. More specifically, to highlight the bed side and laboratory based assessments tools available and to highlight the importance of assessment under dual tasking conditions and their contribution to the early diagnosis of gait and posture disturbances 3. To discuss the therapeutic option available in order to delay the first fall, maintain safe and independent mobilization and prevent or delay the need of a wheel chair. Medical, physical, cognitive and surgical therapeutic interventions will be discussed and demonstrated by video segments of the different options.
Room E 4.002 PD: Sleep disorders B. H¨ogl1° , D. Kaynak2° 1 Innsbruck, Austria; 2 Istanbul, Turkey Disorders of nocturnal sleep and day time sleepiness are so common in Parkinson disease, that almost all patients will be affected by one or more of them during the course of the disease. In this symposium, the attendee will learn to recognize and distinguish the different types of sleep disorders that often coexist in PD – e.g. sleep fragmentation, sleep breathing disorders, REM sleep behaviour disorder, RLS, and daytime sleepiness, and many others. If a physician only asks his patient about quality of night time sleep, this will not detect all of them reliably. Therefore, it is important to take a specific structured sleep history. Moreover, many different factors contribute to sleep disorders and daytime sleepiness in PD, which will be discussed. Educational goals: 1. To take a structured sleep history, that covers the major sleep disturbances in PD 2. To discuss the use of specific scales and tests to quantify sleep disorders and daytime sleepiness 3. To understand specific treatment strategies for disorders of sleep and daytime sleepiness.
Room F 4.003 Towards the molecular understanding of PD by applying proteomic approaches H. Meyer1° , L. Grinberg2° Germany; 2 S˜ao Paulo, Brazil
1 Bochum,
Although an increasing number of genes have been found to be associated with Parkinsonism, the underlying molecular causes for Parkinson’s disease (PD) and the exact aetiology are unknown. The spectrum of Parkinsonian syndromes range from ‘familial, monogenic’ to ‘idiopathic, sporadic’ cases, but all of them have in common a progressive degeneration of the dopaminergic neurons in the substantia nigra pars compacta. A plethora of processes have been identified to contribute to neurodegeneration in PD, including a defective protein degradation, the aggregation of proteins such as alpha-synuclein and the formation of Lewy bodies; an inhibition and disruption of the mitochondrial respiratory chain complexes I–III and an increased formation of free radicals; a severely disturbed iron metabolism; the disturbance of Ca2+ -homoeostasis; an increased NO formation; glutamate excitotoxicity; apoptosis; inflammation; and a reduced neurotrophic support. As a global approach, proteomics aims to comprehensively image these pathological pathways and to uncover new interactions at the protein level. This educational session aspires to give the audience an understanding of state-of-the-art proteomics techniques and their applicability to PD research. Recent advancements in PD research achieved by proteomic approaches ranging from differential analyses of murine model systems to the focussed investigation of sub cellular structures will be presented. Educational goals: 1. To understand the role of proteomics to image various neuropathological processes 2. To understand the techniques and applications of proteomics in PD research 3. To appreciate the results of proteomic research in PD.
Room H 4.004 Tremor P. Bain1° , M. Behari2° 1 London, United Kingdom; 2 New Delhi, India This interactive session will be based on a series of videoclips of patients with different types of pathological tremor. Our aim is to help participants to establish a paradigm for recognizing and classifying tremor on phenomenological (rest, postural, kinetic, intention, task and position specific tremors) and then on an etiological basis. So that these tremors can be identified clinically and appropriate management strategies can be deployed. The session will cover tremors that are commonly encountered in a movement disorders clinic as well as some of the rarer tremor types. In the process of observing the video-clips we intend to discuss the key points in a history and examination that help to distinguish tremors and give a brief overview of the use of selected investigations in refining a clinical diagnosis. The medical and surgical treatment issues and controversies will also be discussed in relationship to the cases that are presented. Educational goals: 1. To establish a paradigm for the phenomenological and the etiological classification of tremors 2. To appreciate the various investigations in refining clinical diagnosis 3. To overview medical and surgical treatment issues and controversies.