Day 1 :
Dementia Connection® LLC, USA
Time : 10:00-10:45
Susan Scanland is a Gerontological Nurse Practitioner and Certified Dementia Practitioner and national Alzheimer’s and Dementia Expert with 34 years of experience. She received her MSN from University of Pittsburgh and BSN from Wilkes University. She has been nationally certified as a Gerontological Nurse Practitioner since 1984 and is also a Certified Dementia Practitioner. She holds a Nursing Faculty Specialist position at the University of Scranton. She taught in geriatric faculty positions at Binghamton University (SUNY) from 1999-2004 and the Wyoming Valley Family Practice Residency in Kingston, Pennsylvania from 1987-1999. She is Founder of Dementia Connection® LLC. She is one of two nurse practitioners in the world to receive the Certified Speaking Professional award (CSP) through the National Speakers Association. She presented to geriatric psychiatrists from 15 countries at the American Association for Geriatric Psychiatry Annual Meeting in Washington DC in March 2016. She is Dementia Consultant to a long-term care facility in northeastern Pennsylvania and also provided rural nursing home consults via telehealth. She co-authored two articles on antipsychotic reduction recently in consultant pharmacist and geriatric nursing.
Psychosis occurs in over 50% and dementia in approximately 80% of persons with Parkinson’s disease. Treatment with non-selective atypical and typical antipsychotics significantly increases mortality rates in Parkinson’s disease; as well as other dementias. Research on the most commonly used antipsychotic in Parkinson’s, quetiapine, has not revealed significant reduction in Parkinson’s psychotic symptoms. Antipsychotic use, due to dopamine antagonism, is associated with unsteady gait and motor dysfunction; which exacerbates pre-existing Parkinsonian symptoms. Persons with Parkinson’s disease are already at risk for falls with gait asymmetry, short strides and increased stride duration. Parkinson’s patients have an increased hip fracture risk. The newly FDA-approved selective serotonin inverse agonist, pimavanserin, offers targeted treatment at the 5-HT2A receptor site responsible for Parkinson’s psychosis; without affecting dopaminergic receptor binding. Research reveals a decrease in hallucinations and delusions in Parkinson’s psychosis without worsening of motor symptoms. An evidence-based/case study format will present management of Parkinson’s psychosis with or without dementia, using FDA-approved treatment; as opposed to antipsychotics with full black box warnings that are commonly prescribed. Clinical outcomes, cost-effectiveness, quality of life, decreased risk for emergency room visits, hospitalizations and mortality and will be discussed.
DR.M.G.R.Medical University, India
Time : 11:00-11:45
A.V. Srinivasan is the President of Indian Academy of Neurology and also he is the emeritus Professor of The Tamilnadu DR.M.G.R.Medical University. · Dr A V Srinivasan, driven by his quest for excellence and the latest discoveries on human brain related disorders, joined Madras Medical College (MMC) and received MD(General Medicine) in 1978.Later he pursued and received DM in Neurology from his alma mater.He is First Neuro physician of his state Tamil Nadu in India in government service to be conferred, the Fellow of the Royal College of Physicians (FRCP) in London in 2012, fellowship of the Indian Academy of Neurology 2004 and fellowship by the American Academy of Neurology, in 2003.He Is the First Indian to receive American Indian Neurology Award (AINA) in USA in 2001, for the best paper presentation IN STROKE during annual American Academy of Neurology meeting in 2001 in PHILADELPHIA. ByTheTamil Nadu DR. MGR Medical University. Currently serving as a Member –in the ACADEMIC COUNCIL of National institute of Mental health and Neurosciences, Deemed University, Bangalore.
Introduction: By the year 2040, neuro degenerative disorders are expected to surpass cancer as the second most cause of death in the elderly. One of the most common neuro degenerative disorder is Parkinson’s’ disease with over 4 million victims identified in the world. Motor and non-motor symptoms tend to return during wearing off phenomenon in levodopa treated Parkinson’s patients. The development of wearing off is due to Parkinson’s disease progression and the rapid break down of levodopa in the body resulting in a feeling that levodopa effects are fading out. This results in the disturbances of the quality of life. In this study ten steps approach to improve quality of life and wearing off phenomenon are discussed: Disability and quality of life are assessed; research tools to assess quality of life; early signs and symptoms of wearing off; staging of Parkinson’s disease and the emergence of wearing off ; management of wearing off; impact of non-motor symptoms on HRQOL (Health Related Quality of Life); Parkinson’s disease well-being map and paper version and management of non-motor symptoms improved quality of life in Parkinson’s disease than motor symptoms; living a full life with Parkinson’s disease; helpful hints in daily life, managing stress with exercise, foot teeth care with diet and nutrition; and creative and complementary therapy.
Conclusion: Depression, fatigue, sleep problems and excessive day time sleepiness require special consideration when trying to optimize Parkinson’s management, due to their strong correlation with negative health status and HRQ-ol. Quantifying Parkinson’s symptoms provide an important basis for optimizing treatment and care.
Stanford University, USA
Keynote: Novel pharmaceutical interventions to relieve L-DOPA induced dyskinesia in Parkinson’s disease
Time : 11:45-12:30
Jayakumar Rajadas is the Founding Director of Biomaterials and Advanced Drug Delivery Laboratory at Stanford University. He is also an Adjunct Professor at UCSF School of Pharmacy, University of California. He is currently working on the molecular mechanism of neurodegenerative disorders involved in Alzheimer's and Parkinson's diseases. His research has also been involved in transforming nano science ideas into biomaterials and drug delivery technologies. Before moving to Stanford, he served as the Founding Chair Person of the bio-organic and neurochemistry division at one of India’s national laboratories. He is a recipient of several awards including Young Scientist award in Chemistry for the year 1996 from the Government of India. He has also won the Best Scientist award from the Tamil Nadu state Government India in the year 1999. He is co-recipient of nine SPARK transnational awards in Stanford University. He has published over 194 papers with numerous granted/disclosed patents.
Parkinson’s disease (PD) is a neurodegenerative disease caused by the death of dopaminergic neurons in the basal ganglia. The golden standard for the treatment of PD is the dopamine (DA) replacement therapy with L-DOPA. DA acts on DA receptors which belong to the superfamily of G Protein coupled receptors (GPCRs). However chronic treatment with L-DOPA results in super sensitivity of DA receptors and unwanted side effects commonly known as L-DOPA induced dyskinesia. Here we screened different formulations of L-DOPA oral route delivery which could result in a slow, sustained and timely delivery of L-DOPA along with repurposed GPCR receptor antagonists that can up regulate two of the G protein coupled receptor kinases GRK3 and 6 in brain that are down regulated in experimental animal models of PD. Our in vitro data in striatal neuronal culture in the presence of DA and GPCR receptor antagonists showed an upregulation of GRK3 and 6 after 24 hours of treatment at lower doses of DA. The behavioral studies in unilateral PD mice with DOPA formulations showed oral delivery of DOPA relieved the akinesia seen in Parkinson’s disease and at the same time had less dyskinetic effects as revealed by mouse cylinder test and AIMS respectively. Together our behavioral and signaling data demonstrate that L-DOPA delivered orally in a sustained release form along with the peripheral DOPA decarboxylase inhibitors carbidopa and benserazide could relieve the dyskinetic effects due to L-DOPA therapy in Parkinson’s disease.