World Parkinson's Day
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Talking about Parkinson's disease in times of pandemic

11 April was chosen to be World Parkinson's Disease Day in honour of James Parkinson who was born on this day in 1755. Unfortunately, this year, the usual events that allow us to draw attention to this disease will have to respect the rules of discretion and prudence imposed by the pandemic. More than 200 years after its initial description, this remains a mysterious and intriguing disease.

Mysterious because...

We still do not know what causes it in almost all patients. It manifests and progresses differently in each patient. Its various stages of evolution almost seem to correspond to different diseases. It almost always affects one side of the body the most for reasons that we do not yet know. Some of the signs and symptoms can begin decades before diagnosis.

And intriguing because...

Patients have periods when they are doing very well and stages when they are not feeling well. They can change from one moment to the next. They may find it very difficult to perform some tasks or walk and be able to carry out more complex activities. Patients may experience shaking and other involuntary movements that they cannot control.

Unfortunately, we still don't have any medications to cure, delay or stop its progression. One of the oldest drugs, which started to be used more than 50 years ago (levodopa), remains the most potent and safest treatment.

With this pandemic, many patients saw their complaints aggravated due to less mobility, stopping therapies, less access to health care and the whole context of family and social isolation.

However, we have learned a lot. We learned that it is possible to follow-up patients from a distance or by visiting them at home. We found that it is possible to do physiotherapy, speech therapy and other therapeutic interventions individually or in group on the Web. And thus ensure that many more patients can access differentiated care, despite the distance and the limited access to tertiary centres. We learned that it is essential that we all know more about this and other diseases associated with ageing. And we identified the enormous need to train more and better health professionals and caregivers.

Unfortunately, we also saw confirmed what we already suspected. The decrease in physical activity and in the various stimuli aggravate the disease. We have advanced in the realization of the need to implement new models of care delivery, more focused on the patients and the community where they live.

One hundred years ago, during the Spanish Flu pandemic, and for reasons that we do not yet know, there were many cases of Parkinson’s disease associated with a form of encephalitis. Despite its enormous severity, the study of these patients contributed, years later, to an enormous progress in the knowledge of the mechanisms of Parkinson's disease and its treatment.

We are therefore keen to hope that, from this crisis that was and is “cruel” for many, further progress in scientific knowledge and in the way of treating the disease can also arise. But in order to be successful, we need everyone's help: patients, family members, caregivers, healthcare professionals, the gym, scientists, the pharmaceutical industry, drug agencies, funders, everyone.

And it is this request for help that I would like to leave to everyone on this day…

Fotografia Professor Joaquim Ferreira

Joaquim Ferreira

Professor of Neurology and Clinical Pharmacology at FMUL

President of the Pedagogical Council of FMUL