Pain is experienced by up to 85% of people with Parkinson’s disease, yet is poorly understood and often overlooked. In this talk, Dr. Alfonso Fasano will address the five main types of pain experienced by people living with Parkinson’s, such as musculoskeletal pain, neuropathic pain caused by dystonia or rigidity, akathisia, and central pain. Pain management strategies will also be explored.
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Dr. Alfonso Fasano, Movement Disorder Specialist |
Dr. Alfonso Fasano holds the chair in Neuromodulation at the University of Toronto and University Health Network. He is a Professor in the Department of Medicine, Division of Neurology, at the University of Toronto. He is a staff Neurologist and Co-Director of the Surgical Program for Movement Disorders at Toronto Western Hospital, University Health Network and the Hospital of Sick Children in Toronto. Dr. Fasano is also a Clinician Investigator at the Krembil Research Institute and KITE – Toronto Rehabilitation Hospital. He leads the Core E (closed-loop capabilities) of the Center for Advancing Neurotechnological Innovation to Application, and sits on the Scientific Advisory Board of the Dystonia Medical Research Foundation and International Essential Tremor Foundation. He is the chair of the Normal Pressure Hydrocephalus study group and a member of the study group on tremors of the International Parkinson Movement Disorders Society. Dr. Fasano is also a member of the Tremor Research Group and the Parkinson Study Group.
Dr. Fasano received his medical degree from the Catholic University of Rome, Italy, in 2002 and became a Neurologist in 2007. After a two-year fellowship at the University of Kiel, Germany, he completed a PhD in neuroscience at the Catholic University of Rome. His main areas of interest are the treatment of movement disorders with advanced technology (infusion pumps and neuromodulation), pathophysiology, and treatment of tremor and gait disorders. He has authored more than 400 scientific papers and book chapters, and is the co-editor of the section “Gaps and Controversies” in Movement Disorders Journal. He is also an editorial board member of Annals of Neurology, Movement Disorders Journal, Movement Disorders Clinical Practice, and Parkinsonism and Related Disorders. Additionally, Dr. Fasano is a Principal Investigator of several clinical trials.
In this talk, Dr. Penny MacDonald and Maggie Prenger will provide an overview of the current research documenting the presence and distinct types of social symptoms that occur in people with Parkinson’s disease (for example, emotional symptoms, such as facial masking and communication symptoms, such as difficulty recognizing nonverbal cues of others). They will discuss the current theories and research investigating why these social symptoms occur in those with Parkinson’s, as well as how they impact the lives of people with the disease and their loved ones. Strategies for mitigating the symptoms’ effects will also be explored.
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Dr. Penny MacDonald, Movement Disorder Specialist |
Dr. Penny MacDonald is a Movement Disorders Neurologist, Canada Research Chair Tier II in Cognitive Neuroscience and Neuroimaging, and Associate Professor in Neurology in the Department of Clinical Neurological Sciences at the University of Western Ontario. She is also a Principal Investigator at The Brain and Mind Institute. Dr. MacDonald obtained a PhD in Experimental Psychology from the University of Toronto under the supervision of Dr. Colin MacLeod prior to completing medical school at McMaster University and residency training in Neurology at McGill University. She pursued clinical and research fellowship training in Movement Disorders as a Canadian Institutes of Health, Phase 1 Clinician-Scientist at the Montreal Neurological Institute and the Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal from October 2008 to July 2011. She evaluates and treats patients with a variety of movement disorders, with a special interest in Parkinson’s disease. In addition to attending to movement-related symptoms, she is interested in improving the diagnosis and treatment of cognitive impairments in movement disorders.
Her long-term research aims are to uncover neural bases for cognitive processes, with a particular interest in understanding the role of the basal ganglia in these functions. The research involves probing different facets of cognition, with a variety of neuropsychological tests in patients with prominent basal ganglia dysfunction, such as Parkinson’s disease, compared to healthy volunteers. Performance on these tests is correlated with levels of activation in different brain regions, including the basal ganglia, and is assessed with functional neuroimaging techniques. The aim is to investigate differences in function-related brain activity in patients and healthy participants, as well as the effect of medications on cognitive performance and brain activity in patients. A further objective is to develop more precise cognitive profiles of various movement disorders with the overarching goal of improving diagnosis and suggesting more effective treatments of cognitive impairments in these conditions.
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Maggie Prenger, PhD Candidate |
Maggie Prenger is an MD/PhD student supervised by Dr. Penny MacDonald and Dr. Adrian Owen at the University of Western Ontario. She completed her Master of Neuroscience in 2020 at the University of Western Ontario after graduating from Lakehead University with an Honors Bachelor of Science in Psychology in 2018. Maggie’s research focuses on the social symptoms of Parkinson’s disease that can arise due to the degeneration of dopamine neurons in particular areas of the brain. For her PhD, she is currently investigating the presence and nature of humor processing deficits in Parkinson’s disease using functional magnetic resonance imaging techniques.
Session Summary
Medication management plays an important role for many people with Parkinson’s disease. However, it can become overwhelming and confusing as medication regimens are adjusted, new medications are introduced, and side effects arise. In this talk, Dr. Alan Low will answer common questions about medications for Parkinson’s and how they work, or do not work, together with other medications. Information about the side effects of medications, types of medications available for people with Parkinson’s, and tips for effective medication management will be provided.
Speaker Biography
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Dr. Alan Low, Registered Pharmacist |
Dr. Alan Low is a registered pharmacist who also completed an accredited hospital pharmacy residency. He graduated with a Doctor of Pharmacy degree from the University of British Columbia. Dr. Low has a wide range of experience in various sectors, such as direct patient care in hospitals and clinics, academics, research, healthcare consulting, and pharmaceutical industry work. He has presented at local and international conferences and is a Fellow of the Canadian Society of Hospital Pharmacists, and a Clinical Associate Professor in the Faculty of Pharmaceutical Science at the University of British Columbia. He is also a former Chief Operating Officer at Network Healthcare.
Dr. Alan Low wears many hats within his career as a pharmacist, hospital practitioner, researcher, advisor, instructor, author, speaker, and corporate officer. In February 2017, he applied his decades of practical experience and clinical knowledge by opening BioPro Biologics Pharmacy an innovative pharmacy.
Session Summary
Falling has been associated with reduced quality of life and survival. In this talk, Dr. Alfonso Fasano will discuss how gait disorders often contribute to limited mobility and cause falls in people with Parkinson’s disease. He will also explore how gait disorders and falls stem from a variety of different mechanisms that individuals with Parkinson’s and their loved ones should be aware of, as treatment is often possible if the correct underlying cause is determined.
Speaker Biography
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Dr. Alfonso Fasano, Movement Disorder Specialist |
Dr. Alfonso Fasano holds the chair in Neuromodulation at the University of Toronto and University Health Network. He is a Professor in the Department of Medicine, Division of Neurology, at the University of Toronto. He is a staff Neurologist and Co-Director of the Surgical Program for Movement Disorders at Toronto Western Hospital, University Health Network and the Hospital of Sick Children in Toronto. Dr. Fasano is also a Clinician Investigator at the Krembil Research Institute and KITE – Toronto Rehabilitation Hospital. He leads the Core E (closed-loop capabilities) of the Center for Advancing Neurotechnological Innovation to Application, and sits on the Scientific Advisory Board of the Dystonia Medical Research Foundation and International Essential Tremor Foundation. He is the chair of the Normal Pressure Hydrocephalus study group and a member of the study group on tremors of the International Parkinson Movement Disorders Society. Dr. Fasano is also a member of the Tremor Research Group and the Parkinson Study Group.
Dr. Fasano received his medical degree from the Catholic University of Rome, Italy, in 2002 and became a Neurologist in 2007. After a two-year fellowship at the University of Kiel, Germany, he completed a PhD in neuroscience at the Catholic University of Rome. His main areas of interest are the treatment of movement disorders with advanced technology (infusion pumps and neuromodulation), pathophysiology, and treatment of tremor and gait disorders. He has authored more than 400 scientific papers and book chapters, and is the co-editor of the section “Gaps and Controversies” in Movement Disorders Journal. He is also an editorial board member of Annals of Neurology, Movement Disorders Journal, Movement Disorders Clinical Practice, and Parkinsonism and Related Disorders. Additionally, Dr. Fasano is a Principal Investigator of several clinical trials.
Session Summary
We live within social communities, individual families, work organizations, and religious and social groups that are structured in ways that allows us to feel a sense of belonging through shared values, clear roles, expectations, and boundaries. We receive positive feedback or rewards for fitting in, and negative consequences when we do not. Public stigma is a negative social consequence, and unfortunately, health conditions like Parkinson’s disease are stigmatized due to a lack of public awareness and understanding. Exposure to public stigma results in a neurological response in the individual, which we call shame.
When an individual with Parkinson’s begins to believe public stigma about their condition and the false ideas and negative attitudes that are perpetuated about the illness, self-stigma is created, which can lead to the internalization of shame. Combating self-stigma and reducing the experience of shame can seem overwhelming, but it is important to address to prevent negative impacts such as self-isolation, avoidance of treatment, and worsening of symptoms. In this talk, Parkinson Society BC counsellor, Madelaine Ross, will discuss strategies to help navigate and cope with stigma and shame.
Speaker Biography
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Madelaine Ross, Counsellor |
Madelaine Ross is Parkinson Society BC’s newest part-time counsellor. She was the Parkinson’s Client and Family Service Manager for HeadWay in Victoria for several years, where she also provided counselling to people with Parkinson’s and carepartners. Her support was greatly appreciated by the Victoria and area Parkinson’s community.
Session Summary
Dr. Sanjay Mohan Ram will discuss complementary therapies for Parkinson’s disease, such as natural supplements, acupuncture, and traditional Chinese medicine. He will explore how these complementary therapies, including vitamins, minerals, amino acids, and herbs, may help with Parkinson’s, as well as how they can complement medical approaches and management of the disease.
Speaker Biography
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Dr. Sanjay Mohan Ram, Naturopathic Doctor |
Dr. Sanjay Mohan Ram was born and raised in Singapore, and graduated from the University of British Columbia with a BSc (Hon.) in Human Physiology and Biochemistry in 1997. He joined the Boucher Institute of Naturopathic Medicine (BINM) and was in the first BINM graduating class in May 2004.
Currently, Dr. Mohan Ram is also a senior instructor, teaching several medical physiology and pathology classes for the first and second-year Canadian College of Naturopathic Medicine - Boucher Naturopathic Biomedicine courses. His areas of interest in Naturopathic Medicine include:
- Neurological conditions, such as Alzheimer’s, Parkinson’s, and Multiple Sclerosis
- Acupuncture and traditional Chinese medicine
- Digestive conditions, food allergy testing, and treatment
- Clinical nutrition and diet therapy for weight loss
- Hormonal testing and treatment for men and women’s health
- Adjunctive naturopathic anti-aging and anti-cancer treatments
- Intravenous vitamin treatments
- Cardiovascular disease treatment and prevention
- Chronic conditions, such as diabetes, arthritis, and skin and autoimmune conditions
- Neural therapy for chronic injuries, pain, and scar tissue
Dr. Mohan Ram has always been interested in giving back and supporting the naturopathic medical profession by continuing his work as an elected member of the College Of Naturopathic Physicians Of British Columbia Board of Directors, as well as the chair of the College of Naturopathic Physicians Examination Committee. Dr. Mohan Ram has also been actively involved in the sporting community. He currently coordinates and plays in the competitive division of an adult volleyball league while also being on its Board of Directors. He is also a certified volleyball official and referee for local tournaments. As such, Dr. Mohan Ram leads a very active life, both professionally and privately. He believes in a well-rounded, healthy, and happy lifestyle.
Session Summary
In this talk, Dr. Penny MacDonald will discuss common cognitive deficits seen in Parkinson’s disease. Specifically, she will explore why cognitive deficits occur, as well as when they may surface in people with Parkinson’s. Common interventions (medical and non-medical) will also be covered, as well as to whom on the healthcare team referrals could be made.
Speaker Biography
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Dr. Penny MacDonald, Movement Disorder Specialist |
Dr. Penny MacDonald is a movement disorders neurologist, Canada Research Chair Tier II in Cognitive Neuroscience and Neuroimaging, and associate professor in Neurology in the Department of Clinical Neurological Sciences at the University of Western Ontario. She is also a principal investigator at The Brain and Mind Institute. Dr. MacDonald obtained a PhD in Experimental Psychology from the University of Toronto under the supervision of Dr. Colin MacLeod prior to completing medical school at McMaster University and residency training in Neurology at McGill University. She pursued clinical and research fellowship training in Movement Disorders as a Canadian Institutes of Health, Phase 1 Clinician-Scientist at the Montreal Neurological Institute and the Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal from October 2008 to July 2011. She evaluates and treats patients with a variety of movement disorders, with a special interest in Parkinson’s disease. In addition to attending to movement-related symptoms, she is interested in improving the diagnosis and treatment of cognitive impairments in movement disorders.
Her long-term research aims are to uncover neural bases for cognitive processes, with a particular interest in understanding the role of the basal ganglia in these functions. The research involves probing different facets of cognition, with a variety of neuropsychological tests in patients with prominent basal ganglia dysfunction, such as Parkinson’s disease, compared to healthy volunteers. Performance on these tests is correlated with levels of activation in different brain regions, including the basal ganglia, and is assessed with functional neuroimaging techniques. The aim is to investigate differences in function-related brain activity in patients and healthy participants, as well as the effect of medications on cognitive performance and brain activity in patients. A further objective is to develop more precise cognitive profiles of various movement disorders with the overarching goal of improving diagnosis and suggesting more effective treatments of cognitive impairments in these conditions.
Session Summary
Both patients and practitioners in the Parkinson’s community have sought to understand how cannabis use can aid in managing Parkinson’s disease. In this talk, Dr. Jean Paul Lim discusses how cannabis can help manage symptoms. He will begin by providing an overview of the physiology of Parkinson’s, followed by an overview of cannabis, including the different ways it can be administered. In his discussion of the symptoms patients with Parkinson’s experience, Dr. Lim will delve into his data-supported discussion on which symptoms it may be reasonable to treat with cannabis, as well as any potential side effects that could occur.
Speaker Biography
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Dr. Jean Paul Lim, Internal Medicine and
Complex Care Specialist |
Dr. Jean Paul Lim believes in proactively treating his patients so they can attain optimal health by building solid foundations consisting of a proper diet, nutrition, and exercise. Once the patient has established a foundation, he then addresses their more complex health-related issues. Dr. Lim’s mission is to explore different approaches to health and find ways to integrate them all into a comprehensive and cohesive model, where patients are seen in their entirety.
As part of exploring different approaches to health, Dr. Lim has also become a recent leader in the medical cannabis space, as he believes it has numerous clinical benefits. All of Dr. Lim’s training took place at the University of British Columbia (UBC) where he earned a Bachelor of Science degree in Microbiology and Immunology, as well as a Doctor of Medicine. He has been in practice as a Medical Specialist since 2011. In addition to his work in Internal Medicine and Complex Care, he holds training in echocardiography. He is a Clinical Instructor at UBC and the Medical Director of PerceiveMD, a multidisciplinary, team-based, patient-focused center providing free, comprehensive assessments for medical cannabis.
Session Summary
In this talk, Dr. Omesh Kulkarni will discuss the types of motor symptoms experienced by those with Parkinson’s disease, such as tremor, rigidity, bradykinesia (slow movement), and postural instability (balance problems). How these motor symptoms present themselves in Parkinson’s patients, and the impact on daily living, will also be reviewed. The importance of identifying motor complications, such as motor fluctuations, which includes the wearing-off phenomenon and Levodopa-induced dyskinesia, will also be explored, alongside how these complications can be managed. Further, Dr. Kulkarni will also address the types of advanced therapies that aim to control the motor symptoms of PD without causing the troublesome side effects that occur with the patient’s current treatment. These advanced therapies include Duodopa®, Deep Brain Stimulation (DBS), and Apomorphine.
Speaker Biography
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Dr. Omesh Kulkarni, Neurologist |
Dr. Omesh Kulkarni is a Neurologist specializing in Parkinson’s disease, serving mid to north Vancouver Island. After completing medical school in India, he trained as a neurologist in England, followed by a year as a fellow at the Parkinson's Disease and Movement Disorders Center at the Beth Israel Deaconess Medical Center in Boston, Massachusetts. After his fellowship, he started a Parkinson’s and Movement Disorders clinic in England, which ran from 2013 to 2021. Presently, Dr. Kulkarni works between two sites in Nanaimo – the Parkinson’s and Movement Disorders Clinic at Nanaimo Regional General Hospital, and a private clinic.
Session Summary
Regret has commonly been seen as something that holds us back. However, researchers have confirmed that regret is useful; it’s necessary to guide us through life, helping us to avoid mistakes and gain insight into ourselves and others, while striving toward our goals. This talk, led by clinical counsellor, Tricia Wallace, will review ways to consider the role of regret in our lives, and to see how it affects decisions about health, healthcare, and social well-being.
Speaker Biography
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Tricia Wallace, Counsellor |
Tricia Wallace has practiced as a registered nurse since 1988 in hospital and community settings, attaining a Bachelor of Science in Nursing (BSN) and a Master's of Nursing (MSN) from the University of Victoria, BC. In June of 2019, she completed a Master of Arts in Counselling Psychology (MACP) at Yorkville University.
Tricia has extensive experience working with adults of all ages in the field of mental health, including case management for those 55 and older who live with co-occurring disorders, work as a clinical educator on mood and neuropsychiatric inpatient wards, and counselling individuals and groups in a residential substance use recovery program. Drawing on this diverse background, Tricia recognizes the importance of a strength-based, holistic approach to Parkinson’s disease that includes emotional support and skill building for individuals and their families.
Session Summary
In this talk, registered dietician, Suzanne Kaye, will offer recommended diet and nutrition strategies for people living with Parkinson's disease. This includes discussing the benefits of the Mediterranean diet, and how the essential vitamins and antioxidants that it provides can improve the well-being of individuals living with Parkinson’s. Bone density and weight loss that can occur because of dyskinesia and even tremor (due to increased use of energy), loss of appetite due to mental health complications or medications, swallowing difficulties, and challenges with food transit and absorption, will also be explored. Practical strategies to reduce the risk of malnutrition and nutrient deficiencies will be provided, and the subject of when to take protein with Levodopa will also be discussed.
Speaker Biography
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Suzanne Kaye, Registered Dietitian |
Suzanne Kaye is a Registered Dietitian at 4 My Health Nutritional Consulting in Vancouver, British Columbia.
Session Summary
Dr. Penny MacDonald will provide a quick review of the Part I: Cognitive Deficits breakout session. Then, in part II, she will transition into a discussion on special considerations that healthcare professionals should be aware of when supporting people with Parkinson’s experiencing cognitive deficits. Strategies that can help with communication, activities of daily life, and cognitive exercises or trips that can be trialled, will also be explored.
Speaker Biography
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Dr. Penny MacDonald, Movement Disorder Specialist |
Dr. Penny MacDonald is a movement disorders neurologist, Canada Research Chair Tier II in Cognitive Neuroscience and Neuroimaging, and associate professor in Neurology in the Department of Clinical Neurological Sciences at the University of Western Ontario. She is also a principal investigator at The Brain and Mind Institute. Dr. MacDonald obtained a PhD in Experimental Psychology from the University of Toronto under the supervision of Dr. Colin MacLeod prior to completing medical school at McMaster University and residency training in Neurology at McGill University. She pursued clinical and research fellowship training in Movement Disorders as a Canadian Institutes of Health, Phase 1 Clinician-Scientist at the Montreal Neurological Institute and the Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal from October 2008 to July 2011. She evaluates and treats patients with a variety of movement disorders, with a special interest in Parkinson’s disease. In addition to attending to movement-related symptoms, she is interested in improving the diagnosis and treatment of cognitive impairments in movement disorders.
Her long-term research aims are to uncover neural bases for cognitive processes, with a particular interest in understanding the role of the basal ganglia in these functions. The research involves probing different facets of cognition, with a variety of neuropsychological tests in patients with prominent basal ganglia dysfunction, such as Parkinson’s disease, compared to healthy volunteers. Performance on these tests is correlated with levels of activation in different brain regions, including the basal ganglia, and is assessed with functional neuroimaging techniques. The aim is to investigate differences in function-related brain activity in patients and healthy participants, as well as the effect of medications on cognitive performance and brain activity in patients. A further objective is to develop more precise cognitive profiles of various movement disorders with the overarching goal of improving diagnosis and suggesting more effective treatments of cognitive impairments in these conditions.