Allison Allen is a Licensed Clinical Social Worker and Center of Excellence Coordinator at the Duke Movement Disorders Center, a Parkinson’s Foundation Center of Excellence. As a member of the interdisciplinary Movement Disorders team, she has particular interest in mental health, non-motor symptoms, crisis support, family centered care and facilitating support groups. She also works with the World Parkinson’s Coalition, having facilitated programs at the World Parkinson’s Congress 2019 in Kyoto, Japan, presented in the recent carepartner webinar series on Mental Health and is currently on the planning committee for the Carepartner Lounge at the upcoming Congress in 2022. Allison is also a member of the Parkinson's Outcomes Project Mental Health Work Group. In 2020, Allison was awarded the Duke Brandy McDaniel Clinical Social Worker of the year at Duke University Medical Center.

Anne Kosem joined the Duke Movement Disorders team in 2019 as a Clinical Social Worker and Center of Excellence Co-Coordinator. She has worked at Duke for 22 years providing counseling and support to patients and their carepartners around difficult diagnosis, adjustment to illness, palliative care and end of life issues. She created and facilitated carepartner support groups and educational programs in the Bone Marrow Transplant Clinic and the Pediatric Oncology Division. She is currently co-leading two support groups in the Movement Disorders clinic: one for patients with Parkinson’s disease and their carepartners and the other for patients with Huntington’s disease and their carepartners and is in the process of developing a group for patients with Early Onset Parkinson’s disease. She has served as the President of the Association of Pediatric Oncology Social Work and also President of the North Carolina Social Work Oncology Group. She has a special interest in training the next generation of Social Workers. She has served as a field instructor for the University of North Carolina School of Social Work for many years and co-developed and presented a workshop for new Pediatric Oncology Social Workers at the Association of Pediatric Oncology Social Work national conference for 6 consecutive years. She also served as a Team Leader in the Duke Department of Social Work for 10 years providing supervision and training to team members.

Clarissa Martinez-Rubio is the Sr. Director of Clinical Affairs at the Parkinson's Foundation. She completed her PhD in Anatomy and Neurobiology at the University of Puerto Rico, Medical Center followed by her postdoctoral training at the Massachusetts General Hospital/Harvard Medical School focusing in Deep Brain Stimulation and Neuromodulation. She worked at the Massachusetts General Hospital/Harvard Medical School as an Instructor in Neurosurgery for 3 years before joining the Parkinson’s Foundation in 2016. Since joining, Clarissa has led the foundation’s global Centers of Excellence network with designated centers in 9 countries, 34 US and 14 international.

Joseph M. Salvatore joined Miller Tabak Asset Management in October 2008 as Senior Municipal Credit Analyst. Mr. Salvatore has analyzed municipal bond credits since 1990. At MTAM, Mr. Salvatore reviews and approves (or denies) all municipal bonds before purchase and assigns internal ratings and credit trends to all municipal holdings. Mr. Salvatore maintains strategic relationships with issuers, rating agencies, and credit enhancers. Prior to joining MTAM, he was a municipal consultant for MacKay Shields (New York Life Insurance Company’s investment subsidiary). He was responsible for the credit research of all municipal assets and made buy/sell recommendations with the criteria of no defaults and no surprise rating downgrades. Prior to this experience, Mr. Salvatore spent 16 years at BlackRock in their Fixed Income Municipal Credit Research Department where he became a Director. He is an active member of the National Federation of Municipal Analysts and the Philadelphia Area Municipal Analyst Society. Mr. Salvatore holds an MBA from LaSalle University in Philadelphia. Mr. Salvatore is also a history buff, sports enthusiast, and amateur chef. He lives in Worcester, PA with his partner of 20 years.

Dr. Veronica Bruno, MD, MPH is a neurologist with a subspecialty in movement disorders. She received her medical degree and neurology residency in Buenos Aires, Argentina. She completed her fellowship in Movement Disorders at the University of Toronto and a Master of Public Health degree at the Harvard TH Chan School of Public Health.

Dr. Bruno was recognized with different international awards including the American Academy of Neurology and American Brain Foundation Clinical Fellowship and the Argentine Presidential Fellowship in Science and Technology, part of the U.S. State Department’s ‘100,000 Strong in the Americas’ initiative. 

Dr. Bruno’s primary interest is the treatment of advanced Parkinson’s disease, with a particular research interest in the non-motor symptoms of the disease. She has also a special interest in Global Neurology and the search for innovative solutions to improve the quality of neurological care in low and middle-income countries.

If you’ve heard of alpha-synuclein, it was likely in the context of Lewy bodies. Lewy bodies are abnormal clumps of alpha-synuclein that are found in the parts of the brain that control movement, thinking, and behavior, and they are related to the development of Parkinson’s. Lewy body dementia is a general term that includes both Parkinson’s disease dementia (when you have Parkinson’s and dementia develops later on) and Dementia with Lewy bodies (DLB) (when dementia comes on before or within one year of Parkinson’s motor symptoms).

Another term used in this episode that you might not be familiar with is “ligand.” A ligand is a molecule that binds to another molecule. Ligands are used in imaging, such as PET scans, to help doctors visualize different parts of the body, including the brain. Currently there is no ligand for alpha-synuclein to let us see how Lewy bodies are forming, or how they might be cleared by a potential therapy.

Dr. Guttman remarks that the alpha-synuclein story is the most exciting development to date in terms of potential for altering the progression of Parkinson’s. It has taken the PD community a long time to reach this point. The first revolution in Parkinson’s care came in the 1960s, with the discovery that Parkinson’s is a disease of dopamine. One hundred and fifty years after James Parkinson’s Essay on the Shaking Palsy, researchers developed a treatment to greatly improve PD symptoms. Over time, many variations of levodopa have provided additional modest benefits for people with PD, and now new delivery methods for levodopa promise to improve outcomes.

Decades later the next breakthrough in care came when the FDA approval deep brain stimulation for the treatment of PD. Today, we know that Parkinson’s is a synucleinopathy – a disease of alpha-synuclein – which brings us to the therapeutic approaches being discussed in this episode.

Dr. Guttman is a movement disorder neurologist at the Centre for Movement Disorders in Toronto, Canada. He provides specialized neurological services to people with movement disorders and is involved with clinical research at the Centre and at the University of Toronto.

John Eric Duda, MD
Professor of Neurology at the Veteran's Administration Medical Center
Director, Parkinson's Disease Research, Education and Clinical Center of the Michael J. Crescenz VA Medical Center, University of Pennsylvania
Co-Director, Center for Neurotrauma, Neurodegeneration and Restoration of the Michael J. Crescenz VA Medical Center, University of Pennsylvania

James F. Morley, MD, PhD
Assistant Professor of Neurology at the Veteran's Administration Medical Center Staff Neurologist, Philadelphia VA Medical Center
Associate Director, University of Pennsylvania/PADRECC Movement Disorders Fellowship Program. Co-director, Parkinson's Disease Research, Education and Clinical Center, Crescenz VA Medical Center