Dr. Sean Udow - Diagnosing and treating cognitive deficits with Parkinson’s disease
Dr. Sean Udow, Post-Doctoral Fellow
Understanding the contribution of orthostatic hypotension to cognitive impairment in Parkinson’s disease using physiological MR imaging
One of the most difficult aspects of Parkinson’s disease is that although doctors can treat its motor symptoms, they often underestimate the impact of accompanying thinking and reasoning problems.
At Toronto’s Sunnybrook Research Institute, Dr. Sean Udow divides his time during his Clinical Movement Disorders Fellowship by focusing on ways to treat those cognitive problems, and on research to investigate a possible link between memory, judgment and reasoning deficits and blood pressure regulation.
Udow, a neurologist, knows that without any confirmed diagnostic tests for Parkinson’s, doctors need keen clinical skills to determine whether and what type of neurodegenerative disorder their patients have. The doctors rely on their experience, patient history, and observation.
“Parkinson’s disease isn’t diagnosed by an MRI or a blood test, so you really have to have a strong clinical acumen,” says Udow. “A lot of what we do is like detective work, or good old-fashioned doctoring.”
That’s why Udow is excited about his fellowship, which allows him to work with and learn from expert clinicians like Dr. Mario Masellis, and also to participate in research studies.
During their research, Udow and his colleagues will use unique Magnetic Resonance Imaging techniques to scan the brains of people with Parkinson’s disease and dementia with Lewy bodies, another form of dementia. Some of those people will also have orthostatic hypotension – variable blood pressure, which can cause dizziness and fainting when blood pressure drops abruptly. By comparing any changes in the brain the scans reveal, Udow hopes to find further evidence that suggests the variations in blood pressure may cause the cognitive symptoms people with Parkinson’s and other people with dementia experience.
If he can confirm the link between orthostatic hypotension, cognitive problems and these two neurodegenerative diseases, Udow hopes the findings will lead to a further research to determine if early, aggressive treatment of blood pressure fluctuations can prevent the progression of cognitive symptoms.