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Accreditation/Credit Designation

Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Physicians' Education Resource®, LLC designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Physicians' Education Resource®, LLC is approved by the California Board of Registered Nursing, Provider #16669 for 1.5 Contact Hour.

Acknowledgment of Commercial Support

This activity is supported by educational grants from by Acorda Therapeutics, Inc, and Neurocrine Biosciences, Inc.

Medical Crossfire®: Managing Motor Fluctuations And Dyskinesia In Parkinson's Disease: Turning The “Off” Switch “On”

Release Date: November 30, 2018
Expiration Date: November 30, 2019
Media: Internet - based

Activity Overview

Parkinson's disease (PD) is the second most common neurogenerative disease after Alzheimer’s disease, affecting approximately 1 million people in the United States. The progression of PD and degree of impairment vary by individual and include impaired motor function, bradykinesia, tremor, gait and balance disturbances, and nonmotor symptoms such as sleep disorders, neuropsychiatric disturbances, gastrointestinal symptoms, and sensory deficits. The gold standard for management of motor symptoms is levodopa, the metabolic precursor of dopamine. However, levodopa has a short half-life and is poorly absorbed by some patients, leading to motor fluctuations and dyskinesia in long-term treatment of patients with PD. Approximately 10% of patients per year develop motor fluctuations after initiating levodopa, and 50% of patients with PD will develop these complications after 5 years of treatment. Dyskinesia typically follows motor fluctuations and is commonly associated with levodopa. The time when pharmacologic therapies are providing patient benefits in treating PD motor symptoms is referred to as “on” time. Conversely, the time when these therapies are not providing motor benefits is referred to as “off” time. Adequate management of off time remains one of the major unmet needs of PD management, and emerging treatments can provide effective and convenient relief.

During this Medical Crossfire®, a panel of expert faculty will review evidence-based therapeutic options for the management of motor fluctuations and dyskinesia in PD and discuss new and emerging levodopa and non-levodopa-based therapies. The panel will also discuss the importance of developing a patient-centered approach to care and strategies to effectively engage a multidisciplinary team to improve the management of PD motor fluctuations during off periods.

Acknowledgment of Commercial Support

This activity is supported by educational grants from by Acorda Therapeutics, Inc, and Neurocrine Biosciences, Inc.

Instructions for This Activity and Receiving Credit

  • You will need to login to participate in the activity.
  • Each presentation may contain an interactive question(s). You may move forward through the presentation; however, you may not go back to change answers or review videos/content until you finish the presentation.
  • At the end of the activity, “educational content/video files” will be available for your reference.
  • In order to receive a CME/CE certificate, participants must complete the activity.
  • Complete the posttest and pass with a score of 70% or higher, complete the evaluation and then click on request for credit. Participants may immediately download a CME/CE certificate upon completion of these steps.

Target Audience

This continuing medical education (CME) activity is intended for neurologists, nurse practitioners (NPs), physician assistants (PAs), and other health care professionals involved in the treatment and management of patients with PD.

Educational Objectives

Upon successful completion of this educational program, you should be better prepared to:

  1. Review evidence-based pharmacologic treatment options for management of motor fluctuations and dyskinesia in PD.
  2. Review new and emerging treatments for motor fluctuations and dyskinesia in PD.
  3. Discuss ways to add midlevel providers to the PD treatment team.

Faculty, Staff, and Planners' Disclosure


Paul P. Doghramji, MD, FAAFP
Family Physician, Collegeville Family Practice
Medical Director, Health Services, Ursinus College
Collegeville, Pennsylvania

Disclosure: No financial information to disclose.

Peter A. LeWitt, MD
Director Parkinson Disease and Movement Disorder Program
Henry Ford Hospital
West Bloomfield, Michigan

Disclosures: Grant/research support: Acorda Therapeutics, Adamas, Biotie Therapies, Lundbeck, The Michael J. Fox Foundation for Parkinson’s Research, Parkinson Study Group, Pharma Two B, Revance, Roche, Sunovion, US WorldMeds; Consultant: Abide Therapeutics, Acorda Therapeutics, Biogen, Britannia Pharmaceuticals, Cavion, Denali Therapeutics; Intec Pharma, Jazz Pharmaceuticals, Lundbeck, Neurocrine Biosciences, NeuroDerm, Prexton Therapeutics, Revance, Sage Therapeutics, SynAgile, Titan Pharmaceuticals, US WorldMeds; Other support: annual stipend as editor-in-chief of Clinical Neuropharmacology

Corneliu Luca, MD
Associate Professor of Neurology
University of Miami
Miami, Florida

Disclosures: Grant/research support: Medtronic, National Institutes of Health, Parkinson’s Foundation; Consultant: Abbott, Abbvie, Medtronic

Cathi A. Thomas, MS, RN, CNRN
Assistant Clinical Professor of Neurology
Program Director, Parkinson Disease and Movement Disorders Center
Boston University Medical Campus
Boston, Massachusetts

Disclosures: Consultant: Acorda Therapeutics, Allied Health Professionals Medical Advisory Board meeting, Delsys

The staff of Physicians’ Education Resource®, LLC have no relevant financial relationships with commercial interests to disclose.

Disclosure Policy and Resolution of Conflicts of Interest

As a sponsor accredited by the ACCME, it is the policy of PER® to ensure fair balance, independence, objectivity, and scientific rigor in all of its CME activities. In compliance with ACCME guidelines, PER® requires everyone who is in a position to control the content of a CME/CE activity to disclose all relevant financial relationships with commercial interests. The ACCME defines “relevant financial relationships” as financial relationships in any amount occurring within the past 12 months that creates a COI.
Additionally, PER® is required by ACCME to resolve all COI. PER® has identified and resolved all COI prior to the start of this activity by using a multistep process.

Off-Label Disclosure and Disclaimer

This CME/CE activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME/CE activity is for continuing medical and nursing education purposes only, and is not meant to substitute for the independent clinical judgment of a physician or nurse relative to diagnostic, treatment, or management options for a specific patient’s medical condition. The opinions expressed in the content are solely those of the individual faculty members and do not reflect those of PER®.

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