Searching for a Cure: Research Focus on Rapid-Onset Dystonia-Parkinsonism
Allison Brashear, MD, professor and chair of the Department of Neurology
Allison Brashear, MD, professor and chair of the Department of Neurology at Wake Forest Baptist, has been leading the way in the treatment of patients with movement disorders and spasticity for 20 years. She was an investigator on a number of key clinical trials, including the trials that led to the approval of botulinum toxin for the treatment of cervical dystonia and upper limb spasticity after a stroke.
Late last year, she co-edited Spasticity: Diagnosis and Treatment, the first book for medical professionals dedicated to spasticity. Brashear is also a leader in teaching physicians about spasticity treatment, with courses at the American Academy of Neurology (AAN) and at the Wake Forest Baptist campus.
The central component of Brashear’s research and clinical program is the investigation of Rapid-Onset Dystonia-Parkinsonism (RDP), a rare movement disorder that causes a person to suddenly present with dystonic movements or postures of the limbs, limited movement, the inability to speak or swallow, and postural instability.
“This particular disease is heartbreaking because it typically affects young individuals and it comes on abruptly,” said Brashear. “I’ve had stories where people are running a marathon and by the end of the marathon, they can’t walk, they can’t talk and they can’t swallow. Often, the symptoms present over hours to days, sometimes weeks. At this time, RDP is permanent and untreatable.”
Wake Forest Baptist is the worldwide center for the study of RDP. With NIH funding, Brashear and colleagues at Wake Forest Baptist and other health care institutions in the United States and globally are searching for a better understanding of RDP. They are characterizing all aspects of the disease, including an animal model, and continue to investigate its mechanisms and functionality.
“We are studying how the genetic mutation affects patients and what the possible treatments are,” said Brashear. “It may have implications for people who have more common diseases like dystonia and parkinsonism, both of which look somewhat like this particular disease.”
Currently, there are only 100 patients with RDP worldwide that have been studied by Brashear’s group; however, Brashear suspects the disease’s prevalence is much higher.
“We believe the study of RDP may have an impact on our understanding of how environment affects certain genetic movement disorders, such as parkinsonism,” said Brashear. “RDP may be more common than we think.”