Neurological Movement Disorders

This research theme harbours several main approaches, all centered around patients with neurological movement disorders. There are two main target groups. The first one is patients with Parkinson’s disease or a form of atypical parkinsonism. The second one is patients with rare genetic neurological movement disorders, with a specific interest in patients with ataxia, hereditary spastic paraplegia, and neurometabolic disorders. The research interests of the participating members are outlined below.

The first research line aims at studying human motor control in health and disease, as a basis for innovative treatment strategies. Patients with neurological movement disorders are studied to recognize pathological brain alterations (as a basis for tailored treatment approaches), and to identify areas involved in adaptive cerebral compensation (again with the aim of exploiting such compensation as targets for treatment). Special emphasis is placed on the evaluation of gait and balance control (including freezing of gait), using both clinical epidemiological approaches (clinical trials, diagnostic studies, case reports) as well as pathophysiology studies using advanced electrophysiological techniques (dynamic posturography, automated gait analysis with motorized treadmills) and functional imaging techniques (in particular fMRI).

A second main interest is in health care innovation, aiming to develop and scientifically evaluate patient-centred collaborative care. Examples include the development of new therapeutic strategies (mainly in the field of allied health care interventions, such as physiotherapy, occupational therapy or speech-language therapy); the development and implementation of clinical management guidelines; diagnostic studies (including analyses of advanced imaging or cerebrospinal fluid for early diagnosis); and clinical trials. Our work is also increasingly focused on the use of wearable sensors and other forms of tele-monitoring for diagnostic and evaluative purposes. An important new study is the large Personalized Parkinson Project (PPP study), which aims to develop a personalized “precision” medicine approach for Parkinson patients, using a large cohort of 650 patients who will receive deep phenotyping and longitudinal follow-up using wearable sensors. Finally, the research groups values the publishing of well-documented, illustrative clinical case reports.

2018

• Proactive and Integrated Management and Empowerment of Parkinson’s disease. Role Bloem: co-principal investigator. Total funding » 1,300,000 euros.
• The Michael J Fox Foundation for Parkinson’s Research. The PERSPECTIVE trial. Role Bloem: co-principal investigator. Total funding » 500,000 euros.
• The Michael J Fox Foundation for Parkinson’s Research. Cerebral compensation and the progression of Parkinson’s disease. Role Bloem: co-principal investigator. Total funding » 500,000 euros.
• The Michael J Fox Foundation for Parkinson’s Research. Altitude effects in Parkinson’s disease. Role Bloem: co-principal investigator. Total funding » 50,000 euros.
• The Michael J Fox Foundation for Parkinson’s Research. Mindfulness as a novel treatment for Parkinson’s disease. Role Bloem: co-principal investigator. Total funding » 50,000 euros.
• H2020. Palliative care in Parkinson’s disease. Role Bloem: co-principal investigator. Total funding » 4,000,000 euros (of which 400,000 euros for our center).

2017

• Verily Life Sciences together with the Topsector Life Sciences and Health. The Personalized Parkinson Project. Role Bloem: principal investigator. Total funding level » 15 million euros.
• The Netherlands Organization for Health Research and Development (ZonMw) together with Stichting Parkinson Nederland. ParkinsonSupport: a clinical trial. Role Bloem: co-investigator. Total funding » 380,000 euros.
• Eurostars/RVO. REHAB-e-NOVATION: serious games to alleviate gait and balance disorders in Parkinson’s disease. Role Bloem: co-investigator (project leader: Marie-Laure Welter). Total funding » 120,000 euros.
• The Netherlands Organization for Health Research and Development (ZonMw). Cost-effectiveness of specialized nursing interventions for patients with Parkinson's disease. Role Bloem: project leader (with Nienke de Vries). Total funding » 300,000 euros.

2016

• The Netherlands Organization for Health Research and Development (ZonMw). ParkinsonSupport: van A naar Beter. Role Bloem: co-investigator. Total funding » 240,000 euros.
• Topsector Life Sciences and Health. The Real-Life Parkinson Study: towards development of personalized medicine for patients with Parkinson's disease. Role Bloem: project leader. Total funding » 120,000 euros.
• Nederlandse Organisatie voor Wetenschappelijk Onderzoek (NWO). Big data for personalized medicine. Role Bloem: project leader. Total funding » 650,000 euros.
• UCB Biopharma. The REAL-PD study. Role Bloem: project leader. Total funding » 380,000 euros.
• Stichting Parkinson Fonds. Ophthalmologic disorders in Parkinson’s disease: prevalence and clinical impact. Role Bloem: project leader (with prof. Klaus Seppi). Total funding » 150,000 euros.
• European Union. Integrated care in Nijmegen. Role Bloem: project leader (together with Marten Munneke). Total funding » 120,000 euros.
• Stichting Parkinson Nederland. Regional integrated care for Parkinson’s. Role Bloem: project leader (with Marten Munneke). Total funding » 60,000 euros.

2015

• Michael J Fox Foundation. The REAL-PD study. Role Bloem: project leader. Total funding » 350,000 euros.
• Stichting Parkinson Fonds. The REAL-PD study. Role Bloem: project leader. Total funding » 170,000 euros.
• Hersenstichting Nederland. Cue-shoe for Parkinson's disease: a single step from freezing to freedom. Role Bloem: co-investigator (project leader: Muriëlle Ferraye). Total funding » 130,000 euros.

Key research group prizes (from the past 5 years)

2017: ParkinsonNet awarded with the Pearl Award of the Nijmegen Economic Board
2015: ParkinsonNet awarded with the Value Based Health Care prize

• Araujo R, Bloem BR. Listen to your patient: a fiddler’s tale. Ann Neurol 2018; 84(6):931-933.

• Ypinga JHL, de Vries NM, Boonen LHHM, Koolman X, Munneke M, Zwinderman AH, Bloem BR. Effectiveness and costs of specialised physiotherapy given via ParkinsonNet: a retrospective analysis of medical claims data. Lancet Neurol 2018;17:153-161.

• Nonnekes J, Goselink RJ, Ruzicka E, Fasano A, Nutt JG, Bloem BR. Neurological disorders of gait, balance and posture: a sign-based approach. Nat Rev Neurol 2018;14:183-189.

• Bloem BR, Pfeijffer IL, Krack P. Art for better health and wellbeing. Br Med J 2018; 363:k5353

• Bloem BR, Rompen L, de Vries NM, Klink A, Munneke M, Jeurissen P. ParkinsonNet: a low cost health care innovation with a systems approach from the Netherlands. Health Affairs 2017;36:1987–96.