{"version":"1.0.0","segments":[{"startTime":0.0,"endTime":2.833,"body":"(uplifting music)"},{"startTime":5.47,"endTime":7.12,"body":"- Hi. I'm Margaret Preston, president"},{"startTime":7.12,"endTime":8.98,"body":"of Power Over Parkinson's, and today"},{"startTime":8.98,"endTime":11.35,"body":"in conjunction with our Pop Profile series"},{"startTime":11.35,"endTime":14.53,"body":"we have Dr. Binit Shah,"},{"startTime":11.35,"endTime":14.53,"body":"associate professor"},{"startTime":14.53,"endTime":16.64,"body":"at the University of"},{"startTime":14.53,"endTime":16.64,"body":"Virginia, the division head"},{"startTime":16.64,"endTime":19.3,"body":"of the Parkinson's and"},{"startTime":16.64,"endTime":19.3,"body":"Movement Disorders Division"},{"startTime":19.3,"endTime":20.9,"body":"and the neurology clerkship director"},{"startTime":20.9,"endTime":22.32,"body":"also at the University of Virginia."},{"startTime":22.32,"endTime":25.67,"body":"Dr. Shah, thank you so much"},{"startTime":22.32,"endTime":25.67,"body":"for being with us today."},{"startTime":25.67,"endTime":26.7,"body":"- Thanks for having me Margaret."},{"startTime":26.7,"endTime":27.95,"body":"- Yeah. Yeah, we're excited."},{"startTime":27.95,"endTime":29.68,"body":"I know you've got a lot of great content"},{"startTime":29.68,"endTime":32.55,"body":"you wanna share that our"},{"startTime":29.68,"endTime":32.55,"body":"listeners will really value."},{"startTime":32.55,"endTime":33.943,"body":"So, let's get right to it."},{"startTime":35.03,"endTime":35.88,"body":"- Sounds good."},{"startTime":35.88,"endTime":39.102,"body":"- Dr. Binit, Dr. Shah,"},{"startTime":35.88,"endTime":39.102,"body":"tell me a little bit about"},{"startTime":39.102,"endTime":41.53,"body":"and our listeners, spend a"},{"startTime":39.102,"endTime":41.53,"body":"few minutes, walk us through"},{"startTime":41.53,"endTime":45.91,"body":"how you got into a career"},{"startTime":41.53,"endTime":45.91,"body":"of neurology, neurosurgery?"},{"startTime":45.91,"endTime":49.72,"body":"- Yeah. You know, I think"},{"startTime":45.91,"endTime":49.72,"body":"everyone's journey is similar,"},{"startTime":49.72,"endTime":53.037,"body":"though there are many,"},{"startTime":49.72,"endTime":53.037,"body":"many different particular"},{"startTime":53.037,"endTime":57.3,"body":"sort of inspirations and"},{"startTime":53.037,"endTime":57.3,"body":"other things like that."},{"startTime":57.3,"endTime":60.44,"body":"You know, for me, you"},{"startTime":57.3,"endTime":60.44,"body":"know, my decision to go"},{"startTime":60.44,"endTime":64.21,"body":"into medicine overall was"},{"startTime":60.44,"endTime":64.21,"body":"sort of with this thought"},{"startTime":64.21,"endTime":66.75,"body":"that I would be somebody"},{"startTime":64.21,"endTime":66.75,"body":"who'd build relationships"},{"startTime":66.75,"endTime":70.926,"body":"with people, get to know patients,"},{"startTime":66.75,"endTime":70.926,"body":"have them get to know me."},{"startTime":70.926,"endTime":74.81,"body":"And, really sort of"},{"startTime":70.926,"endTime":74.81,"body":"forge a partnership for,"},{"startTime":74.81,"endTime":77.71,"body":"you know, years potentially."},{"startTime":77.71,"endTime":79.78,"body":"And so, as I went through"},{"startTime":77.71,"endTime":79.78,"body":"medical school, you know,"},{"startTime":79.78,"endTime":83.034,"body":"I sort of was between internal medicine"},{"startTime":83.034,"endTime":87.24,"body":"and neurology and"},{"startTime":83.034,"endTime":87.24,"body":"neurology really kind of is"},{"startTime":87.24,"endTime":88.9,"body":"a medicine specialty."},{"startTime":88.9,"endTime":92.78,"body":"So, I ultimately did a neurology rotation"},{"startTime":92.78,"endTime":95.05,"body":"and found that that patient interaction"},{"startTime":95.05,"endTime":97.03,"body":"especially in the clinic setting,"},{"startTime":97.03,"endTime":99.31,"body":"but even to some degree in"},{"startTime":97.03,"endTime":99.31,"body":"the inpatient setting is"},{"startTime":99.31,"endTime":103.229,"body":"kind of what I saw myself"},{"startTime":99.31,"endTime":103.229,"body":"being as a physician"},{"startTime":103.229,"endTime":105.9,"body":"even before my medical career started."},{"startTime":105.9,"endTime":110.9,"body":"And, it's really been a"},{"startTime":105.9,"endTime":110.9,"body":"journey where that's been"},{"startTime":111.44,"endTime":113.67,"body":"sort of corroborated and supported"},{"startTime":113.67,"endTime":116.22,"body":"where I've gotten to know"},{"startTime":113.67,"endTime":116.22,"body":"really meaningful people."},{"startTime":117.22,"endTime":119.714,"body":"- And, I would presume if I can elaborate"},{"startTime":119.714,"endTime":122.19,"body":"on that a little bit,"},{"startTime":119.714,"endTime":122.19,"body":"with the type of disease"},{"startTime":122.19,"endTime":124.546,"body":"that you're working with,"},{"startTime":122.19,"endTime":124.546,"body":"you have a long relationship"},{"startTime":124.546,"endTime":126.03,"body":"with a lot of your patients"},{"startTime":126.03,"endTime":130.07,"body":"where that relationship"},{"startTime":126.03,"endTime":130.07,"body":"approach is just so important"},{"startTime":130.07,"endTime":133.04,"body":"to their navigating their diagnosis"},{"startTime":133.04,"endTime":134.773,"body":"and ultimately their care?"},{"startTime":135.81,"endTime":138.62,"body":"- Yeah. I mean, and I"},{"startTime":135.81,"endTime":138.62,"body":"think that that goes along"},{"startTime":138.62,"endTime":140.7,"body":"with going into movement"},{"startTime":138.62,"endTime":140.7,"body":"disorders neurology."},{"startTime":140.7,"endTime":141.54,"body":"- Mm-hmm (affirmative). Yeah."},{"startTime":141.54,"endTime":144.37,"body":"- Where those relationships"},{"startTime":141.54,"endTime":144.37,"body":"are really long lasting"},{"startTime":144.37,"endTime":146.47,"body":"and sort of the deeper, the better."},{"startTime":146.47,"endTime":147.743,"body":"- Yeah, definitely."},{"startTime":148.63,"endTime":150.84,"body":"Well, I'd like to ask"},{"startTime":148.63,"endTime":150.84,"body":"you a question I ask many"},{"startTime":150.84,"endTime":155.11,"body":"of our interviewees around"},{"startTime":150.84,"endTime":155.11,"body":"how you stay optimistic"},{"startTime":155.11,"endTime":157.84,"body":"and enthusiastic while"},{"startTime":155.11,"endTime":157.84,"body":"you work in this space"},{"startTime":157.84,"endTime":159.79,"body":"that a lot of the disease have"},{"startTime":159.79,"endTime":162.36,"body":"an inevitable decline"},{"startTime":159.79,"endTime":162.36,"body":"associated with them."},{"startTime":162.36,"endTime":163.877,"body":"So, how do you remain optimistic"},{"startTime":163.877,"endTime":167.614,"body":"and positive about the"},{"startTime":163.877,"endTime":167.614,"body":"outlook within neurology?"},{"startTime":167.614,"endTime":171.57,"body":"- You know, it can be"},{"startTime":167.614,"endTime":171.57,"body":"a challenge at times,"},{"startTime":171.57,"endTime":173.923,"body":"but I think the key is sort of focusing"},{"startTime":173.923,"endTime":175.516,"body":"on positives."},{"startTime":175.516,"endTime":176.55,"body":"- Mm-hmm (affirmative)."},{"startTime":176.55,"endTime":179.58,"body":"- And I think you know Pop,"},{"startTime":176.55,"endTime":179.58,"body":"other sort of entities do"},{"startTime":179.58,"endTime":182.437,"body":"that really well which"},{"startTime":179.58,"endTime":182.437,"body":"is focusing on abilities"},{"startTime":182.437,"endTime":184.253,"body":"as opposed to disabilities."},{"startTime":184.253,"endTime":185.086,"body":"- Mm-hmm (affirmative)."},{"startTime":185.086,"endTime":188.79,"body":"- You know, in sort of"},{"startTime":185.086,"endTime":188.79,"body":"the rehab community,"},{"startTime":188.79,"endTime":192.14,"body":"there's different ways of"},{"startTime":188.79,"endTime":192.14,"body":"defining what disability is"},{"startTime":192.14,"endTime":193.947,"body":"versus changes that can happen with life."},{"startTime":193.947,"endTime":196.487,"body":"You know, I tell a lot"},{"startTime":193.947,"endTime":196.487,"body":"of patients, you know,"},{"startTime":196.487,"endTime":199.41,"body":"\"Michael Jordan probably"},{"startTime":196.487,"endTime":199.41,"body":"can't dunk anymore.\""},{"startTime":199.41,"endTime":204.13,"body":"And so, we focus on the"},{"startTime":199.41,"endTime":204.13,"body":"things that we enjoy doing,"},{"startTime":204.13,"endTime":206.486,"body":"the things that we can do safely."},{"startTime":206.486,"endTime":210.506,"body":"And, to the extent that"},{"startTime":206.486,"endTime":210.506,"body":"those are not limiting"},{"startTime":210.506,"endTime":213.417,"body":"sort of function in a meaningful way is"},{"startTime":213.417,"endTime":217.48,"body":"really an opportunity"},{"startTime":213.417,"endTime":217.48,"body":"more than anything else"},{"startTime":217.48,"endTime":219.86,"body":"for people to get out"},{"startTime":217.48,"endTime":219.86,"body":"do new things, explore"},{"startTime":219.86,"endTime":221.67,"body":"new things that they haven't before,"},{"startTime":221.67,"endTime":223.57,"body":"or really get to the things"},{"startTime":221.67,"endTime":223.57,"body":"that they haven't enjoyed"},{"startTime":223.57,"endTime":226.18,"body":"that they may not have"},{"startTime":223.57,"endTime":226.18,"body":"paid as much attention to"},{"startTime":226.18,"endTime":227.37,"body":"in the recent past."},{"startTime":227.37,"endTime":229.85,"body":"- Yeah. I think sometimes"},{"startTime":227.37,"endTime":229.85,"body":"that change in perspective"},{"startTime":229.85,"endTime":233.11,"body":"and whether it's a diagnosis"},{"startTime":229.85,"endTime":233.11,"body":"that is the genesis of this is"},{"startTime":233.11,"endTime":234.783,"body":"sometimes a good thing."},{"startTime":235.621,"endTime":236.454,"body":"- Yeah."},{"startTime":236.454,"endTime":237.54,"body":"- Yeah. Definitely."},{"startTime":237.54,"endTime":239.098,"body":"I'd like to jump into a"},{"startTime":237.54,"endTime":239.098,"body":"series of questions regarding"},{"startTime":239.098,"endTime":241.38,"body":"focused ultrasound."},{"startTime":241.38,"endTime":244.26,"body":"So, at a high level, can"},{"startTime":241.38,"endTime":244.26,"body":"you share with our listeners"},{"startTime":244.26,"endTime":246.96,"body":"what is entailed in the procedure?"},{"startTime":246.96,"endTime":249.48,"body":"- Yeah. And, you know, I think a little"},{"startTime":249.48,"endTime":252.472,"body":"of the background on it"},{"startTime":249.48,"endTime":252.472,"body":"is that focused ultrasound"},{"startTime":252.472,"endTime":256.77,"body":"as it applies to treating"},{"startTime":252.472,"endTime":256.77,"body":"Parkinson's and essential tremor"},{"startTime":256.77,"endTime":259.35,"body":"currently is in the category"},{"startTime":259.35,"endTime":260.83,"body":"of sort of lesioning procedures."},{"startTime":260.83,"endTime":262.576,"body":"So, those have been around for decades,"},{"startTime":262.576,"endTime":265.59,"body":"but what focused ultrasound"},{"startTime":262.576,"endTime":265.59,"body":"really provides is"},{"startTime":265.59,"endTime":269.74,"body":"a means of delivering"},{"startTime":265.59,"endTime":269.74,"body":"lesions, or targeting lesions"},{"startTime":269.74,"endTime":272.15,"body":"in a way that doesn't"},{"startTime":269.74,"endTime":272.15,"body":"involve making any incisions"},{"startTime":272.15,"endTime":273.77,"body":"or drilling through the skull."},{"startTime":273.77,"endTime":278.72,"body":"So, the way that that's done is that"},{"startTime":278.72,"endTime":281.59,"body":"the head is unfortunately,"},{"startTime":278.72,"endTime":281.59,"body":"has to be shaved to avoid"},{"startTime":281.59,"endTime":283.61,"body":"any sort of heat getting"},{"startTime":281.59,"endTime":283.61,"body":"trapped, you know,"},{"startTime":283.61,"endTime":285.57,"body":"beneath the hair."},{"startTime":285.57,"endTime":287.778,"body":"So, for people like me,"},{"startTime":285.57,"endTime":287.778,"body":"that's not that big of a deal,"},{"startTime":287.778,"endTime":291.633,"body":"but for other people, rest"},{"startTime":287.778,"endTime":291.633,"body":"assured, it grows back."},{"startTime":291.633,"endTime":296.59,"body":"And then, after that,"},{"startTime":291.633,"endTime":296.59,"body":"there's sort of a frame"},{"startTime":296.59,"endTime":299.885,"body":"with a bladder filled with"},{"startTime":296.59,"endTime":299.885,"body":"water placed over the skull."},{"startTime":299.885,"endTime":303.1,"body":"And, that water is sort of a means"},{"startTime":303.1,"endTime":307.082,"body":"for the ultrasound energy to"},{"startTime":303.1,"endTime":307.082,"body":"sort of go from the transducers"},{"startTime":307.082,"endTime":310.49,"body":"to the skull and through"},{"startTime":307.082,"endTime":310.49,"body":"the skull and so on."},{"startTime":310.49,"endTime":312.915,"body":"Sound waves don't tend"},{"startTime":310.49,"endTime":312.915,"body":"to travel in air as well"},{"startTime":312.915,"endTime":316.1,"body":"as they do through a more dense material"},{"startTime":316.1,"endTime":317.873,"body":"like water, for example."},{"startTime":317.873,"endTime":321.78,"body":"And so, attached to that"},{"startTime":317.873,"endTime":321.78,"body":"bladder are these transducers,"},{"startTime":321.78,"endTime":324.109,"body":"1024 ultrasonic transducers."},{"startTime":324.109,"endTime":329.109,"body":"And, it's sort of like a sort"},{"startTime":324.109,"endTime":329.109,"body":"a hemicircumferential helmet"},{"startTime":329.16,"endTime":331.74,"body":"where the transducers"},{"startTime":329.16,"endTime":331.74,"body":"are oriented all around"},{"startTime":331.74,"endTime":333.082,"body":"up to the top."},{"startTime":333.082,"endTime":337.07,"body":"And, using those, our"},{"startTime":333.082,"endTime":337.07,"body":"neurosurgical colleagues can"},{"startTime":337.07,"endTime":339.8,"body":"sort of use certain coordinate targeting"},{"startTime":339.8,"endTime":344.27,"body":"both via an individual's"},{"startTime":339.8,"endTime":344.27,"body":"imaging prior to the procedure"},{"startTime":344.27,"endTime":345.77,"body":"as well as based on sort of"},{"startTime":345.77,"endTime":349.5,"body":"where a certain target"},{"startTime":345.77,"endTime":349.5,"body":"should be anatomically,"},{"startTime":349.5,"endTime":353.4,"body":"and start the energy"},{"startTime":349.5,"endTime":353.4,"body":"focusing in an MRI scan"},{"startTime":353.4,"endTime":354.76,"body":"during the procedure."},{"startTime":354.76,"endTime":355.593,"body":"- Okay."},{"startTime":355.593,"endTime":358.63,"body":"So, as a follow up to that question, share"},{"startTime":358.63,"endTime":360.92,"body":"with our listeners who might be eligible"},{"startTime":360.92,"endTime":362.773,"body":"for the focused ultrasound procedure."},{"startTime":363.68,"endTime":365.297,"body":"- Yeah, and I think that's important."},{"startTime":365.297,"endTime":367.3,"body":"And, I will make a note there Margaret,"},{"startTime":367.3,"endTime":369.13,"body":"because I think a lot of people"},{"startTime":369.13,"endTime":371.114,"body":"with Parkinson's will"},{"startTime":369.13,"endTime":371.114,"body":"ask, \"Oh, am I eligible"},{"startTime":371.114,"endTime":374.731,"body":"for this particular"},{"startTime":371.114,"endTime":374.731,"body":"treatment or procedure?\""},{"startTime":374.731,"endTime":378.66,"body":"And, I like to sort of"},{"startTime":374.731,"endTime":378.66,"body":"reframe how that question is"},{"startTime":378.66,"endTime":380.299,"body":"sort of asked, because it's really more"},{"startTime":380.299,"endTime":384.266,"body":"of a question of does this"},{"startTime":380.299,"endTime":384.266,"body":"procedure have much to offer me?"},{"startTime":384.266,"endTime":388.01,"body":"And, if it doesn't, then"},{"startTime":384.266,"endTime":388.01,"body":"it's not necessarily"},{"startTime":388.01,"endTime":388.843,"body":"a worth while thing."},{"startTime":388.843,"endTime":389.676,"body":"- Right."},{"startTime":389.676,"endTime":392.61,"body":"- And so, we try to align"},{"startTime":392.61,"endTime":394.82,"body":"what our expectations and goals are"},{"startTime":394.82,"endTime":397.57,"body":"with the treatments we have,"},{"startTime":394.82,"endTime":397.57,"body":"whether that's medication,"},{"startTime":397.57,"endTime":401.2,"body":"whether that's a procedure,"},{"startTime":397.57,"endTime":401.2,"body":"whether that's, you know,"},{"startTime":401.2,"endTime":404.07,"body":"other things like physical"},{"startTime":401.2,"endTime":404.07,"body":"therapy, et cetera."},{"startTime":404.07,"endTime":406.007,"body":"So, you know, a lot of"},{"startTime":406.007,"endTime":408.53,"body":"what ultrasound can offer is related"},{"startTime":408.53,"endTime":409.764,"body":"to the targets that we use."},{"startTime":409.764,"endTime":413.84,"body":"The first target was a thalamic target"},{"startTime":413.84,"endTime":417.11,"body":"or in the thalamus of the"},{"startTime":413.84,"endTime":417.11,"body":"brain, something called the VIM,"},{"startTime":417.11,"endTime":420.28,"body":"which really is used to suppress tremors."},{"startTime":420.28,"endTime":423.05,"body":"And so, it was developed"},{"startTime":420.28,"endTime":423.05,"body":"initially in people"},{"startTime":423.05,"endTime":425.12,"body":"who had essential tremor,"},{"startTime":423.05,"endTime":425.12,"body":"and it was applied"},{"startTime":425.12,"endTime":428.02,"body":"to Parkinson's based"},{"startTime":425.12,"endTime":428.02,"body":"on a study that we did"},{"startTime":428.02,"endTime":429.79,"body":"a few years ago now."},{"startTime":429.79,"endTime":432.32,"body":"And, it's really just treating tremor."},{"startTime":432.32,"endTime":434.6,"body":"And so, for people who have tremor"},{"startTime":434.6,"endTime":436.68,"body":"that's really severe can be interfering"},{"startTime":436.68,"endTime":438.797,"body":"with their function or quality of life"},{"startTime":438.797,"endTime":441.411,"body":"and my not respond well to medication,"},{"startTime":441.411,"endTime":444.93,"body":"then or that medication"},{"startTime":441.411,"endTime":444.93,"body":"may cause side effects,"},{"startTime":444.93,"endTime":449.45,"body":"then that's certainly an"},{"startTime":444.93,"endTime":449.45,"body":"option that we can use."},{"startTime":449.45,"endTime":452.411,"body":"What it doesn't do, or"},{"startTime":449.45,"endTime":452.411,"body":"what that previous target"},{"startTime":452.411,"endTime":456.06,"body":"doesn't do is treat any other"},{"startTime":452.411,"endTime":456.06,"body":"features of Parkinson's,"},{"startTime":456.06,"endTime":458.43,"body":"slowness, stiffness that can manifest"},{"startTime":458.43,"endTime":460.93,"body":"as decreased dexterity."},{"startTime":460.93,"endTime":463.77,"body":"So, just recently in the last few weeks,"},{"startTime":463.77,"endTime":466.592,"body":"we've had a second target"},{"startTime":463.77,"endTime":466.592,"body":"that's been FDA approved"},{"startTime":466.592,"endTime":469.92,"body":"in the globus pallidus or a pallidotomy"},{"startTime":469.92,"endTime":471.58,"body":"with focused ultrasound."},{"startTime":471.58,"endTime":474.87,"body":"And that, really is a target"},{"startTime":471.58,"endTime":474.87,"body":"that has good evidence"},{"startTime":474.87,"endTime":477.53,"body":"for lesioning procedures,"},{"startTime":474.87,"endTime":477.53,"body":"again, going back decades"},{"startTime":477.53,"endTime":481.53,"body":"with deep brain stimulation to"},{"startTime":477.53,"endTime":481.53,"body":"not only help suppress tremor"},{"startTime":481.53,"endTime":484.658,"body":"but also to reduce stiffness"},{"startTime":481.53,"endTime":484.658,"body":"and slowness of movement,"},{"startTime":484.658,"endTime":487.63,"body":"and for people who take PD meds who have"},{"startTime":487.63,"endTime":489.74,"body":"excessive movements as a consequence."},{"startTime":489.74,"endTime":492.65,"body":"Dyskinesia, it can really"},{"startTime":489.74,"endTime":492.65,"body":"suppress those dyskinesias"},{"startTime":492.65,"endTime":495.0,"body":"on the side of the body"},{"startTime":492.65,"endTime":495.0,"body":"that's being treated."},{"startTime":495.0,"endTime":498.651,"body":"- Okay, well share with our listeners"},{"startTime":498.651,"endTime":500.714,"body":"the risks associated with the procedure."},{"startTime":500.714,"endTime":503.23,"body":"- You know, I think"},{"startTime":500.714,"endTime":503.23,"body":"that's really important"},{"startTime":503.23,"endTime":507.195,"body":"because we're talking about"},{"startTime":503.23,"endTime":507.195,"body":"neurosurgical procedures."},{"startTime":507.195,"endTime":510.96,"body":"And, I think that having"},{"startTime":507.195,"endTime":510.96,"body":"something that doesn't involve"},{"startTime":510.96,"endTime":513.65,"body":"an incision doesn't mean"},{"startTime":510.96,"endTime":513.65,"body":"that it's not invasive."},{"startTime":513.65,"endTime":515.88,"body":"If we're talking about"},{"startTime":513.65,"endTime":515.88,"body":"making a lesion in the brain,"},{"startTime":515.88,"endTime":517.97,"body":"I think that has to be"},{"startTime":515.88,"endTime":517.97,"body":"done with a lot of thought"},{"startTime":517.97,"endTime":519.937,"body":"and a lot of discussion."},{"startTime":519.937,"endTime":524.02,"body":"You know, when we first"},{"startTime":519.937,"endTime":524.02,"body":"started sort of doing trials"},{"startTime":524.02,"endTime":527.014,"body":"with this technology, we saw"},{"startTime":527.014,"endTime":530.885,"body":"some degree of imbalance"},{"startTime":527.014,"endTime":530.885,"body":"happen in many people."},{"startTime":530.885,"endTime":534.87,"body":"That imbalance usually"},{"startTime":530.885,"endTime":534.87,"body":"lasted for a few hours,"},{"startTime":534.87,"endTime":537.37,"body":"maybe a few days and"},{"startTime":534.87,"endTime":537.37,"body":"resolved in the vast majority"},{"startTime":537.37,"endTime":538.43,"body":"of people."},{"startTime":538.43,"endTime":540.41,"body":"Now, those were people"},{"startTime":538.43,"endTime":540.41,"body":"with essential tremor"},{"startTime":540.41,"endTime":542.715,"body":"who didn't necessarily have"},{"startTime":540.41,"endTime":542.715,"body":"issues with balance prior."},{"startTime":542.715,"endTime":546.501,"body":"And, with Parkinson's"},{"startTime":542.715,"endTime":546.501,"body":"it's a different disease."},{"startTime":546.501,"endTime":549.98,"body":"So, we had to be very"},{"startTime":546.501,"endTime":549.98,"body":"cognizant of that and careful"},{"startTime":549.98,"endTime":552.71,"body":"as we sort of applied this"},{"startTime":549.98,"endTime":552.71,"body":"treatment in Parkinson's."},{"startTime":552.71,"endTime":555.144,"body":"And, what we found is as the"},{"startTime":552.71,"endTime":555.144,"body":"technology's gotten better,"},{"startTime":555.144,"endTime":559.04,"body":"people have really done well"},{"startTime":555.144,"endTime":559.04,"body":"in terms of adverse affects."},{"startTime":559.04,"endTime":562.714,"body":"In the procedure, when their"},{"startTime":559.04,"endTime":562.714,"body":"sonication is being delivered,"},{"startTime":562.714,"endTime":565.93,"body":"and this is to say take a"},{"startTime":562.714,"endTime":565.93,"body":"little bit of a step back."},{"startTime":565.93,"endTime":568.51,"body":"You know, it's not a one time procedure"},{"startTime":568.51,"endTime":571.24,"body":"of you go in, you have the procedure done,"},{"startTime":571.24,"endTime":572.42,"body":"and then you come out."},{"startTime":572.42,"endTime":574.1,"body":"It's a little bit of a scaling effect."},{"startTime":574.1,"endTime":576.532,"body":"So, the energy is dialed"},{"startTime":574.1,"endTime":576.532,"body":"up in those transducers"},{"startTime":576.532,"endTime":578.74,"body":"until we see an effect that might last"},{"startTime":578.74,"endTime":580.812,"body":"only for a few seconds or a few minutes,"},{"startTime":580.812,"endTime":583.388,"body":"and we can use that"},{"startTime":580.812,"endTime":583.388,"body":"transient effect to identify,"},{"startTime":583.388,"endTime":585.0,"body":"hey are we in the right spot?"},{"startTime":585.0,"endTime":586.969,"body":"Do we need to move"},{"startTime":585.0,"endTime":586.969,"body":"things a few millimeters"},{"startTime":586.969,"endTime":588.91,"body":"in one direction or another,"},{"startTime":588.91,"endTime":592.25,"body":"both to maximize benefit, but"},{"startTime":588.91,"endTime":592.25,"body":"also minimize side effects."},{"startTime":592.25,"endTime":593.8,"body":"- Mm-hmm (affirmative)."},{"startTime":593.8,"endTime":597.15,"body":"- And so, within the procedure"},{"startTime":593.8,"endTime":597.15,"body":"as that energy is scaled up,"},{"startTime":597.15,"endTime":600.45,"body":"there can be some degree"},{"startTime":597.15,"endTime":600.45,"body":"of scalp pain or headache."},{"startTime":600.45,"endTime":604.167,"body":"And, that's usually pretty"},{"startTime":600.45,"endTime":604.167,"body":"temporary during the sonications,"},{"startTime":604.167,"endTime":607.93,"body":"and can be mitigated by"},{"startTime":604.167,"endTime":607.93,"body":"things like IV Tylenol"},{"startTime":607.93,"endTime":610.34,"body":"or other treatments during the procedure."},{"startTime":610.34,"endTime":613.72,"body":"After the procedure, some"},{"startTime":610.34,"endTime":613.72,"body":"patients have noticed"},{"startTime":613.72,"endTime":616.66,"body":"some abnormal sensation"},{"startTime":613.72,"endTime":616.66,"body":"around the side of the mouth"},{"startTime":616.66,"endTime":617.87,"body":"or the hand."},{"startTime":617.87,"endTime":619.72,"body":"Again, that's usually pretty transient,"},{"startTime":619.72,"endTime":623.27,"body":"again lasting for hours,"},{"startTime":619.72,"endTime":623.27,"body":"days, maybe weeks at a time,"},{"startTime":623.27,"endTime":624.726,"body":"but usually resolves."},{"startTime":624.726,"endTime":628.39,"body":"The imbalance that we"},{"startTime":624.726,"endTime":628.39,"body":"had seen in a little bit"},{"startTime":628.39,"endTime":630.949,"body":"more frequency earlier"},{"startTime":628.39,"endTime":630.949,"body":"is less prominent now."},{"startTime":630.949,"endTime":633.545,"body":"But, we do have to be careful about people"},{"startTime":633.545,"endTime":636.41,"body":"who might be on the edge"},{"startTime":633.545,"endTime":636.41,"body":"in terms of their balance"},{"startTime":636.41,"endTime":638.68,"body":"of needing something to help them walk"},{"startTime":638.68,"endTime":641.567,"body":"versus being wheelchair bound and saying,"},{"startTime":641.567,"endTime":643.77,"body":"\"We might want to be"},{"startTime":641.567,"endTime":643.77,"body":"careful about considering"},{"startTime":643.77,"endTime":645.02,"body":"this type of treatment.\""},{"startTime":645.02,"endTime":645.853,"body":"- That makes sense."},{"startTime":645.853,"endTime":647.84,"body":"Thank you for sharing that."},{"startTime":647.84,"endTime":651.756,"body":"Well, walk us through a"},{"startTime":647.84,"endTime":651.756,"body":"typical Parkinson's progression"},{"startTime":651.756,"endTime":654.59,"body":"with a tremor, and how it might look,"},{"startTime":654.59,"endTime":657.14,"body":"or how it might differ for"},{"startTime":654.59,"endTime":657.14,"body":"someone who has underwent"},{"startTime":657.14,"endTime":659.98,"body":"or undergone rather the focused ultrasound"},{"startTime":659.98,"endTime":661.58,"body":"and how those two run parallel"},{"startTime":661.58,"endTime":664.788,"body":"and the differences once"},{"startTime":661.58,"endTime":664.788,"body":"someone undergoes the procedure."},{"startTime":664.788,"endTime":669.13,"body":"- Yeah. And, it is important"},{"startTime":664.788,"endTime":669.13,"body":"to note some people"},{"startTime":669.13,"endTime":670.964,"body":"with PD don't have much tremor,"},{"startTime":670.964,"endTime":673.14,"body":"whereas some people have what we call"},{"startTime":673.14,"endTime":674.43,"body":"a tremor dominant form,"},{"startTime":674.43,"endTime":676.578,"body":"and that's kind of the dominant feature."},{"startTime":676.578,"endTime":680.34,"body":"And, I think where the"},{"startTime":676.578,"endTime":680.34,"body":"procedure, you know,"},{"startTime":680.34,"endTime":681.95,"body":"and not just the focused ultrasound,"},{"startTime":681.95,"endTime":683.9,"body":"but deep brain stimulation as well,"},{"startTime":683.9,"endTime":686.324,"body":"where those procedures can sort of change"},{"startTime":686.324,"endTime":689.928,"body":"a trajectory of management of disease is"},{"startTime":689.928,"endTime":692.91,"body":"in what the main priority is"},{"startTime":692.91,"endTime":695.88,"body":"and where, for example,"},{"startTime":692.91,"endTime":695.88,"body":"medications have been used"},{"startTime":695.88,"endTime":697.9,"body":"to try to control symptoms."},{"startTime":697.9,"endTime":701.43,"body":"So, we've had a lot of"},{"startTime":697.9,"endTime":701.43,"body":"patients who have been"},{"startTime":701.43,"endTime":703.597,"body":"on a large dose of"},{"startTime":701.43,"endTime":703.597,"body":"medications to help control"},{"startTime":703.597,"endTime":706.287,"body":"a tremor that can be quite severe,"},{"startTime":706.287,"endTime":709.56,"body":"and in doing so can develop dyskinesia,"},{"startTime":709.56,"endTime":712.7,"body":"can develop fluctuation"},{"startTime":709.56,"endTime":712.7,"body":"and have tremor control"},{"startTime":712.7,"endTime":716.77,"body":"that may only be sufficient"},{"startTime":712.7,"endTime":716.77,"body":"for 50 to 60% of the day."},{"startTime":716.77,"endTime":719.01,"body":"And, in the meanwhile,"},{"startTime":716.77,"endTime":719.01,"body":"they may have dyskinesia,"},{"startTime":719.01,"endTime":721.37,"body":"or they may just feel sedated or have"},{"startTime":721.37,"endTime":723.98,"body":"other adverse effects from medication."},{"startTime":723.98,"endTime":727.59,"body":"So, the procedure can really"},{"startTime":723.98,"endTime":727.59,"body":"sort of dial back the clock"},{"startTime":727.59,"endTime":731.18,"body":"a little bit when it comes"},{"startTime":727.59,"endTime":731.18,"body":"to medication treatment."},{"startTime":731.18,"endTime":733.27,"body":"That doesn't mean people"},{"startTime":731.18,"endTime":733.27,"body":"can get off medication"},{"startTime":733.27,"endTime":734.825,"body":"for their Parkinson's necessarily,"},{"startTime":734.825,"endTime":737.6,"body":"but it can sort of reduce the burden."},{"startTime":737.6,"endTime":740.192,"body":"And, if we talk about using tools,"},{"startTime":740.192,"endTime":743.31,"body":"you know using tools in different amounts"},{"startTime":743.31,"endTime":745.47,"body":"at different levels to"},{"startTime":743.31,"endTime":745.47,"body":"target different things is"},{"startTime":745.47,"endTime":748.193,"body":"always better than trying"},{"startTime":745.47,"endTime":748.193,"body":"to just use one single thing"},{"startTime":748.193,"endTime":750.861,"body":"and just keep escalating that."},{"startTime":750.861,"endTime":753.83,"body":"- You kind of jumped into"},{"startTime":750.861,"endTime":753.83,"body":"my next question was going"},{"startTime":753.83,"endTime":756.198,"body":"to be related to what's the relationship"},{"startTime":756.198,"endTime":758.35,"body":"between the procedure and medication?"},{"startTime":758.35,"endTime":760.54,"body":"So, let's say, I'm sure"},{"startTime":758.35,"endTime":760.54,"body":"there's a lot of patients"},{"startTime":760.54,"endTime":762.36,"body":"who are coming in or"},{"startTime":760.54,"endTime":762.36,"body":"listening to this thinking,"},{"startTime":762.36,"endTime":764.293,"body":"oh, I can get off my levodopa,"},{"startTime":765.276,"endTime":768.26,"body":"or whatever I'm taking to"},{"startTime":765.276,"endTime":768.26,"body":"manage my Parkinson's symptoms."},{"startTime":768.26,"endTime":769.68,"body":"So, talk to me about the relationship,"},{"startTime":769.68,"endTime":772.0,"body":"and what you typically"},{"startTime":769.68,"endTime":772.0,"body":"see if there's a typical"},{"startTime":772.0,"endTime":774.64,"body":"which we know it's a little"},{"startTime":772.0,"endTime":774.64,"body":"bit of the snowflake effect"},{"startTime":774.64,"endTime":777.2,"body":"but what you see in"},{"startTime":774.64,"endTime":777.2,"body":"terms of the relationship"},{"startTime":777.2,"endTime":780.99,"body":"between the procedure"},{"startTime":777.2,"endTime":780.99,"body":"and medication usage."},{"startTime":780.99,"endTime":783.62,"body":"- Yeah, and I think the"},{"startTime":780.99,"endTime":783.62,"body":"key there, Margaret is"},{"startTime":783.62,"endTime":785.33,"body":"these aren't mutually exclusive things."},{"startTime":785.33,"endTime":786.6,"body":"- Of course."},{"startTime":786.6,"endTime":788.97,"body":"- It's not to say, well let's"},{"startTime":786.6,"endTime":788.97,"body":"choose one or the other."},{"startTime":788.97,"endTime":789.803,"body":"- Right."},{"startTime":789.803,"endTime":793.61,"body":"- But, you know, like we've"},{"startTime":789.803,"endTime":793.61,"body":"said, some people don't tolerate"},{"startTime":793.61,"endTime":796.525,"body":"medication as well or"},{"startTime":793.61,"endTime":796.525,"body":"can have adverse effects."},{"startTime":796.525,"endTime":798.98,"body":"And, really, trying to"},{"startTime":796.525,"endTime":798.98,"body":"scale that back is helpful,"},{"startTime":798.98,"endTime":801.09,"body":"but even people who tolerate medications."},{"startTime":801.09,"endTime":805.17,"body":"You know, one thing"},{"startTime":801.09,"endTime":805.17,"body":"that is inspiring to me"},{"startTime":805.17,"endTime":807.691,"body":"in taking care of so many"},{"startTime":805.17,"endTime":807.691,"body":"people who have Parkinson's is,"},{"startTime":807.691,"endTime":810.59,"body":"you know, they can take"},{"startTime":807.691,"endTime":810.59,"body":"medications three, four"},{"startTime":810.59,"endTime":813.63,"body":"times a day and, you know,"},{"startTime":810.59,"endTime":813.63,"body":"I have trouble remembering"},{"startTime":813.63,"endTime":815.67,"body":"to take something once a day if I have to."},{"startTime":815.67,"endTime":819.171,"body":"So, that's a remarkable thing,"},{"startTime":815.67,"endTime":819.171,"body":"but it's also burdensome."},{"startTime":819.171,"endTime":820.29,"body":"- Yes."},{"startTime":820.29,"endTime":823.1,"body":"- And, to the extent that,"},{"startTime":820.29,"endTime":823.1,"body":"you know, people have to"},{"startTime":823.1,"endTime":824.99,"body":"sort of set a lot of alarms and do"},{"startTime":824.99,"endTime":827.089,"body":"a number of different"},{"startTime":824.99,"endTime":827.089,"body":"things to sort of keep on"},{"startTime":827.089,"endTime":830.52,"body":"a medication schedule,"},{"startTime":827.089,"endTime":830.52,"body":"that's tough to being with,"},{"startTime":830.52,"endTime":832.935,"body":"but if the consequence of"},{"startTime":830.52,"endTime":832.935,"body":"getting of the schedule is"},{"startTime":832.935,"endTime":835.969,"body":"really being disabled, then the role"},{"startTime":835.969,"endTime":839.83,"body":"of any surgical procedure"},{"startTime":835.969,"endTime":839.83,"body":"is to really try to create"},{"startTime":839.83,"endTime":842.95,"body":"a floor effect that if"},{"startTime":839.83,"endTime":842.95,"body":"the medication wears off,"},{"startTime":842.95,"endTime":845.17,"body":"for example, I'm not gonna be as disabled"},{"startTime":845.17,"endTime":846.003,"body":"as I would be otherwise."},{"startTime":846.003,"endTime":847.8,"body":"- Yeah. Mm-hmm (affirmative)."},{"startTime":847.8,"endTime":849.593,"body":"- And so, I'm not as locked"},{"startTime":847.8,"endTime":849.593,"body":"to that sort of schedule."},{"startTime":849.593,"endTime":850.426,"body":"- Yeah."},{"startTime":850.426,"endTime":851.46,"body":"- And, I can live my life."},{"startTime":851.46,"endTime":856.43,"body":"And then, the second"},{"startTime":851.46,"endTime":856.43,"body":"is, you know, for people"},{"startTime":856.43,"endTime":859.73,"body":"where we're aligning the goals in what"},{"startTime":859.73,"endTime":861.37,"body":"the surgical treatments can do"},{"startTime":861.37,"endTime":864.996,"body":"and the ultrasound can do"},{"startTime":861.37,"endTime":864.996,"body":"to what the priorities are,"},{"startTime":864.996,"endTime":867.89,"body":"you know, it really can allow"},{"startTime":867.89,"endTime":870.35,"body":"for medications to be"},{"startTime":867.89,"endTime":870.35,"body":"scaled back significantly."},{"startTime":870.35,"endTime":873.52,"body":"Maybe not permanently, but"},{"startTime":870.35,"endTime":873.52,"body":"at least for a window of time"},{"startTime":873.52,"endTime":875.623,"body":"that like I said is almost"},{"startTime":873.52,"endTime":875.623,"body":"akin to kind of setting"},{"startTime":875.623,"endTime":877.02,"body":"the clock back a little bit."},{"startTime":877.02,"endTime":878.414,"body":"- Mm-hmm (affirmative)."},{"startTime":878.414,"endTime":879.247,"body":"I love how you described that."},{"startTime":879.247,"endTime":880.84,"body":"And, it's such a wonderful"},{"startTime":879.247,"endTime":880.84,"body":"take away I think"},{"startTime":880.84,"endTime":884.93,"body":"of your last answer regarding"},{"startTime":880.84,"endTime":884.93,"body":"it's such a combination"},{"startTime":884.93,"endTime":889.105,"body":"of things that go into"},{"startTime":884.93,"endTime":889.105,"body":"ultimately the success"},{"startTime":889.105,"endTime":892.29,"body":"of the procedure and treatment"},{"startTime":892.29,"endTime":895.469,"body":"and creating that floor,"},{"startTime":892.29,"endTime":895.469,"body":"elevating that floor rather"},{"startTime":895.469,"endTime":897.58,"body":"that your baseline is a little bit higher"},{"startTime":897.58,"endTime":899.96,"body":"so you're not so burdened by times"},{"startTime":899.96,"endTime":902.66,"body":"and medication alerts on your phone."},{"startTime":902.66,"endTime":905.96,"body":"So, it frees up the individual a lot"},{"startTime":905.96,"endTime":909.513,"body":"which I think is fantastic"},{"startTime":905.96,"endTime":909.513,"body":"how you articulated that."},{"startTime":910.451,"endTime":913.46,"body":"To kind of tie a bow"},{"startTime":910.451,"endTime":913.46,"body":"on focused ultrasound,"},{"startTime":913.46,"endTime":915.89,"body":"if our listeners are"},{"startTime":913.46,"endTime":915.89,"body":"interested in learning"},{"startTime":915.89,"endTime":918.23,"body":"more about the procedure,"},{"startTime":915.89,"endTime":918.23,"body":"where would you direct"},{"startTime":918.23,"endTime":919.77,"body":"them to go?"},{"startTime":919.77,"endTime":922.981,"body":"- You know, I think there's"},{"startTime":919.77,"endTime":922.981,"body":"sort of two resources."},{"startTime":922.981,"endTime":926.15,"body":"One is what's called the"},{"startTime":922.981,"endTime":926.15,"body":"Focused Ultrasound Foundation"},{"startTime":926.15,"endTime":928.5,"body":"which is the not for profit entity"},{"startTime":928.5,"endTime":931.22,"body":"that really promotes the technology,"},{"startTime":931.22,"endTime":933.47,"body":"not just for neurologic applications,"},{"startTime":933.47,"endTime":936.423,"body":"but for other applications in healthcare."},{"startTime":937.52,"endTime":939.495,"body":"And, that's just FUSFoundation.org."},{"startTime":939.495,"endTime":943.61,"body":"The other is sort of"},{"startTime":939.495,"endTime":943.61,"body":"centers that sort of provide"},{"startTime":943.61,"endTime":944.443,"body":"the treatment."},{"startTime":944.443,"endTime":946.974,"body":"So, at UVA, we have a"},{"startTime":944.443,"endTime":946.974,"body":"very comprehensive website"},{"startTime":946.974,"endTime":949.86,"body":"that goes through the"},{"startTime":946.974,"endTime":949.86,"body":"University of Virginia's"},{"startTime":949.86,"endTime":951.624,"body":"Focused Ultrasound Center, and kind of"},{"startTime":951.624,"endTime":953.8,"body":"what the patient experience is,"},{"startTime":953.8,"endTime":955.98,"body":"a couple of videos of"},{"startTime":953.8,"endTime":955.98,"body":"the patient's journey,"},{"startTime":955.98,"endTime":958.24,"body":"which can always be helpful."},{"startTime":958.24,"endTime":960.82,"body":"- Yeah. And, we can, for those listening,"},{"startTime":960.82,"endTime":963.48,"body":"we can certainly provide"},{"startTime":960.82,"endTime":963.48,"body":"all of those websites"},{"startTime":963.48,"endTime":965.93,"body":"at the end of this presentation as well."},{"startTime":965.93,"endTime":967.57,"body":"So, thank you for that."},{"startTime":967.57,"endTime":969.11,"body":"You know, I would be remiss to,"},{"startTime":969.11,"endTime":972.27,"body":"I've run many of these Pop"},{"startTime":969.11,"endTime":972.27,"body":"profiles starting under COVID,"},{"startTime":972.27,"endTime":974.275,"body":"and I don't think I've never said COVID,"},{"startTime":974.275,"endTime":977.03,"body":"or had an interview that"},{"startTime":974.275,"endTime":977.03,"body":"we've never mentioned"},{"startTime":977.03,"endTime":979.77,"body":"COVID-19, so I'd be remiss not to say it."},{"startTime":979.77,"endTime":984.77,"body":"So, Dr. Shah, tell me what"},{"startTime":979.77,"endTime":984.77,"body":"target advice you would give"},{"startTime":984.985,"endTime":986.858,"body":"to people with Parkinson's"},{"startTime":984.985,"endTime":986.858,"body":"under this climate"},{"startTime":986.858,"endTime":989.84,"body":"who are still a little bit apprehensive,"},{"startTime":989.84,"endTime":992.308,"body":"hesitant to get out there, start restart"},{"startTime":992.308,"endTime":996.21,"body":"their lives and exercise"},{"startTime":992.308,"endTime":996.21,"body":"routine, et cetera?"},{"startTime":996.21,"endTime":998.34,"body":"- Yeah, and this is always a tough thing,"},{"startTime":998.34,"endTime":1002.561,"body":"because, you know,"},{"startTime":998.34,"endTime":1002.561,"body":"everyone who is watching"},{"startTime":1002.561,"endTime":1003.79,"body":"and you as well Margaret, as well as me,"},{"startTime":1003.79,"endTime":1006.58,"body":"we have different family"},{"startTime":1003.79,"endTime":1006.58,"body":"members or other people"},{"startTime":1006.58,"endTime":1009.535,"body":"we know who have different"},{"startTime":1006.58,"endTime":1009.535,"body":"levels of comfort."},{"startTime":1009.535,"endTime":1012.88,"body":"I think the key is safety"},{"startTime":1009.535,"endTime":1012.88,"body":"and trying to be as safe"},{"startTime":1012.88,"endTime":1015.66,"body":"as possible, but also understanding"},{"startTime":1012.88,"endTime":1015.66,"body":"that we have to balance"},{"startTime":1015.66,"endTime":1017.083,"body":"that with what's healthy."},{"startTime":1018.107,"endTime":1019.187,"body":"And so, we can say,"},{"startTime":1019.187,"endTime":1023.34,"body":"\"Well, if our goal is to"},{"startTime":1019.187,"endTime":1023.34,"body":"not get infected by a virus"},{"startTime":1023.34,"endTime":1024.984,"body":"that can be really bad,\" that's great."},{"startTime":1024.984,"endTime":1028.61,"body":"But, staying in the house for"},{"startTime":1028.61,"endTime":1031.23,"body":"the rest of our lives is"},{"startTime":1028.61,"endTime":1031.23,"body":"not really a viable option"},{"startTime":1031.23,"endTime":1032.8,"body":"for our overall health and wellbeing."},{"startTime":1032.8,"endTime":1037.8,"body":"So, what safety entails is"},{"startTime":1032.8,"endTime":1037.8,"body":"talking with people's doctors,"},{"startTime":1037.87,"endTime":1041.046,"body":"making sure they understand"},{"startTime":1037.87,"endTime":1041.046,"body":"the role of vaccination,"},{"startTime":1041.046,"endTime":1043.77,"body":"getting vaccinated if"},{"startTime":1041.046,"endTime":1043.77,"body":"they feel comfortable,"},{"startTime":1043.77,"endTime":1046.743,"body":"and having a chance to talk"},{"startTime":1043.77,"endTime":1046.743,"body":"to their doctors about it,"},{"startTime":1046.743,"endTime":1051.59,"body":"getting boosted as is the"},{"startTime":1046.743,"endTime":1051.59,"body":"latest CDC sort of guidelines."},{"startTime":1051.59,"endTime":1054.96,"body":"But then, also just being"},{"startTime":1051.59,"endTime":1054.96,"body":"cognizant of surroundings"},{"startTime":1054.96,"endTime":1058.14,"body":"and saying, \"Okay, well if"},{"startTime":1054.96,"endTime":1058.14,"body":"I'm gonna be seeing family"},{"startTime":1058.14,"endTime":1061.389,"body":"and maybe a child or grandchild"},{"startTime":1058.14,"endTime":1061.389,"body":"who might be in daycare"},{"startTime":1061.389,"endTime":1064.49,"body":"or some other setting where"},{"startTime":1061.389,"endTime":1064.49,"body":"they might be at high risk"},{"startTime":1064.49,"endTime":1066.738,"body":"making sure to either"},{"startTime":1064.49,"endTime":1066.738,"body":"distance or wear a mask."},{"startTime":1066.738,"endTime":1071.625,"body":"But, in terms of, for"},{"startTime":1066.738,"endTime":1071.625,"body":"example, you know, gyms,"},{"startTime":1071.625,"endTime":1076.625,"body":"exercise programs, I think"},{"startTime":1071.625,"endTime":1076.625,"body":"staff and facilities have made"},{"startTime":1077.7,"endTime":1080.833,"body":"such great accommodations,"},{"startTime":1077.7,"endTime":1080.833,"body":"and have responded well"},{"startTime":1080.833,"endTime":1084.76,"body":"to the pandemic that I can"},{"startTime":1080.833,"endTime":1084.76,"body":"clearly see the difference"},{"startTime":1084.76,"endTime":1089.186,"body":"in the people that I follow"},{"startTime":1084.76,"endTime":1089.186,"body":"who are back to doing"},{"startTime":1089.186,"endTime":1090.019,"body":"those things versus not."},{"startTime":1090.019,"endTime":1092.79,"body":"And, the ones who are just,"},{"startTime":1090.019,"endTime":1092.79,"body":"you know, getting back"},{"startTime":1092.79,"endTime":1094.73,"body":"to having some semblance of normality"},{"startTime":1094.73,"endTime":1097.15,"body":"and improved quality of life."},{"startTime":1097.15,"endTime":1098.501,"body":"- Mm-hmm (affirmative)."},{"startTime":1098.501,"endTime":1100.06,"body":"And, I would suspect that"},{"startTime":1098.501,"endTime":1100.06,"body":"just a simple getting"},{"startTime":1100.06,"endTime":1105.06,"body":"outdoors and walking is generally"},{"startTime":1100.06,"endTime":1105.06,"body":"with low risk associated"},{"startTime":1105.96,"endTime":1108.446,"body":"with it and gets people"},{"startTime":1105.96,"endTime":1108.446,"body":"out and moving as well."},{"startTime":1108.446,"endTime":1111.362,"body":"- Definitely. Especially"},{"startTime":1108.446,"endTime":1111.362,"body":"now that it's not like"},{"startTime":1111.362,"endTime":1112.195,"body":"100 degrees every day."},{"startTime":1112.195,"endTime":1113.028,"body":"- You're right. You're right."},{"startTime":1113.028,"endTime":1114.914,"body":"And, so far it's been"},{"startTime":1113.028,"endTime":1114.914,"body":"mild here in Virginia, so."},{"startTime":1114.914,"endTime":1117.86,"body":"Well, Dr. Shah as we summarize,"},{"startTime":1117.86,"endTime":1120.364,"body":"where can our listeners go"},{"startTime":1117.86,"endTime":1120.364,"body":"to find out more about you"},{"startTime":1120.364,"endTime":1123.19,"body":"and the research you're conducting?"},{"startTime":1123.19,"endTime":1126.582,"body":"- Yeah, I think, you know,"},{"startTime":1123.19,"endTime":1126.582,"body":"the University of Virginia,"},{"startTime":1126.582,"endTime":1129.62,"body":"we have sort of a clinical trials website,"},{"startTime":1129.62,"endTime":1131.5,"body":"and I think that's a good place to know"},{"startTime":1131.5,"endTime":1134.13,"body":"kind of what our group is up to"},{"startTime":1134.13,"endTime":1136.683,"body":"in terms of our clinical research profile."},{"startTime":1137.81,"endTime":1141.01,"body":"And, I think that applies"},{"startTime":1137.81,"endTime":1141.01,"body":"to centers everywhere."},{"startTime":1141.01,"endTime":1144.12,"body":"So, you know a lot of people"},{"startTime":1141.01,"endTime":1144.12,"body":"with Parkinson's might think"},{"startTime":1144.12,"endTime":1145.77,"body":"well I kind of live in"},{"startTime":1144.12,"endTime":1145.77,"body":"the middle of nowhere."},{"startTime":1145.77,"endTime":1149.59,"body":"There's not really a university"},{"startTime":1145.77,"endTime":1149.59,"body":"or a large hospital system"},{"startTime":1149.59,"endTime":1152.78,"body":"near me, but there are"},{"startTime":1149.59,"endTime":1152.78,"body":"resources that might be closer"},{"startTime":1152.78,"endTime":1153.613,"body":"than they think."},{"startTime":1153.613,"endTime":1156.99,"body":"And, I think looking at even"},{"startTime":1153.613,"endTime":1156.99,"body":"local community hospitals,"},{"startTime":1156.99,"endTime":1160.14,"body":"there might be relationships"},{"startTime":1156.99,"endTime":1160.14,"body":"with research entities."},{"startTime":1160.14,"endTime":1163.776,"body":"Of course, the Michael"},{"startTime":1160.14,"endTime":1163.776,"body":"J. Fox Foundation, Pop,"},{"startTime":1163.776,"endTime":1168.776,"body":"and, the ClinicalTrials.gov"},{"startTime":1163.776,"endTime":1168.776,"body":"entity is really"},{"startTime":1169.69,"endTime":1173.275,"body":"a comprehensive place to"},{"startTime":1169.69,"endTime":1173.275,"body":"look at research trials"},{"startTime":1173.275,"endTime":1175.36,"body":"and to find out what's going on."},{"startTime":1175.36,"endTime":1176.193,"body":"- Okay."},{"startTime":1177.06,"endTime":1178.81,"body":"Well, we will certainly, as I said before,"},{"startTime":1178.81,"endTime":1182.13,"body":"we will put those at the"},{"startTime":1178.81,"endTime":1182.13,"body":"conclusion of this presentation"},{"startTime":1182.13,"endTime":1184.479,"body":"as well for folks to access."},{"startTime":1184.479,"endTime":1186.76,"body":"Well, that does it for me Dr. Shah."},{"startTime":1186.76,"endTime":1188.58,"body":"Thank you so much for being a part"},{"startTime":1188.58,"endTime":1190.488,"body":"of the Pop Profile series."},{"startTime":1190.488,"endTime":1192.24,"body":"- Thanks for having me, Margaret."},{"startTime":1192.24,"endTime":1193.603,"body":"- Yeah. Thanks."},{"startTime":1193.603,"endTime":1196.436,"body":"(uplifting music)"}]}