Parkinson Weekly

EP 38 - The Parkinson Weekly Helpdesk

🎙️ We’re back with the 38th episode of Parkinson Weekly, hosted by Prof. Bas Bloem — and the third instalment of the Parkinson Weekly Helpdesk. In Episode 38 of Parkinson Weekly, Professor Bas Bloem returns with the third Helpdesk episode, answering questions submitted by listeners from around the world. This week, Bas explores the important relationship between Parkinson’s and the gut, including constipation, SIBO and how gut health can affect levodopa absorption and weight loss. He also discusses emerging research into intermittent hypoxia and its potential effects on Parkinson’s symptoms, before looking at whether Parkinson’s may be increasing among younger people and why more research into young-onset Parkinson’s disease is needed. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 37 - Smart Therapies for Parkinson’s – When Is the Right Time?

🎙️ We’re back with Episode 37 of Parkinson Weekly, hosted by Prof. Bas Bloem. On this week’s episode of Parkinson Weekly, recorded live at the European Academy of Neurology (EAN) Congress in Geneva, Prof. Bas Bloem discusses advanced treatment options for people with Parkinson’s experiencing complex response fluctuations. Prof. Bloem explores why the term “advanced therapies” may itself create a barrier to treatment and explains why he prefers the term “smart therapies”. He discusses the range of options available, including deep brain stimulation, focused ultrasound and pump therapies, and explains how the 5-2-1 rule can help identify when it may be time to start the conversation. The episode also looks at the importance of shared decision-making, ensuring people with Parkinson’s and their loved ones are informed about all available treatment options and can work together with their clinical team to determine the most appropriate approach. Key topics include: What are “smart therapies” for Parkinson’s? Recognising complex response fluctuations The 5-2-1 rule and when to start the conversation Deep brain stimulation, focused ultrasound and pump therapies Why discussions around treatment may be happening too late The importance of shared decision-making and individualised care Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 36 - Think Gut: Why Parkinson’s Medication Sometimes Stops Working

🎙️ Parkinson Weekly – Episode 36 In Episode 36 of Parkinson Weekly, Prof. Bas Bloem explores one of the most overlooked reasons why oral Parkinson’s medications can become unreliable: the gut. Drawing on his presentation at the European Academy of Neurology (EAN) Congress in Geneva, Prof. Bloem explains why fluctuating symptoms are not always caused by disease progression alone. While predictable “wearing-off” episodes can often be managed by adjusting medication schedules or adding adjunctive therapies, he highlights the importance of recognising delayed ONs, dose failures and unpredictable OFF periods—all of which may point towards impaired gastrointestinal function. The episode examines how Parkinson’s disease affects the digestive tract long before diagnosis in many people, including delayed gastric emptying (gastroparesis), constipation and small intestinal bacterial overgrowth (SIBO). Prof. Bloem discusses how these conditions can prevent levodopa from reaching the small intestine for absorption or even cause the medication to be broken down before it reaches the brain, leading to inconsistent symptom control. He also reviews practical management strategies, including treating constipation, understanding the current evidence surrounding SIBO, and recognising when it may be appropriate to bypass the gut altogether using device-aided therapies such as deep brain stimulation, continuous infusion therapies, or emerging on-demand treatments like inhaled levodopa. This practical and clinically focused episode provides valuable insights into recognising gastrointestinal causes of motor fluctuations and highlights how addressing the gut can help restore more reliable symptom control, improve mobility, and ultimately enhance quality of life for people living with Parkinson’s disease. Tune in now to discover why, when Parkinson’s medications stop working as expected, the answer may lie in the gut rather than the brain. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 35 - “What to do, if even David Marsden would not have a clue”

🎙️ We’re back with Episode 35 of Parkinson Weekly, hosted by Prof. Bas Bloem. Recorded live at the European Academy of Neurology (EAN) Congress in Geneva, this special episode sees Prof. Bas Bloem reflect on his C. David Marsden Award Lecture, entitled “What to do, if even David Marsden would not have a clue”. Prof. Bloem explores how clinicians can approach particularly challenging movement disorder presentations when the diagnosis is far from straightforward. Drawing on the themes of his lecture, he outlines the value of a structured, multistep approach to reaching a clinically based diagnosis, even in the most complex cases. The episode also highlights the importance of developing an eclectic approach to clinical practice. Prof. Bloem discusses the value of identifying your own clinical heroes, learning from the skills and qualities that make them exceptional, and incorporating the best of these into your own clinical repertoire — while combining them with your individual strengths, preferences and abilities. Recorded from EAN 2026 in Geneva, this episode offers a fascinating insight into clinical reasoning, lifelong learning and the art of becoming a better clinician. Tune in now to hear Prof. Bas Bloem share the key lessons from his C. David Marsden Award Lecture. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 34 - Pesticides Callout!

🎙️ We’re back with Episode 34 of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 34 of Parkinson Weekly, “Pesticides Callout!”, Prof. Bas Bloem delivers a powerful call to action regarding proposed changes to European pesticide regulations. Prof. Bloem explores concerns surrounding the current omnibus proposal, particularly the possibility that real-world evidence may no longer be considered when assessing the long-term safety of pesticides once they have been approved for market use. Drawing on decades of research into Parkinson’s disease and environmental risk factors, he explains why ongoing scrutiny of pesticides and other chemicals remains essential, especially as new evidence emerges from real-world exposure. The episode examines the limitations of current testing methods, the importance of post-approval monitoring, and recent research linking environmental exposures to an increased risk of neurodegenerative disease. Prof. Bloem also discusses the need to support greener agricultural alternatives and questions proposals that could extend the use of chemicals already identified as harmful to human health. This thought-provoking episode highlights the intersection of environmental policy, public health, and Parkinson’s disease, while urging policymakers to prioritise long-term population health when making regulatory decisions. Tune-in now to hear why Prof. Bloem believes real-world evidence must remain at the heart of efforts to protect future generations from potential environmental contributors to neurodegenerative disease. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 33 - Four innovations to bridge the evidence-practice gap in Parkinson's disease allied health guidelines

🎙️ We’re back with episode 33 of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 33 of Parkinson Weekly, Prof. Bas Bloem discusses a newly published multidisciplinary allied health guideline for people living with Parkinson’s disease. Published in Parkinsonism and Related Disorders, the guideline introduces an innovative, problem-orientated approach to Parkinson’s care, moving beyond traditional single-discipline recommendations. Instead, it brings together input from physiotherapists, occupational therapists, speech-language therapists, dieticians, and other allied health professionals to address complex symptoms such as falls, fatigue, swallowing difficulties, constipation, breathing problems, and sexual health concerns. Bas highlights four key innovations: its multidisciplinary structure, decision support based on problems raised by people with Parkinson’s, full accessibility for patients themselves, and automated annual updates to ensure the guidance remains aligned with the latest evidence. This episode explores why this Dutch guideline may serve as a template for future Parkinson’s guidelines worldwide, supporting more collaborative, person-centred, and up-to-date care. A forward-looking episode on how multidisciplinary guidance could help shape the next era of Parkinson’s disease management. Read the full article here: https://pubmed.ncbi.nlm.nih.gov/42115018/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 32 - The Parkinson Weekly Helpdesk

🎙️ We’re back with episode 32 of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 32 of Parkinson Weekly, Prof. Bas Bloem returns with the third Parkinson Weekly Helpdesk, answering three insightful questions from listeners. This episode explores the fascinating relationship between art, dopamine, creativity, and brain function, including how art may support wellbeing in Parkinson’s disease and why future clinical trials could help define its therapeutic potential. Bas also discusses altered perception in Parkinson’s, including hearing, vision, proprioception, posture awareness, and how practical tools such as visual feedback may help support therapy. The episode concludes with an open and thoughtful discussion on lifespan in Parkinson’s disease. Bas explains why honest conversations about prognosis, quality of life, falls, swallowing, infections, and multidisciplinary care are essential, while also highlighting the positive impact that specialist support and services such as ParkinsonNet can have on outcomes. A wide-ranging Helpdesk episode covering creativity, perception, realistic hope, and practical ways to support better living with Parkinson’s disease. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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Ep 31 - The Unseen Burden: Uncovering Shame and Its Determinants in Parkinson's Disease

🎙️ We’re back with episode 31 of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 31 of Parkinson Weekly, Prof. Bas Bloem explores an often overlooked but deeply important aspect of Parkinson’s disease: shame. Discussing a thought-provoking new paper published in Movement Disorders Clinical Practice, Bas examines how feelings of shame can significantly affect the lives of people living with Parkinson’s. The episode highlights findings from a Swiss study investigating the relationship between shame, anxiety, guilt, dyskinesias, depression, apathy, and overall quality of life in Parkinson’s disease. Bas reflects on why this under-recognised issue deserves far greater attention in clinical practice and everyday conversations. Importantly, the discussion goes beyond medication, emphasising the value of open communication, awareness, and non-pharmacological support in helping reduce the burden of shame for people with Parkinson’s and their families. A thoughtful and compassionate episode shedding light on the emotional realities of living with Parkinson’s disease — and why acknowledging these experiences is an essential step toward better care. You can read the full article here: https://pubmed.ncbi.nlm.nih.gov/40384367/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 30 - Tolerability and efficacy of full-body head-up tilt sleeping in Parkinson's disease and multiple system atrophy

🎙️ We’re back with episode 30 of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 30, Prof. Bas Bloem explores orthostatic hypotension — the significant drop in blood pressure that can occur when standing up, commonly affecting people with Parkinson’s disease and multiple system atrophy. This debilitating condition can lead to fainting, falls, fatigue, and the so-called “twilight zone” of brain fog. The episode discusses new research published this week in NPJ Parkinson’s Disease investigating “heads-up tilt sleeping” — sleeping with the bed elevated at an angle — as a simple, non-pharmacological treatment approach. Prof. Bloem explains how this technique may help improve both daytime blood pressure drops and nighttime hypertension, potentially offering a rare treatment strategy that addresses both problems simultaneously. Drawing on findings from the international HEADS-UP Parkinson study, the episode examines the science behind this old clinical observation, practical ways patients can try the intervention themselves, and why this could represent an important advance in managing autonomic dysfunction in Parkinson’s disease. You can read the full article here: https://pubmed.ncbi.nlm.nih.gov/42143029/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 29 - The Parkinson Weekly Helpdesk

🎙️ We’re back with the twenty-ninth episode of Parkinson Weekly, hosted by Prof. Bas Bloem — and the second instalment of the Parkinson Weekly Helpdesk. In this episode, Prof. Bloem answers three new listener questions covering some of the most talked-about topics in Parkinson’s care. He explores the role of diet and the gut, offering practical advice on nutrition, constipation, and how these may impact medication effectiveness. The episode also dives into Mucuna pruriens — what it is, how it compares to standard levodopa therapy, and when it may (or may not) be appropriate. Finally, Prof. Bloem discusses cognitive training, addressing whether brain exercises can help manage symptoms or slow cognitive decline. As always, the Helpdesk combines evidence with real-world clinical insight — helping to cut through conflicting advice and focus on what truly matters for patients. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 28 - The Parkinson Weekly Helpdesk

🎙️ We’re back with the twenty-eighth episode of Parkinson Weekly, hosted by Bas Bloem. In Episode 28, we introduce a brand-new segment — the Parkinson Weekly Helpdesk — where Prof. Bloem answers listener-submitted questions from across the global Parkinson’s community. Following an overwhelming response, this new format tackles three key questions per episode, offering practical, evidence-based insights while ensuring advice remains general and applicable to all. This first Helpdesk episode explores: The growing interest in methylene blue and whether there is any real clinical evidence behind its use in Parkinson’s disease How to regain confidence after a fall, including the role of balance confidence training and physiotherapy The broader topic of supplements in Parkinson’s, examining what the evidence actually shows — and where caution is needed Prof. Bloem brings his characteristic clarity and scientific rigour to each topic, highlighting the importance of distinguishing promising theory from proven, evidence-based treatments, while also addressing the real concerns and experiences of people living with Parkinson’s. A thoughtful and highly practical episode that marks the start of an important new initiative — designed to answer your questions, at scale. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 27 - Parkinsonism and Related Disorders

🎙️ We’re back with the twenty-seventh episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 27, Prof. Bloem explores an intriguing and under-researched question in Parkinson’s disease: can temperature influence symptoms? Inspired by a 2024 study published in Parkinsonism and Related Disorders by Nahid Mohammadzadeh & Joseph Friedman the episode examines how exposure to cold may worsen tremor in people with Parkinson’s disease. Drawing on both clinical observations and emerging evidence, Prof. Bloem discusses how nearly one-third of patients with tremor reported worsening symptoms in cold conditions—often independent of shivering—while warmer environments may offer relief for some individuals. The episode also reflects on earlier research, including findings from Prof. Bloem’s own “holiday survey,” which suggested that many patients experience symptom improvement in warmer climates, though responses can vary significantly. Importantly, Prof. Bloem highlights the limitations of current evidence—small sample sizes, self-reported data, and a lack of objective measurements—while emphasising the potential clinical relevance of temperature as a modifiable factor. Finally, the episode calls for a more personalised, holistic approach to Parkinson’s care, encouraging patients and clinicians to consider environmental factors such as temperature, and urging researchers to further investigate this overlooked dimension of the disease. Articles can be found here: https://www.prd-journal.com/issue/S1353-8020(24)X0006-1 & https://www.researchgate.net/publication/364544026_How_vacations_affect_Parkinson's_disease Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 26 - Article Of The Week: Clinical severity in Parkinson's disease is determined by decline in cortical compensation

🎙️ We’re back with the twenty-sixth episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 26, Prof. Bloem explores a thought-provoking shift in how we understand Parkinson’s disease progression. Inspired by a 2024 study published in Brain by Martin Johansson and colleagues, the episode examines whether we may have been focusing too heavily on the substantia nigra — and overlooking the crucial role of the brain’s cortex. Drawing on data from the Parkinson Precision Project, the study suggests that faster disease progression may be driven more by a breakdown in cortical compensation than by continued degeneration in the basal ganglia. Prof. Bloem discusses what this could mean for future disease-modifying strategies, and why approaches that support or protect cortical function — including exercise — may become increasingly important. A short but impactful episode that challenges conventional thinking and opens new directions for Parkinson’s research. Article can be found here: https://pubmed.ncbi.nlm.nih.gov/37757883/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 25 - Article Of The Week: The impact of diet on Parkinson's disease risk: A data-driven analysis in a large Italian case-control population

🎙️ We’re back with the twenty-five episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 25, Prof. Bloem explores the complex and evolving role of diet in the risk of developing Parkinson’s disease. Inspired by a recent study published in the Journal of Parkinson’s Disease (2026) by Angelo Gigante and colleagues, the episode examines how different dietary patterns may influence Parkinson’s risk alongside established environmental and genetic factors. Prof. Bloem discusses findings from a large Italian multi-centre case-control study, which suggests that higher consumption of sweets, red meat, and processed meats may be associated with an increased risk of Parkinson’s disease, while fruit intake appears to have a modest protective effect. The episode also places these findings into context, comparing the impact of diet with other known risk factors such as pesticide exposure, metals, family history, coffee consumption, and physical activity, and highlights the emerging theory that Parkinson’s disease may begin in the gut. Finally, Prof. Bloem reflects on the limitations of current evidence — including reliance on self-reported dietary data — and emphasises the need for further research to better understand how nutrition could play a role in prevention and disease progression. Article can be found here: https://journals.sagepub.com/doi/10.1177/1877718X251388058 Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 24 - Article Of The Week: Spiritual Assessment of Neurologic Patients

🎙️ We’re back with the twenty-fourth episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 24, Prof. Bas Bloem discusses an important and often overlooked topic in Parkinson’s care: spirituality. Inspired by a recent paper published in Neurology Clinical Practice (2026) by Dr Indu Subramanian and colleagues, the episode explores how spirituality — the search for meaning, purpose, and connection — can help people living with Parkinson’s disease cope with the challenges of diagnosis and disease progression. Prof. Bloem highlights the distinction between spirituality and religion, the role of spirituality in fostering hope and resilience, and why addressing spiritual needs may be an important part of holistic care for people with neurological diseases. The paper also offers practical guidance for clinicians, including simple screening questions that can help open conversations about spiritual wellbeing in clinical practice. Article can be found here: https://www.neurology.org/doi/10.1212/CPJ.0000000000200591 Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 23 - Papers on 'Response Fluctuations'

🎙️ We’re back with the twenty third episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In Episode 23 of Parkinson Weekly, Prof. Bas Bloem explores the phenomenon of response fluctuations, where the benefits and side effects of oral Parkinson’s medications vary throughout the day. Rather than focusing on a single new study, this episode revisits several influential papers that have reshaped how clinicians understand these fluctuations and their underlying mechanisms. Listeners will learn about key concepts including “on” and “off” states, predictable wearing-off, dose failures, and different types of dyskinesias—including peak-dose and biphasic dyskinesias. The episode also highlights how Parkinson’s disease progression narrows the brain’s therapeutic window, making it increasingly difficult to maintain stable symptom control. Prof. Bloem also discusses an often overlooked factor: the gut. Gastrointestinal issues such as delayed gastric emptying, constipation, small intestinal bacterial overgrowth (SIBO), and Helicobacter pylori infection can significantly affect how levodopa is absorbed, leading to delayed or unpredictable medication responses. Finally, the episode explores treatment strategies—from adjusting dosing schedules and adding adjunct medications to the role and limitations of continuous dopaminergic therapies, while emphasising the importance of realistic treatment goals and expectation management. This episode offers practical insights for clinicians, people living with Parkinson’s disease, and caregivers seeking to better understand and manage medication fluctuations. Listen now to discover how evolving research is shaping the way we approach response fluctuations in Parkinson’s disease. Articles mentioned can be found here: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(15)00007-1/abstract https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.870120304 https://pmc.ncbi.nlm.nih.gov/articles/PMC2865731/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

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EP 22 - Article Of The Week: Dual-Risk axis: GBA1 mutations and occupational pesticide exposure in Parkinson's Disease

🎙️ We’re back with the twenty second episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In this episode, Bas explores the role of gene–environment interactions in Parkinson’s disease, examining why some individuals develop Parkinson’s following environmental exposure while others do not. Discussing a recent study published in the Journal of Parkinson’s Disease, he reviews new evidence linking GBA1 genetic mutations with occupational pesticide exposure, highlighting how genetic susceptibility may influence vulnerability to environmental risk factors. Bas explains the biological mechanisms behind this interaction, including impaired cellular waste clearance and mitochondrial dysfunction, and reflects on the broader implications for research, prevention strategies, and regulatory policy. The key message: Parkinson’s risk may be shaped not by genes or environment alone, but by the interaction between the two. An important episode that advances our understanding of Parkinson’s disease risk and underscores the need to consider genetic vulnerability in environmental health and future research. 👉 You can read the full article here: https://pubmed.ncbi.nlm.nih.gov/41549707/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

EP 21 - Article Of The Week: Hearing Loss in Parkinson's Disease: A Systematic Review and Meta-Analysis

🎙️ We’re back with the twenty first episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In this episode, Bas explores a surprising and often overlooked question: is hearing loss part of the Parkinson’s disease phenotype? Discussing a 2026 systematic review and meta-analysis published in Movement Disorders, he highlights compelling evidence that hearing impairment is common in Parkinson’s — affecting nearly 80% of patients across pooled studies. High-frequency hearing loss was particularly prevalent, and abnormalities in central auditory processing suggest this is not simply age-related decline, but potentially linked to Parkinson’s-specific brain changes. Bas reflects on why this matters clinically, including the association between hearing loss, cognitive decline, and social isolation. The key message: hearing impairment is common, under-recognised, and should not be dismissed as “just ageing.” An important episode that broadens our understanding of the non-motor and sensory features of Parkinson’s disease. 👉 You can read the full article here: https://pubmed.ncbi.nlm.nih.gov/41618507/ And don't forget, you can listen here: Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

EP 20 - Article Of The Week: Exploring the impact of Parkinson's disease on driving: a population-based survey

🎙️ We’re back with the twentieth episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In this episode, Bas discusses Exploring the impact of Parkinson’s disease on driving: a population-based survey, a large real-world study examining how Parkinson’s affects driving ability, licence retention, and conversations between patients and healthcare professionals. Driving is closely tied to independence, identity, and quality of life — yet both motor and non-motor symptoms of Parkinson’s can compromise safety behind the wheel. Bas walks listeners through the findings of this population-based survey, which showed that most people with Parkinson’s still hold a valid driving licence, often many years after diagnosis, with many voluntarily adapting their driving habits by reducing distances or avoiding night-time travel. However, fewer than half had discussed driving with a healthcare professional, highlighting an important and often overlooked gap in routine care. He explores the broader factors that influence safe driving, including cognitive slowing, executive dysfunction, visual–spatial challenges, and the ability to respond under pressure — issues that may not always be captured during standard clinic assessments. Bas also considers the limitations of self-reported confidence and discusses the potential role of structured or simulator-based testing. This episode provides practical, real-world guidance for clinicians, patients, and families, emphasising the importance of regular conversations, early identification of risks, and supportive strategies to help people with Parkinson’s maintain safe mobility and independence for as long as possible. 👉 You can read the full article here: https://pubmed.ncbi.nlm.nih.gov/39545559/ Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.

EP 19 - Parkinson’s disease: cognitive challenges and the practical “detours” people use to navigate them in daily life

🎙️ We’re back with the nineteenth episode of Parkinson Weekly, hosted by Prof. Bas Bloem. In this episode, Bas shines a light on an often overlooked aspect of Parkinson’s disease: cognitive challenges and the practical “detours” people use to navigate them in daily life. He pays tribute to the late Marina Noordegraaf — artist, advocate, and person with Parkinson’s — whose pioneering work helped make these invisible thinking obstacles visible. Building on her earlier work around motor “detours” for freezing of gait, Bas explores Marina’s beautifully illustrated book Detours through the Parkinsonian Brain, which focuses on strategies to compensate for cognitive difficulties such as slowed thinking, attention problems, planning challenges, memory lapses, and executive dysfunction. Drawing on interviews with more than 450 people with Parkinson’s and over 130 care partners, the project captures real-world solutions developed by patients themselves. Bas discusses the concept of functional cognition — how cognitive skills translate into everyday performance — and why challenges often emerge not in clinic-based tests but in complex, stressful, real-life situations. He highlights the practical tools outlined in the book, including environmental adjustments, behavioural strategies, and simple communication techniques to help patients and families manage thinking obstacles more effectively. This episode offers a thoughtful and highly practical perspective for clinicians, patients, and caregivers alike, emphasising that while cognitive symptoms may not always be visible, they are common, impactful, and often manageable with the right strategies. Have a question you’d like Bas to answer in a future episode? Email us at parkinsonweekly@gmail.com – we’d love to hear from you.