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An Interview with Sacha Ghandi
By David Michelson

Research takes many forms – the white-coated scientist in a lab surrounded by test tubes is perhaps out of date?  Unsurprisingly, computers play an increasingly vital part in modern research! I talked to Dr Sacha Gandhi, a Clinical Research Fellow at the [SG1] University of Glasgow.  She is currently doing an MD on Parkinson's disease.  This research project is led by Prof Donald Grosset, who, whilst retired from clinical practice, is a long-term friend and supporter of the West of Scotland Research Interest Group!


It is a mammoth task of analysis: using data collected over the last 12 years from clinical studies, looking for patterns and correlations. The Glasgow team is working in collaboration with teams in Bristol, Oxford and London.  The data is predominantly from the Glasgow-led Tracking Parkinson’s study, the largest observational cohort study to date, but also from the Oxford Discovery and the US-led PPMI study, funded by the Michael J Fox Foundation.


One of the streams is looking at motor complications in People with Parkinson’s (PwP).  Sacha’s team feels that [SG(2] the reported prevalence of motor complications has varied in the literature, and their functional impact has not been well studied.


The team’s objectives are to quantify the presence, severity, impact and associated factors for motor complications in PD.  Conclusions include: “Off” periods are more common, and cause greater functional impairment, than dyskinesia. The data analysis confirms that females, patients who are younger at diagnosis, on higher levodopa doses and who respond better to medication are more likely to develop motor complications. A higher genetic risk score is also a significant, independent[SG(3]  risk factor for the development of motor complications.


A further study is focussed on examining the response to [SG(4] dopaminergic medication in recently-diagnosed patients, and how this changes over time. The results are interesting, showing that there are 3 different patterns of the treatment response, with patients having either a striking, excellent or a more modest response. The response to treatment improves over time, and higher doses, L-dopa (rather than other treatments) and starting treatment earlier are associated with the best (i.e. striking) treatment response.

The next step will be (after the usual peer reviews) to publish this in a format useful to clinicians supporting PwP.


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