New clinic will aid autonomic symptoms in Parkinson’s and MSA patients

By Jeff Kelley 

A new clinic that will help treat autonomic symptoms experienced by patients with Parkinson’s Disease (PD) and Multiple System Atrophy (MSA) is expected to get moving in early 2024.

The clinic would bring in specialists from multiple disciplines to care for PD and MSA patients living with autonomic (nervous system-related) symptoms associated with their disease. That includes urinary incontinence, sudden drops or spikes in blood pressure, heat or cold intolerance, sweating profusely (or not enough), and constipation, says Cameron Miller-Patterson, M.D., a VCU associate professor of neurology.

Those symptoms can be particularly disruptive for patients already experiencing motor symptoms of PD and MSA. A patient already struggling with their gait, for example, can face repeated need to get up and go to the bathroom due to urinary dysfunction, Miller-Patterson says.

PD and MSA (similar to Parkinson’s) are characterized by a build-up of the alpha synuclein proteins in the brain and nervous system that not only cause motor symptoms associated with the diseases but also impair the body’s autonomic functions, explains Miller-Patterson, the movement disorders neurologist for the new clinic, part of the VCU Parkinson’s and Movement Disorders Center. 

“Oftentimes, treatment of these autonomic symptoms is complicated and involves other doctors outside a neurologist,” he says.

The PMDC will refer patients to the clinic where there will be a range of specialists, including a urologist, a psychologist, and a physical medicine rehabilitation specialist, Miller-Patterson says. Thomas Chelimsky, M.D., an autonomic neurologist who joined VCU in 2022, will also be at the clinic to recommend ways to treat autonomic symptoms.

“The big benefit of the multidisciplinary clinic is that you have multiple providers all in the same place,” Miller-Patterson says. “Patients aren’t waiting weeks or months in between appointments to see different providers.”

Chelimsky currently runs another autonomic clinic at VCU Health for people with specific autonomic disorders, including Postural Orthostatic Tachycardia Syndrome (POTS). The new clinic will expand that care for PD and MSA patients, Miller-Patterson says.

“We already have the foundation for this new clinic. It’s just establishing a similar care model to a different population,” he explains.

Miller-Patterson will find ways of treating patients’ motor symptoms without worsening some of their autonomic symptoms such as blood pressure drops.

The new clinic will see patients once a month at VCU Health’s Stony Point campus in South Richmond.

“We’ll have to see if one clinic a month is enough or whether we have enough patients through the PMDC and VCU at large where we might actually consider expanding the frequency of when it’s open,” he says.