Alastair Noyce

Consultant Neurologist @NHSbartshealth. Professor of Neurology and Neuroepidemiology @qmul @preventiveneur1. Leading @predictpdstudy. Research & own views.

[Dr Kamalesh Dey @Kamalesh_Dey]

📢 We’re hiring a Project Coordinator for @EastLondonPD!

Join our @preventiveneur1 #Parkinsons team, led by @predictPD, and help advance inclusive research with @sumitdey94 @QMUL_WIPH @QMUL.

🔗 Find out more and apply: https://t.co/gfGxvHMUJ4

#Parkinsons #ResearchJobs #QMUL

[Alastair Noyce @predictPD]

@Kamalesh_Dey @EastLondonPD @Alex_Zirra @preventiveneur1 @MichaelJFoxOrg @ParkinsonsUK Great job @Kamalesh_Dey 🤩

[The Science of Parkinson's @ScienceofPD]

Best moment of the day yesterday at the @WorldPDCongress was interviewing early career researchers Senegal Mabry @Cornell & Sophie Meyer @predictpdstudy about their research on #Parkinsons - it was great fun!

[MDS @movedisorder]

Apply now: MDS Task Force on Parkinson’s Disease Exposome Integration
Contribute to an important initiative focused on environmental, lifestyle, genetic, and clinical factors in PD. https://t.co/P7PecNSaGT

[JAMA Neurology @JAMANeuro]

#PureAutonomicFailure carries an annual phenoconversion rate of 5% to central a-synucleinopathies including #ParkinsonDisease, #MSA, and #DLB; subtle motor signs and REM sleep behavior disorder consistently predict conversion risk. https://t.co/oPkFcCqCJU

[Michael Okun @MichaelOkun]

From autonomic failure to Parkinson’s and beyond: tracking the early warning signs of synuclein related disease. Phenoconversion means the transition from one clinical condition to another over time, in this case from pure autonomic failure to disorders like Parkinson’s disease, dementia with Lewy bodies or multiple system atrophy. Virameteekul and colleagues describe in a new paper in JAMA Neurology how frequently and under what conditions folks w/ pure autonomic failure develop central α-synucleinopathies.
Key points:
- Approximately 30% of individuals w/ pure autonomic failure developed a central α-synucleinopathy over follow-up, w/ an annual conversion rate of about 5%.
- Multiple system atrophy tended to emerge earlier, while Parkinson’s disease and dementia with Lewy bodies showed a more gradual and sustained risk over time.
- Clinical features such as REM sleep behavior disorder, subtle motor signs and hyposmia (smell loss) were among the most consistent predictors of conversion.
My take: This study reinforces something many of us have suspected for years: the autonomic nervous system may be one of the earliest windows into neurodegeneration. The ability to identify who is at highest risk and when conversion may occur could reshape how we think about early diagnosis and intervention.
Here are 5 points that resonated w/ me:
1- Autonomic symptoms may represent an early stage of Parkinson’s biology rather than a separate condition.
2- A 5% annual conversion rate is meaningful and highlights the need for close longitudinal follow-up.
3- Timing matters as different diseases emerge on different trajectories.
4- Simple clinical features like smell loss and dream enactment may help stratify risk today.
5- The future will likely combine clinical signs w/ biomarkers to identify the right folks for early intervention and disease modifying trials.
https://t.co/TcDtHeU1wG @JAMANetwork @jamaneuro @ParkinsonDotOrg #parkinson

[JAMA Neurology @JAMANeuro]

💬 Editorial: #PureAutonomicFailure is firmly established as prodromal for central a-synucleinopathies, with mild motor signs, REM sleep behavior disorder, and bladder symptoms reliably predicting conversion to #ParkinsonDisease, #MSA, or #DLB. https://t.co/m0616W4TNC

[The Science of Parkinson's @ScienceofPD]

Findings of a systematic review & meta-analysis (9 longitudinal cohorts; n=900; 6.4 yrs follow-up) finds that pure autonomic failure "may be a prodromal presentation of #Parkinsons, DLB, or MSA with phenoconversion incidence rates similar to those of RBD"
https://t.co/ed6sF0mGCs

[Alastair Noyce @predictPD]

📢New clinical research fellow post focused on developing, implementing, and evaluating a psychosocial support programme for people affected by nitrous oxide related harms funded by @Barts_Charity at @preventiveneur1

https://t.co/js38bKUFkm

[Alastair Noyce @predictPD]

@ParkinsonsUK @MichaelJFoxOrg It’s a privilege to be working on this partnership with so many great UK investigators @predictpdstudy @EastLondonPD @preventiveneur1
Thanks so much to @MichaelJFoxOrg and @ParkinsonsUK for the support 🤩

[Parkinson's UK @ParkinsonsUK]

We're teaming up with @MichaelJFoxOrg for a major £1.7 million partnership!

Introducing the Parkinson’s Clinical Cohorts Collaborative (PC3) – creating a powerful dataset from over 20,000 people to better understand Parkinson’s.

Read the full story: https://t.co/l57RUTDovh

[Alastair Noyce @predictPD]

@MichaelOkun Thanks for highlighting this paper Michael!

[Alastair Noyce @predictPD]

📢Advertising new coordinator position for the @predictpdstudy funded by @ParkinsonsUK

Please check out details below https://t.co/AJQBXvQAoP

[Julie Jones @julie_physio]

Huge thank you Alastair @predictPD for you time to record this podcast to hear was has been learnt over the last 15 years and how this study is informing the direction of future research.

[Dr Kamalesh Dey @Kamalesh_Dey]

Very exciting to present our @LDCSPD findings at annual Global Parkinson’s Genetics Program (GP2) meeting! Special thanks @predictPD, @EastLondonPD, and our collaborator Dhaka team Prof Ahsan Habib @tahiramou Dr Sirajul Haque and team 😊

[Alastair Noyce @predictPD]

Very grateful to @CureParkinsonsT for highlighting this recent work led by @Alex_Zirra and @Kamalesh_Dey

Improving diversity in Parkinson’s research – The East London Parkinson’s Disease Project https://t.co/CmiaCbjfxP

[Alastair Noyce @predictPD]

@RichelleFlan Thanks Richelle! We have BMI, BP & blood sugar (if that’s BS) in the form of Hb1Ac. The later is a focus of some follow-up work. We don’t have a dietary FFQ currently and would welcome suggestions for one that would be valid in this diverse population. TBD on our next call 😀

[Charles Marshall @charl_marshall]

🚨Fantastic job opportunity for neurology trainees @ABNTrainees

Neurology Clinical Lecturer post in Dementia with us @preventiveneur1 @QMUL_WIPH @NHSBartsHealth now open to applications!

Please DM me for info and to discuss

https://t.co/4CMZqQvTP7

[Richelle Flanagan 💚💚💚💚 @RichelleFlan]

This is a PHENOMENAL course about living with Parkinson's for people & their families but also for neurologists, nurses, health professionals, healthcare students & researchers. A major part is learning from the lived experience of people with PD. It also facilitates research. 🤓

[Prof Jane Alty @janealty1]

Pls RT 😊Come and join the new #Parkinsons #MOOC community ! ~6000 enrolments in the first 6 days of opening - and great feedback! ⭐️⭐️⭐️⭐️⭐️This visual based online course is packed with videos and animations 🎬 - gives incredible education and insight into lived experience ✅