Alfonso Fasano
@DrAlfonsoFasano
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Co-director of the Surgical Program of Mov Disord Centre, Toronto Western Hospital | Krembil Brain Institute | Professor of Neurology, University of Toronto
Toronto, Ontario
Joined April 2019
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Last Seen Profiles
Pinned Tweet
You landing on my page: sorry if I'm not as active as I used to be, trying hard to make 'x' grow on me.
Not easy and we all know why
No, I don't think it makes sense to move elsewhere, it is what it is everywhere
And yes, this is still
#twitter
to me.
2
0
18
Certain movement disorders can be
treated,
worsened or
induced
by certain anti-
#seizure
#drugs
...
even frequently prescribed ones such as
#gabapentin
.
A panel of
#mds
and
#epilepsy
experts summarized what we know so far here:
6
108
278
Yes, functional MRI can be used to rapidly predict the optimal
#DBS
settings in
#Parkinsons
.
Our paper is out and a lot more is to come!
6
56
249
Lang, Fasano, Lozano, Consky et al. on their way to the
@movedisorder
meeting in Madrid!
#mds2022
#ipmds
@KBI_UHN
@UHN
@UofTNeurology
@UofTNeuroSurge
10
6
238
Looking at someone’s brain while a messy life surrounds me.
(I rarely post pictures at work but this nicely summarizes it)
#MedTwitter
#doctorlife
#neurology
#neurologylife
#brain
15
7
207
Let’s talk about DBS –
#deepbrainstimulation
Tune in at 6:30 pm EST on November 3 & December 8 to learn about DBS from experts and share in people’s stories and experiences.
More details here:
6
35
197
The results of our sham-controlled unilateral
#pallidotomy
trial with
#MRgFUS
(MRI-guided focused ultrasound) for
#Parkinson
are finally out!
Looking forward to the next steps, bilateral lesions included.
@KBI_UHN
@uhnfoundation
@UofTNeuroSurge
6
33
200
ok let me say it once and for all:
MUSCLE MEMORY IS NOT A THING
MUSCLES HAVE NO MEMORY
YOU'RE TALKING ABOUT THE BASAL GANGLIA
#MedTwitter
9
32
193
Today the first Canadian
#parkinson
patient initiated subcutaneous 24h-infusion of foslevodopa outside a clinical trial.
Excited for the beginning of this new journey in the expanding landscape of advanced/device-aided treatments of Parkinson’s disease.
10
25
175
Messages of our meta-analysis of gait studies in normal pressure hydrocephalus
#nph
:
1. The effect of tap test is stronger 24-48 later
2. VPS improvement is greater than tap test's
3. Gait never normalizes, WE DON'T CURE NPH
2
51
161
Unexpected perks of
#mdscongress
: you get to see people’s real environment and what matters to them!
12
2
131
Da calvo e da Toronto un saluto a
@welikeduel
. E da medico un saluto a tutti i medici italiani!
#propagandalive
4
10
126
Just published in
@MDJ_Journal
the very much needed updated
#levodopa
dose equivalency in
#Parkinsons
In great company of
@angelo_antonini
,
@AlbertoEspay
,
@ctrenkwalder1
,
@KRayChaudhuri1
,
@petryschmelzer
and many more!
2
38
125
I know… really a terrible setup to work on a manuscript…
#AcademicTwitter
#castle
#France
#Countryside
6
1
114
The beauty of
#science
... rejecting your own hypothesis 10 yrs later... but also understanding why!
Check our new paper out, just published in
@MDJ_Journal
: how and why asymmetric
#DBS
really affects
#gait
in
#Parkinson
disease.
3
14
104
Our book on
#dbs
is finally out. Honoured to be in company of some of the giants of this exciting field and happy to see the ‘interdisciplinary’ approach right from the title.
@C_R_A_N_I_A
4
12
100
Wondering if getting the
#vaccine
without posting it on social media is equally effective... I’m pretty sure it wasn’t part of RCTs design
6
2
98
"Functional Neurological Disorders (
#FND
) and
#COVID19vaccine
: A Call for Action" is the title of our editorial in
@JournalCJNS
(doi:10.1017/cjn.2022.61).
We hope this will generate awareness and discussion.
Thank you
@RobertC21093233
for the opportunity.
@CNSFNeuroLinks
55
29
97
Gaps, controversies, and a proposed research roadmap for
#NPH
(Normal Pressure Hydrocephalus): it took a year and some animated discussions but it's finally out!
@movedisorder
@KrembilRI
@KrembilF
@C_R_A_N_I_A
3
26
96
#functional
neurological disorders after neurosurgical procedures for non-functional indications have become one of our areas of research, teaching us about
#FND
but also how we deal with the
#trauma
of interventions and healing.
@DrNirLipsman
4
14
93
Sooooooo good to be at the
@movedisorder
conference IN PERSON this year.
This is what
#zoom
will never replace:
#mds2022
#ipmds2022
0
1
94
in the great company of
@MatteoBologn
,
@AlbertoEspay
,
@MarkHallett007
et al to (re)define
#bradykinesia
.
The more you study something the less you understand it.
@MDJ_Journal
@KBI_UHN
@UHNSHSNeurology
3
21
93
One of us on stage had
#DBS
for
#Parkinson
and was celebrating the return to live
#music
.
Great things happen when patients and doctors team up!
@C_R_A_N_I_A
@KrembilF
@KBI_UHN
@UHN
@PdAvengers
@UofTNeurology
@ParkinsonCanada
@uhnfoundation
3
7
90
Hey
#MedTwitter
what's going on?
All these doctors mocking people with
#FND
(functional neurological disorder) are even worse than the gentleman below.
FND is disabling and real. Would you make fun of someone with stroke?
Shame on you and and go back to school... or change job.
11
13
91
5 years ago I thought that the genetic makeup of
#Parkinson
individuals can predict their
#DBS
outcome, coining the term 'surgicogenomics'.
The McLaughlin Foundation liked the idea!
Results are now public: genes involved in
#neuroinflammation
might predict the effect on
#gait
.
4
18
88
Today I was a passenger on a sailboat entirely manoeuvred by a crew of
#Parkinson
’s patients (who never did so).
More than a passenger, I was a witness of what
#teamwork
is all about.
#sail4parkinson
#CRM
@Neuronologist1
@topdresearch
@IntegratedMove
@MenTourPilot
2
4
89
It's finally here!
Can't wait to start digging into this collection of collaborative works on
#neuroscience
and
#philosophy
edited by Walter Sinnott-Armstrong and
@felipedebrigard
.
4
4
84
Ok… so, when do we admit that a large proportion of these
#postcovid
cases have a
#functional
cause?
#FND
#Covid
7
5
82
Over the past years we’ve been trying to use fMRI to streamline
#dbs
programming.
This is crucial for
#dystonia
, where the effects are not immediate.
Thank you
@dmrf
for your support.
@ANA_journals
@C_R_A_N_I_A
@KBI_UHN
3
24
84
Deep Brain Stimulation (
#DBS
) has enormously expanded our knowledge of the brain.
Here we used its sensing capability to understand the effect of Vagus Nerve Stimulation (
#VNS
) in
#epilepsy
patients.
Well done
@GMI_Canada
and colleagues at
@sickkids
,
@C_R_A_N_I_A
and
@KBI_UHN
.
3
9
81
My grandma used to pray to her favorite saint for me and another one for my brother so that the first one didn't have too much to do.
I'd suggest a similar approach for
#COVID19
: please don't overload Saint Rita!
Btw, anything and everything has been published on covid.
9
7
81
2
5
79
The understanding of how
#functional
disorders (
#fnd
) influence the outcome of
#dbs
(deep brain stimulation) is at its dawn.
The prevalence is clearly underestimated but this is our first multi-center attempt.
@LucaMarsili1
@MichaelOkun
@FiorellaCont
@AlbertoEspay
@AristideMerola
2
22
78
Finally a validated scale for the assessment of
#nonmotor
#fluctuations
in
#Parkinson
. Thank you
@GalitKleiner
and
@AlbertoEspay
for leading the effort.
1
22
77
That feeling on Friday at 5pm after 2 weeks on call, right before a long
#weekend
… couldn’t have survived without this amazing team!
Thank you
@mmotamed6
@LHophing
@MAlHussona
@pjaulag
@UofT_DoM
@UHN
@UofTNeurology
@UHNSHSNeurology
4
0
73
Reprogramming the Brain: A Guide to the Future of the Brain and Neuromodulation by a Patient and his Doctor, by
@Neuronologist1
and myself.
Pre-order here:
#reprogrammingthebrain
#parkinson
#neuromodulation
#dbs
@KBI_UHN
@CRANIA_Toronto
@DBSThinkTank
3
16
77
Levodopa or Dopamine Agonist after
#DBS
in Parkinson's Disease? We finally have some evidence.
Thanks to
@realmikefox
and
@MichaelJFoxOrg
for funding our study.
#openaccess
@MDJ_Journal
3
20
76
"We are finding it very difficult to secure reviewers with the relevant expertise to comment upon this application... I realise that providing a review does take time, however, you will appreciate how important peer review is for us ..."
How about PAYING reviewers?
#MedTwitter
5
4
77
I had the privilege to partecipate in this important study just published in the
@GreenJournal
:
#NPH
patients treated with shunt partially restore their dopaminergic denervation while untreated patients sustain a further decline.
5
12
76
Non-invasive live streaming and storing of brain signals is now reality. Time will clarify the scientific and ethical implications of technology embedded in our bodies. Thank you
@LaurenPelley
for highlighting another 'Canada first' at
@UHN
and
@KrembilRI
.
3
8
76
Publications are like your children, you like them all... but some are special.
This is one of them.
In a collaborative effort and with the help of hundreds of colleagues, we finally elaborated programming guidelines of
#deepbrainstimulation
for
#epilepsy
.
2
14
71
This was one of those nights... with Stanley Fahn and Jose Obeso: the founder and current editor in chief of
@movedisorder
journal.
#mds2019
0
4
71
Ladies and gentleman:
implanted chronic recording of absence
#seizure
with a peak at 3 and 8 Hz (leads in the ANT of the thalamus).
#dbs
for
#epilepsy
has just entered a new era (thank you
@kalialabs
)
@GMI_Canada
@C_R_A_N_I_A
@UHNSHSNeurology
4
10
72
I had the honour to contribute to this
@Brain1878
review on
#bradykinesia
: the most striking point in my view is that we're not only far from understanding it... we also lack a shared definition of the problem (e.g. in diagnostic criteria).
5
17
71
A click on the screen and the satisfied face of the neurologist assessing
#tremor
…
Simple action for the everyday miracle that is focused ultrasound.
Thank you
@BhavyaRShahMD
of
@UTSWNews
for hosting me.
5
7
70
"It's a network disorder" is the new "tip of the iceberg" during neuroscientific presentations.
At this point I wonder what's NOT a network disorder.
#NANS2023
8
3
70
All the Iranian women I had the privilege to meet in my life are the paradigm of strength and courage.
It is so obvious that the REAL
#revolution
in
#iran
has to happen through them.
The Iranian girl who sings the song "Bella Ciao" in Persian language to sympathize with the murder of
#Mahsa_Amini
. He wants freedom
#Iran
#IranProtests2022
#OpIran
360
4K
14K
3
6
65
A new look at
#deepbrainstimulation
as a strategy for dopaminergic desensitization in
#Parkinson
disease.
Our Neurology Grand Rounds is finally out!
@WileyNeuro
@C_R_A_N_I_A
@KBI_UHN
@UHNSHSNeurology
@AA_Kuhn
@foxmdphd
0
26
70
Once again,
#functional
disorders after
#dbs
are an overlooked - probably common - entity. We just described a series of post-surgical functional
#dyskinesias
in
#Parkinson
disease, one of the rarest type of functional movement disorders.
4
10
70
"Mind over motor" is the new "mind over matter" in
#dystonia
.
Our editorial can be found here:
PS thanks to the colleague who inspired the title
3
10
67
Slowly starting to see patients in person and I’m finally realizing how much I missed them and our interactions.
#MedTwitter
1
1
67
Had a blast co-presenting and being chaired at
#ASSFN2022
by Suneil Kalia
@kalialabs
, a gentleman, a scholar, a scientist, a
#dbs
neurosurgeon, etc… but, above all, a real
#team
-player!
@ASSFNeurosurg
@UofTNeuroSurge
@C_R_A_N_I_A
1
4
66
2
3
65
The role of PD
#nurse
in
#Parkinson
’s care is as invaluable as not properly recognized.
This is our international
#levodopa
intestinal gel course: Yu-Yan Poon and Nick Feugas are running the show! Everyday I learn so much from them.
3
7
66
Can
#DBS
be
#neuroprotective
? We don't believe so and 'for now' it'd be dangerous to claim 'evidence' that that's the case. This is what
@Suvorit_B
and I think about this interesting 5-year RCT published in
@GreenJournal
3
17
66
Up to 160 people with
#Parkinson
attended our webinar on 'life after
#dbs
'. Clearly there's a hunger of information and I'm grateful to Fresco Parkinson Institute for the opportunity.
1
3
64
Novel classification of taupathies.
Thank you
@GGKovacsBrain
for ‘simplifying’ it for us!
#MDSCongress
2
18
64
In magical Jerusalem with leaders in the field to tackle
#freezing
of
#gait
. A lot to do but dreams can come true.
@basbloem
,
@profsimonlewis
,
@anat_mirelman
,
@GiladiNir
,
@AliceNieuwboer
,
@MoranGilat
,
@NonnekesJorik
,
@carolinemorea16
7
6
62
Can
#VitaminD
reduce the risk of
#COVID19
? Our data from Italian
#Parkinson
patients seem to confirm it. More studies needed, not just for COVID.
2
17
62
We all need to be vocal about the occurrence of
#functional
disorders triggered by
#CovidVaccine
.
These disorders ARE NOT CAUSED by the vaccine.
History repeats itself (remember the famous cheerleader getting 'dystonia' after the flu shot?).
2
19
62
I hope this guy (
@AlbertoEspay
) will never deconstruct me...
(few days ago in Naples for our course on
#mds
)
5
1
61
"To Fabio, he was Alfonso, the keyboard player. At UHN, the same man was Dr. Fasano, Krembil Brain Institute movement disorders specialist and neurologist"
#dbs
can be life-changing, more when it's your friend's life
#UHNITED
@uhnfoundation
@KevinSmithUHN
3
6
62
Lively and inspiring debate on the pros and cons of
#placebo
use in
#functional
disorders by
@MattBurkeMD
and
@SarahLidstone
: it’s refreshing to finally see academic discussions on this important topic.
@FndPortal
@FNDHopeUK
@FNDSociety
@FNDHope
1
17
62
.
@MichaelOkun
in action at
#wpc2023
, probably tweeting about the session :)
@JankovicJoseph
@WorldPDCongress
7
3
61
The first publication of the
#IPMDS
Normal Pressure
#Hydrocephalus
(
#NPH
) study group is out.
Our first task (Project 0) was a critical review of published signs of this condition.
Thanks to
@MDCP_Journal
and all study group members!
@hydrocephalusso
0
11
60
What's really idiopathic normal pressure
#hydrocephalus
(
#NPH
)?
On May 24, 3-6pm, join me,
@gelarehzadeh
,
@MC_Tartaglia
,
@AlbertoEspay
,
@GGKovacsBrain
, David Tang-Wai, Sylwia Libard and Irina Alafuzoff (from
@UU_University
) and let's find out!
1
17
60
Kapil Sethi was a leader in movement disorders... Many are, but very few are kind and humble as he was, a self-taught expert.
Used to call me 'blue(s)-man' because of my early interest in ceruloplasmin (the latin meaning).
I'll never forget that glass of wine on stage.
3
4
61
Further proof that
#gait
is lateralized to the right deep brain, important for programming
Specular sweet/sour maps: no results if flipping one hemisphere onto the other! to be kept in mind when you read about studies doing so to increase the sample size
5
15
61
Women will save the world
2
2
60
3/10 of major neuroscience discoveries of 2022 have to do with
#neuromodulation
. How many next year?
@C_R_A_N_I_A
@KBI_UHN
@IntlNeuromod
@CanNeuromod
2
17
61
#DBS
is one of the most effective therapies for
#tremor
, yet some patients lose the benefit gained initially. With my friend Rick Helmich (from
@DondersInst
) I tried to tackle this puzzling situation in this review recently published in
#MovementDisorders
.
0
15
58
Any time I write on
#functional
disorders I struggle with the term '
#organic
'. I finally decided to delete it from my vocabulary. I'll use 'non-functional' instead, which paradoxically leads to the impression that we know
#FND
better!
@FNDSociety
@FndPortal
@FNDHope
5
8
59
After half a century, welcome back bilateral brain ablations!
#MRgFUS
and novel
#neuroimaging
techniques are making it safer.
More about our
#Trial
here: .
@C_R_A_N_I_A
@UHNSHSNeurology
@KBI_UHN
@KrembilF
2
19
57
Happy
#PersianNewYear
#Nowruz
#Norooz
#HappyNowruz
to all my Iranian friends.
Day by day more amazed by your culture and traditions, you're really standing on the shoulders of giants!
4
6
54
This is the real priority of
#DBS
(deep brain stimulation):
guaranteeing access to everybody, particularly to
#women
and
#minorities
, who are still largely underserved.
@WNGtweets
@womenspdproject
@UHNwomen
@CANSARICA2
@KBI_UHN
@UofTNews
@kalialabs
1
13
56
Honoured to have contributed to this publication
Bradykinesia is one of the cardinal motor symptoms of Parkinson’s disease, but its mechanisms are not fully understood. Bologna et al. review recent findings on bradykinesia pathophysiology, including the role of network dysfunction.
0
39
82
0
6
55
It’s a wrap.
@franci_morgante
,
@AlbertoEspay
, Davide Martino and I are already working on next edition.
Thanks to
@movedisorder
and
@Limpe_Parkinson
#mdscourse2023
0
3
56
Glad that while discussing the future of
#DBS
at
#WSSFN2022
, Prof Lozano mentioned the issue of costs.
I think the time has come that companies start thinking about that too, not just fancier/more expensive devices.
@ASSFNeurosurg
4
8
57
#MRgFUS
#thalamotomy
is typically performed unilaterally for the
#tremor
of the dominant side. Patients often ask if their head/voice and non-dominant hand will also improve.
We looked into this and found that it happens in a subset with a slightly different targeting.
@JNNP_BMJ
3
13
57
Non-invasive recording of Local Field Potentials (
#LFP
) can be used to program deep brain stimulation (
#DBS
) in conditions without immediate effect of parameter changes (e.g.
#dystonia
,
#epilepsy
).
@C_R_A_N_I_A
@KBI_UHN
@UHNSHSNeurology
1
14
56
Thank you
@AlbertoEspay
for leading a very successful
#PAScongress
2024.
You’re forgiven for your issues taking selfies!
@movedisorder
3
1
56
I saw my first
#dbs
patient 23 years ago...
Back then, I couldn't imagine such explosion of technology and opportunities for our patients.
Remote programming for
#telemedicine
is certainly one of them.
Read more in our recent viewpoint:
0
8
56
While waiting for a cure, we shouldn't forget about symptomatic treatments for Multiple System Atrophy (
#MSA
)
Is
#DBS
one of them?
@dilucadaniel
,
@kalialabs
,
@lukamneuro
and many other joined forces thanks to
@MSACoalition
to explore the effect of GPi/GPe stimulation
@MDJ_Journal
1
11
56
This Friday I'll be in India to give a talk at 7.30 pm, the day after I'll be in Indonesia for another talk at 8 am...
#zoom
is certainly faster/cheaper/eco-friendly than any airline...
#COVID19
keeps on teaching.
@C_R_A_N_I_A
@KrembilRI
@UHNSHSNeurology
@UHN
5
12
56
One of the overlooked benefits of pump therapies for
#Parkinsons
is the reduction of
#pill
intakes, a constant reminder of the disease.
The results of the 5-yr follow-up of the COSMOS study, which I had the honour the lead, are finally out.
4
9
54
.
@MichaelOkun
we’re missing you! … not really :)
@AlbertoEspay
@JankovicJoseph
@PDCMDC
@kailashbhatia
3
3
54
11 years ago I met an Italian family with congenital mirror movements... all the known genes were negative. Just published: ARHGEF7 is yet another
#gene
causing this interesting motor phenomenon.
1
6
54
1
2
55
