Upon completing his medical school training in Colombia, where his research focused on multiple sclerosis, Dr. Patino came to UTHealth Houston to do research in movement disorders as part of Dr. Erin Furr Stimming’s team in 2020. He worked primarily on two studies: irritability in patients with HD, which included trying a medicine called Nuedexta (dextromethorphan-quinidine) and the potential of melatonin to help patients with HD sleep better. He was also involved in clinical reviews on obsessive-compulsive behaviors in HD, loss of the sense of smell as a marker of cognitive decline. Currently, he is researching disruption of the autonomic nervous system in HD (such as heart and gut issues).
He saw 200 patients with HD over the course of this research.
When he applied to residency, he recalls using the analogy of the half-empty glass because of the pessimistic views about neurological disease that abound.
“I think that people share the same pessimism about Huntington’s disease, but we should move forward to the half-full glass analogy instead, and try to improve things for this community,” he said.
To Each Their Own Benefit from ENGAGE-HD
For Dr. Patino, the pull to work in movement disorders and with HD patients was already strong, but through the program, he saw the spark ignite in other participants as well.
“I was already pretty much there myself, but I saw the wheels in the minds of other participants turning, thinking this would be a good specialty for them,” he said.
“At the same time, it’s not for everyone. While it would be amazing if all 30 attendees decided to go into HD research and clinical care, I don’t think that is the program’s expectation,” he said. “It’s valuable to see these people with different backgrounds learning about HD, because at some point they will face someone who has a family member with HD who asks about it — now they will have enough information to advise them what to do, where to go, how to find resources.”
Dr. Patino also points to the impact of the discussions about ethical considerations in genetic testing, especially with minors.
“These really get everyone thinking about how the test results will impact their lives in a way that could be problematic. The point is that we need to be very careful on how we move with that process,” he said. “Someone who has never seen an HD patient before, might just say, ‘Oh, let’s do a lab and get you tested.’ With this training, they now know to be very thoughtful about what they suggest.”
He says the program ended with the perfect capstone: the opportunity to meet patients with HD and speak with them about their diagnosis, their symptoms, their stories.
“If a resident doesn’t know about HD, they obviously don’t know to be interested! With the way our medical training programs are set up right now, a lot of them are never going to know much about it,” he said. “That’s why it’s so important for programs like this to exist — to give exposure to physicians who, otherwise, might never have had that exposure until they are face-to-face with a symptomatic patient.”
Jorge Patino, M.D., is a fourth-year neurology resident at UTHealth Houston, who participated in the newly launched 2023 ENGAGE-HD program in Arizona.