April - Parkinson’s Disease Awareness Month
The Montreal Neurological Institute and Hospital - The Neuro, McGill University and the McGill University Health Centre, is at the forefront of Parkinson’s research and clinical care. Parkinson’s patients are seen at The Neuro’s Movement Disorders Clinic and the Montreal General Hospital. Approximately 100,000 Canadians have Parkinson’s disease.
New Rapid-Access Clinic at The Neuro reduces wait time
The Movement Disorders Clinic, a National Parkinson Foundation Centre of Excellence, has introduced rapid access procedures that greatly reduce patient wait times and improve patient-clinic communications. Central to these procedures are two pivot nurses specially trained to handle issues facing Parkinson’s patients. The nurses serve as the initial points of entry for new patients, and remain as the point of contact throughout the patients’ treatment at the clinic. If their symptoms change, patients are free to call one of the nurses at any time.
“Within two weeks of receiving the patient’s referral, the nurse contacts the patient to get some basic information to help prioritize their referral and to provide a link to our clinic,” explains Dr. Anne-Louise Lafontaine, Director of the Movement Disorders Clinic. “The goal is to see a new patient within three months, which is far less than the Canadian average of up to one year for movement disorder clinics. The nurse makes a comprehensive evaluation, which reveals any potential bio-psycho-social issues that might arise. Soon after, the patients see a neurologist, who will have a comprehensive report of the patient’s condition. The team is now mobilized faster.”
By establishing a point of patient contact early and maintaining a single point of contact who can direct patients, The Neuro is making patient care more personal and sustained. The rapid-access program at the Clinic, which operates at two MUHC sites, The Neuro and the Montreal General Hospital, was made possible by generous, ongoing funding by major Montreal benefactors, Michal and Renata Hornstein.
One of the clinic’s special programs addresses the needs of younger people newly diagnosed with the disease. Professionals with many different skills are required to help manage this complex disease. The clinic has a multidisciplinary team of neurologists, nurse specialists, occupational therapists, speech therapists and social workers. Patients also participate in clinical studies.
Parkinson’s Researchers at The Neuro:
Dr. Edward Fon is a neurologist specializing in movement disorders. He is Director of the McGill Parkinson Program and Associate Director of Clinical and Translational Research at The Neuro. His research focuses on the molecular events leading to the neuronal degeneration in Parkinson's disease. He is particularly interested in the function and cell biology of Parkinson disease genes. Dr. Fon’s work could potentially lead to new therapeutic strategies. He is Chair of the Scientific Advisory Board, Parkinson Society Canada; a member of the board of the Société Parkinson du Québec; and a member of the Program Committee for the World Parkinson’s Congress.
Dr. Anne-Louise Lafontaine, neurologist. As Director of the Movement Disorders Clinic, Dr. Lafontaine is responsible for the interdisciplinary clinic. She was instrumental in developing a rapid access clinic for newly diagnosed Parkinson's disease patients. She is also involved in clinical research trials for Parkinson’s disease.
Dr. Lesley Fellows, neurologist. Dr. Fellows studies complex human behaviour using techniques developed by cognitive neuroscience. She is examining how Parkinson’s disease affects impulsive behaviour, learning, and attention span. Dr. Fellows is seeking to determine whether behavioural changes are due to the disease or to the medications used to treat the disease.
Dr. Alain Dagher, neurologist. Dr. Dagher uses functional brain imaging techniques to understand how Parkinson’s disease affects thinking and emotion. His research could improve the treatment of cognitive and mood problems that severely affect patients’ quality of life.
Dr. Louis Collins, brain-imaging specialist. Dr. Collins employs computerized image-processing methods using magnetic resonance imaging to identify brain structures non-invasively. His techniques are essential in image-guided neurosurgical treatments of Parkinson's disease. Dr. Collins and his team have developed computerized tools and atlases that neurosurgeons use to plan and perform minimally invasive neurosurgical procedures. These techniques enable better visualization of the surgical target and permit more accurate placement of deep brain electrodes that are used to stimulate certain areas of the brain for customized treatment of the symptoms in Parkinson's disease.
Dr. Ron Postuma, neurologist. Dr. Postuma studies non-motor manifestations of Parkinson's disease particularly sleep disorders. He is testing how to predict Parkinson's disease, particularly by studying patients with REM sleep behaviour disorder, which is a major risk factor for the disease. He is also looking for ways to improve detection and treatment of non-motor problems, including clinical trials for treatments of sleepiness and insomnia. He conducts ongoing studies for dance therapy in Parkinson's disease cases, and is initiating a large-scale study of caffeine for treatment of the disease.
Dr. Abbas Sadikot, neurosurgeon. Dr. Sadikot is a specialist in the surgical implantation of Deep Brain Stimulators (DBS) in patients with Parkinson’s disease. The surgery involves inserting a tiny device into a patient’s brain which emits electrical pulses to the surrounding part of the brain, relieving the tremors and rigidity caused by Parkinson’s disease.
What is Parkinson’s Disease?
Parkinson’s disease is a neurological condition related to the death of specific brain cells that produce dopamine, a chemical needed for brain cells to control muscular movement. In Parkinson’s disease, dopamine-producing cells stop functioning for reasons still unknown. There is currently no cure, but some drugs and clinical treatments can help control or minimize symptoms which include: uncontrollable tremors, slowness of movement, stiffness or rigidity, and loss of balance. Parkinson’s disease affects many non-dopaminergic areas of the brain as well. These areas are responsible for symptoms during early stages of the disease such as problems with sleep, constipation, blood pressure, sweating, depression, anxiety, as well as symptoms that cause disability in later stages. Symptoms can appear in people in their thirties and forties, but more commonly appear around the age of 60.
The Montreal Neurological Institute and Hospital — The Neuro, is a unique academic medical centre dedicated to neuroscience. Founded in 1934 by the renowned Dr. Wilder Penfield, The Neuro is recognized internationally for integrating research, compassionate patient care and advanced training, all key to advances in science and medicine. The Neuro is a research and teaching institute of McGill University and forms the basis for the Neuroscience Mission of the McGill University Health Centre. Neuro researchers are world leaders in cellular and molecular neuroscience, brain imaging, cognitive neuroscience and the study and treatment of epilepsy, multiple sclerosis and neuromuscular disorders. For more information, visit theneuro.com.