Developments in Parkinson's Disease Research

Summer 1999 CSANews Issue 32  |  Posted date : Mar 02, 2007.Back to list

Research is an integral part of progress in any health-related program. The Movement Disorder and Functional Neurosurgery Programs at the University of Toronto are dedicated to the treatment of patients with Parkinson's Disease and similar conditions. Researchers believe that they are on the verge of critical breakthroughs ­ breakthroughs which have immense potential for enhancing both our understanding of brain function and our ability to alleviate the substantial disabilities suffered by patients with Parkinson's. Parkinson's occurs when brain cells which produce dopamine, die. Dopamine is a vitally needed substance that allows a person to control his or her movements. If a dopamine deficiency occurs, the condition known as Parkinson's Disease (PD) develops. Parkinson's is treated by oral administration of L-dopa, and most patients have responded well to this medication for several years. However, severe side effects, such as uncontrolled involuntary movements can develop over time.

Dr. William D. Hutchison of the Faculty of Medicine at University of Toronto and the Division of Neurosurgery at The Toronto Western Hospital is working with a team of doctors and researchers to develop surgical therapies to help patients who are not responding well to medication. Surgery is not an option for everyone with PD, and patients with cognitive impairment are not good candidates for some surgeries.

Doctors and researchers have targeted three regions of the brain which control different motor dysfunctions for surgery. During this surgery, doctors use heat to create lesions, called thermolesions, or inactivate these regions with electrical stimulation using a deep-brain electrode. With surgery, doctors hope to correct tremors, slowness of movement and stiffness associated with Parkinson's. The ultimate goal of surgery is to improve a person's movement control as well as to improve their quality of life.

One type of surgery, a "thalamotomy," is directed at the "motor thalamus." Thalamotomies are usually performed on patients who suffer from tremors. For patients who experience primary problems from dopa-induced side effects such as uncontrolled, involuntary movements, doctors recommend a second type of surgery termed "pallidotomy."

Doctors and researchers are evaluating a new target in the brain called the subthalamic nucleus (STN). In preliminary cases, stimulating electrodes placed in the STN have proven to be remarkably beneficial to Parkinson's patients. STN stimulation helps patients with motor problems related to gait, postural stability, slow movement, tremors and stiffness. With this new target, doctors can control many problems at once and the benefits appear to be greater than with the other surgeries.

Researchers at U of T hope to continue to evaluate the best possible surgical procedures to meet the individual needs of patients with Parkinson's, in order to alleviate the suffering of this debilitating condition. At the moment, the key challenge is to find a way to slow or reverse increasing disability for these patients. Efforts also continue towards finding a cure for the root causes themselves.

To make a donation towards the Parkinson's Disease Research Program at the University of Toronto, please call Joanne Roberti at (416) 978-5715.