Donald Calne Lecture

Internationally renowned neuroscientist highlights new developments in Parkinson’s

Dr. Stoessl and Dr. Langston
Dr. Stoessl and Dr. Langston

Dr. J. William Langston, founder, CEO and Scientific Director of the Parkinson’s Institute in Sunnyvale, California addressed a packed banquet hall in Calgary, Friday, January 9th at the 2008 Donald Calne Lecture, hosted by Parkinson Society Canada and Parkinson’s Society of Southern Alberta (PSSA), and sponsored by Solvay Pharma. Dr. Langston brought up to date an audience of over 120, including attendees of the Parkinson Research Alliance meeting, on developments in Parkinson’s.

Earlier in the day, Dr. Langston presented Grand Rounds at Foothills Hospital where he talked about the latest stem cell progress in Japan. Scientists are using skin samples to generate stem cells which could one day lead to the reversal of Parkinson’s.

Special thanks to John Petryshen and his wonderful staff and volunteers at PSSA for all their help in making the event run smoothly.

Lecture highlights

Developments in Parkinson’s

• PD is very likely a protein folding disease like ALS, Alzheimer’s and Huntington’s

Researchers now know that, in Parkinson’s, the protein, a-synuclein, becomes toxic and destroys the cells when it does not fold properly. “This represents a huge shift in the thinking about PD and makes the area of protein folding an important therapeutic target,” said Langston.

• PD may begin in the olfactory bulb

Dr. Langston noted that loss of smell may occur long before the onset of other symptoms, making the olfactory bulb, which governs the sense of smell, a prime target for investigation. “No matter how many people get Parkinson’s, it usually begins with the loss of the sense of smell but only 60 percent of people realize there is a problem.”

• Environmental factors play an important role in PD

Dr. Langston cited many studies showing a link between the use of pesticides and herbicides and Parkinson’s.

Over 50 published studies show an inverse relationship between PD and smoking, according to Dr. Langston. “If you smoked from the time you were a teenager, your risk of getting Parkinson’s is much less.” However, cigarette smoke has 4,000 chemical compounds, so finding the right one poses its own challenges, he cautioned.

Coffee drinking also seems to reduce the risk of Parkinson’s.

• Genetics loads the gun, but the environment pulls the trigger

Dr. Langston discussed the long-standing debate about genetics versus environment and reviewed the studies of twins, both identical and fraternal which showed that the environment plays a role. “While genetics loads the gun, the environment pulls the trigger,” he said.

New research-gathering techniques

Dr. Langston spoke about using the internet to gather research, citing 23andMe, the company that won Time Magazine’s #1 Invention of the Year award, as one example. 23andMe is embarking on a genome project where you “spit in a cup”, send it to a central location and six weeks later, receive a personalized genome that traces your genetics, where your ancestors came from and whether you will ever be an Olympic sprinter. It also can tell whether you are at risk for Type 2 diabetes and which diseases are high risk for you. This study has the ability to gather massive amounts of population information and could change the future of research.

New California Parkinson’s Registry

California recently passed into law new legislation which calls for all cases of PD to be reported in the State of California. According to Dr. Langston, both patients and doctors wanted this law.

Media coverage

Throughout the day, Dr. Langston made stops at radio, television and print media doing interviews with:

• Breakfast Television, CITY TV, 7:07 am. 6 min. with Dave and Kathy –
Dr. Langston Interview
• AM 660: Rogers 10 min. with Aaron Burnett
• The Medical Post
• CBC Radio – Wild Rose Country – 1:07 p.m. – 1:15 p.m. The fight against Parkinson’s disease with Host Donna McCelligott
• The Calgary Herald

DVD coming soon

The Donald Calne Lecture was recorded and will be available soon at www.parkinson.ca.

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Ottawa teacher Shelby Hayter is awarded PSC’s highest honour

Ottawa school teacher, Shelby Hayter, has been awarded one of Parkinson Society Canada’s highest honours, the Morton Shulman Award, for her determination and creative spirit in piloting a unique educational program aimed at children in elementary schools and for teaching over 10,000 children what it means to live with Parkinson’s.

In the Pass the Baton program, Shelby, who has Young Onset Parkinson’s disease, shares the stage with a medical professional and a researcher from the University of Ottawa Parkinson’s Research Consortium.

wp-shelby-hayter-caption1

“It is a perfect forum to teach our young audiences that we work as a team and together we can make a difference,” says Shelby.

Through the Pass the Baton and Pounding the Pavement programs, Shelby has raised thousands of dollars for Parkinson’s research. She says, “I feel fortunate to have the time, energy and enthusiasm to be an advocate for a disease which seems to have a quiet voice. Many people are not in a position to be advocates, due to personal situations; but for those who are in a position to help out, like myself, it is an amazing process to realize how one person’s efforts CAN make a difference.”

The Morton Shulman Award is given annually to an individual or organization who, through fearless advocacy and an ability to make change, makes life better for Canadians with Parkinson’s and their families.

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Fellowship award winners announced

Parkinson Society is pleased to announce that, commencing July 1, 2009, fellowships for post-residency training, have been awarded to:

• Dr. Manon Bouchard (one year)
• Dr. Amitabh Gupta (one year)
• Dr. Michael Sidel (two years)

Dr. Manon BouchardDr. Manon Bouchard
Clinical Movement Disorders Fellowship ($50,000)
Foothills Hospital, University of Calgary

Neurologist Dr. Manon Bouchard will spend her fellowship year working with Dr. Oksana Suchowersky at the Movement Disorders Clinic at the Foothills Hospital in Calgary and gaining expertise in treating Parkinson’s patients for sleep disorders. She will also learn how to select candidates for deep-brain stimulation (DBS) surgery and how to program and re-program the stimulator for DBS patients’ follow-up care. Once trained, Dr. Bouchard will return with her new expertise to Hôtel Dieu de Lévis Hospital in Quebec.

wp-ami-gupta2Dr. Amitabh Gupta
Clinical Research Fellowship ($50,000)
Morton and Gloria Shulman Movement Disorders Centre
Toronto Western Hospital

Dr. Amitabh Gupta will train at the Morton and Gloria Shulman Movement Disorders Centre at Toronto Western Hospital, under the supervision of Dr. Anthony Lang. In addition to providing patient care, Dr. Gupta will focus on Multiple System Atrophy (MSA), a condition that is often misdiagnosed as Parkinson’s but has a worse prognosis and limited therapeutic options. Dr. Gupta’s research will seek to improve the diagnostic criteria of MSA, as well as investigate aspects of sleep-related problems and cognitive deficits, in an effort to enhance disease understanding, patient care and therapeutic options.

Dr. Michael SidelDr. Michael Sidel
Clinical Research Fellowship ($100,000)
Lady Davis Institute for Medical Research
Sir Mortimer B. Davis, Jewish General Hospital

Dr. Michael Sidel will spend his two-year clinical research fellowship training under the supervision of three neurologists: Dr. Calvin Melmed and Dr. Alexander Thiel at the Lady Davis Institute for Medical Research at Montreal’s Jewish General Hospital, and Dr. Anne-Louise Lafontaine, director of the Movement Disorders Clinic at the Montreal Neurological Institute and Chair of PSC’s Research Policy Committee. Using a new technique, called transcranial magnetic stimulation, Dr. Sidel will try to determine which brain pathways are involved when people with Parkinson’s experience dyskinesia, the uncontrollable movements that are often a side-effect of Parkinson’s drug treatments. Finding these pathways will enable researchers to develop drugs or new surgical interventions to prevent or treat dyskinesia. Dr. Sidel will also diagnose and treat patients during his fellowship.

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How can I get the most out of my relationship with the members of my healthcare team?

Douglas HobsonDr. Douglas Everett Hobson
Neurologist
Director, Movement Disorders Clinic, Deer Lodge Centre
Winnipeg, Manitoba

• Stay in touch with your family physician. Even if he or she defers decisions about Parkinson’s disease to a specialist, your primary care physician is often the person who will carry out the specialist’s suggestions.
• Arrive on time for appointments or call ahead to say you will be late.
• Bring a family member or close friend who knows you well.
• Always bring a list of your current medications and your pharmacy’s telephone number. If possible, keep track of previous medications you have tried, the maximal dose and any side-effects.
• Focus on the two to three main issues at each appointment. Realize the doctor cannot always see you on time or address all your concerns in a single session.
• Be honest. Doctors find it difficult to manage patients who say what they think the doctor wants to hear as opposed to saying the truth.
• Make sure you fully understand any new instructions before you leave.
• Take advantage of the resources provided by allied health professionals.
• Beware of internet “cures.” In the absence of current cures, the world of treating chronic illnesses is full of fraudulent claims that may not only be ineffective but also dangerous. Discuss any “cure” first with your doctor.
• Remember, doctors can only provide advice. Ultimately, you have to manage your illness and that also means managing your health. Eat well and keep mentally and physically active.

Lucie LachanceLucie Lachance, B.Sc., M.Sc.
Clinical Nurse Specialist
McGill Movement Disorders Program
Montreal Neurological Institute and Hospital
Montreal, Quebec

Think of the clinical nurse specialist as a companion on your journey, providing continuity of care. He or she is a contact point for patients and family members and a liaison with members of the multidisciplinary team. Take advantage of the clinical nurse specialist’s ability to provide information and advice on symptom management and other concerns during clinic visits or by telephone. The support of the clinical nurse specialist can help you adjust to the many changes you will face.

Janet MillarJanet Millar
Physiotherapist
Maritime Parkinson Clinic
Dalhousie University
Halifax, Nova Scotia

Physiotherapists need to know what you’re experiencing on a day-to-day basis in order to offer appropriate advice for improving your activities of daily living and enhancing your health and fitness.
• Make a list or know what you want to discuss at each visit.
• Be honest about what bothers you most, what limits you most, and what you are willing to do to contribute to your own well-being. If you tell us that you’re not going to do exercises, we can ask if you like to play golf or swim. It’s our job to pinpoint activities that work for you.
• Follow our suggestions.
• If you have difficulty following the recommendations, call and ask for help; don’t just quit. We would like to know why you’re unable to follow through and what we can do to change that.
• Keep an open dialogue with your health team. If you read or hear about another technique or strategy, discuss it with your health team first. You need to have a team you can count on.

Tips for choosing and working with the right pharmacist
(supplied by Parkinson Society British Columbia)

► Ask if the pharmacist is familiar with Parkinson’s medications.

  • Does the pharmacist clearly explain the differences between Parkinson’s medications, the side-effects and potential drug interactions?
  • Is prescription home delivery available? Cost?
  • How quickly can refills be supplied?

► Before filling a new prescription, bring a list of all your medications including:

  •  Parkinson’s medications
  •  other prescription medications
  •  over-the-counter medications, including common drugs such as Aspirin
  •  vitamin, dietary or herbal supplements

► Share this information with the pharmacist and ask if there are any potential complications from using the medications together.

► Have the pharmacist review the doctor’s instructions with you, including:

  • how many times a day to take the medication
  • whether it should be taken with or without food
  • how the medication should be stored
  • what to do if a dose is missed
  • possible side-effects and what to do if they do occur
  • warnings and precautions

► While on medication, speak to your pharmacist if you:

  • experience any of the side-effects and are unclear what to do
  • experience any unusual reactions, such as, constipation, urinary problems, nausea, mood swings, and/or sleep disorders
  • miss a dose and can’t recall what you should do
  • have any questions about your treatment
  • have any questions about generic substitutions

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