One of Canada’s leaders in the fight against Parkinson’s recently gained some extra ammo.
Dr. Oksana Suchowersky, a University of Calgary professor, was recently named the Suter Professorship sponsored by the Parkinson’s Society of Southern Alberta.
"I applied for the Professorship because I wanted to devote more time to research,"said Suchowersky. "That is what it means to me-I will have protected time to do research."
With a schedule such as Dr. Suchowersky’s, protected time for research is at a premium. As Director of the Movement Disorders Program at Foothills Hospital, she has overseen the growth of the program from two doctors and a nurse in 1984 to its current status of four doctors, six nurses, two assistants and a physiotherapist who contribute to providing comprehensive care for individuals affected by Parkinson’s disease.
"When patients come to our clinic, they’re assessed medically, there’s nursing support, we get home care involved if they need it, we get physiotherapists to see them to provide that comprehensive package," explained Suchowersky. "They can stay as our patients for the rest of their lives so there’s an element of continuity, which for chronic diseases is very important."
Parkinson’s disease is a common neurodegenerative disorder characterized by tremors, slowness of movement, gait abnormalities, unstable posture and a general decrease in mobility. The cause of Parkinson’s is unknown, but it is known that the symptoms develop due to a loss of neurons in the brain stem responsible for producing the neurotransmitter dopamine.
Along with her clinical duties, Suchowersky is also a professor of clinical neurosciences and medical genetics with the U of C. Her research focuses on improving treatments for patients with Parkinson’s disease, examining medical and surgical options and, most recently, the use of exercise as a preventative measure.
"I’m actually quite excited about the exercise study," confessed Suchowersky. "We’re just starting this study to see whether early intervention with exercise is going to help the disease down the road, help the patients stay in their homes longer, be more mobile and generally improve their quality of life."
The exercise study consists of three groups of patients. One group engages in a bi-weekly exercise program administered at the Foothills clinic by a physiotherapist; another follows a home program and the last does not exercise. Participants are evaluated by Dr. Suchowersky and one of the clinic nurses, neither of whom are aware of which group the patients are in.
"We’re pretty good at treating the symptoms medically but there’s a lot of other things we can do that haven’t been looked at," said Suchowersky. " If we can give people a set of exercises to do at home, if they’re motivated to continue the program and it does the same thing as a clinical exercise program. That’s much easier than for the patient to come in to the clinic."
Although the study is in the early stages, Suchowersky cautions that the results will likely only delay and not eliminate the need for surgical intervention.
"Overall, we’re just hoping to improve people’s quality of life," she explained. "I don’t think it’ll change medical or surgical therapy, but they’ll just do better at whatever else they’re doing."
Suchowersky explained that although surgery is not considered until a patient’s symptoms can no longer be managed through medical therapies, advances in surgical treatments for Parkinson’s patients have yielded significant results.
"The patients go through a very extensive pre-surgery assessment," she said. "They have neuropsychological testing, MRI scans of the brain and then we determine what type of sugery would be best for them."
Patients may undergo a pallidotomy, in which cells in one of three locations in the brain are disabled, resulting in an improvement of the symptoms. Alternatively, they may opt for the insertion of a deep-brain stimulator-a wire inserted in a specific location and attached to a pacemaker which stimulates the sub-thalamic nuclei-resulting in a reduction of certain symptoms. "The different surgeries we can do for Parkinson’s patients and other patients with similar disorders are based on what their main symptoms are," said Suchowersky. "The surgery is the same, the only question is whether we burn the cells out, making a lesion, or leave the wire in and connect it to a pacemaker. So the surgery is the same, it’s just whether people want the stimulator or not."
Suchowersky’s research is funded by the Parkinson’s Society of Southern Alberta, the National Institutes of Health (USA), the MSI Foundation and the Calgary Health Region.