Movement Disorders

Patient Population
Movement disorders (MD) include Parkinson's Disease (PD), Huntington's Disease, Tourette's Syndrome, tremor and dystonia. Patients are referred to the MD clinic for investigation and management from throughout Canada and across the world. More than 3,500 patients were evaluated in the Toronto Western Hospital Movement Disorders Clinic in the past year and 40 patients underwent neurosurgical procedures for movement disorders.

Education
The MD program is involved in educational activities at every level for undergraduate medical students, postgraduate and post doctoral scientists, residents at all levels of training and postgraduate clinical/research fellows. In addition, the MD program provides education for all of the allied health professions.

Three subspecialty nurses dedicated to MD teach patients and families about their disorders and interact with lay organizations. Post-graduate fellows throughout the world seek out the MD program for subspecialty training in medical and surgical MD. International physicians visit this centre to gain insight and experience from the MD neurology unit and/or the MD neurosurgical program, both of which have international reputations for excellence.

Research
The Toronto Western Hospital Movement Disorders Program has an international reputation for its research and productivity, with numerous publications in the worlds' leading journals.

MD research activities include:

• Clinical Studies documenting poorly recognized/undescribed disorders

• Evaluation of functional neurosurgical treatments for PD and other movement disorders

• Studies investigating mechanisms of neurodegeneration and neuroregeneration using animal models of Parkinson's disease

• Neurophysiological studies of mechanisms of action of deep brain stimulating electrodes; transcranial magnetic stimulation in PD, dystonia and other MD; neurophysiological characteristics of MD

• Neuroimaging studies in MD including SPECT in PD, fMRI in MD patients with deep brain stimulation and PET in surgical MD patients

• Neuropathology studies of MD including clinical-pathological correlative studies, neuropathological hallmarks of corticobasal degeneration and surgical interventions

• Neuropsychology studies evaluating effects of surgical interventions and neuropsychological disturbances accompanying MDs

• Pharmacological trials encompassing a variety of therapeutic agents in PD and other MDs including botulinum toxin treatment of tics and dystonia

• Genetic and molecular biological studies such as work with the Parkinson Study group and University of Indiana evaluating siblings with PD and studies of synuclein molecular biology and animal models of PD at CRND