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Neurology - Parkinson's

Houston, Texas

The Cullen Building at Baylor College of Medicine.
Department of Neurology
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Patient Care, Education, and Research

Multidisciplinary approach at the Parkinson's Disease Center promotes comprehensive clinical evaluations. Diagnosis and treatment planning are carried out in a modern ambulatory clinic, located on the 18th floor of the Smith Tower. In addition to an up-to-date laboratory and imaging facilities, the Center provides access to physical and speech therapy. The Center collaborates with neuropsychologists within the Department of Neurology (Alzheimer's Research Center) and with colleagues in the Department of Psychiatry to address the complex neurobehavioral problems associated with Parkinson's disease. The patients and care givers receive information packets on Parkinson's disease and on various local and national resources. Patient-oriented seminars are held in cooperation with the local and national Parkinson's disease organizations. Several forms of treatment are used, including conventional and experimental medications, botulinum toxin injections, and neurosurgery. In all cases, the therapeutic approach is tailored to the specific needs of each patient. The goal of the Center's treatment program is to improve the patients' coordination and mobility while increasing their motivation and reducing their dependence.

The Parkinson's Disease Center and Movement Disorders Clinic provides a setting for education of fellows and residents in the recognition and management of Parkinson's disease and other movement disorders. The fellows develop skills not only in the diagnosis and treatment of a large variety of movement disorders, but also in clinical research techniques. They have an opportunity to participate in new and ongoing clinical research studies and develop skills in designing and conducting studies in experimental therapeutics, pharmacology, physiology, epidemiology, and genetics of movement and motor control disorders.

On a national and international level, the PDCMDC is committed to educating physicians and health care providers by organizing and participating in scientific symposia. In addition to sponsoring national and international symposia for physicians and scientists, the Center provides educational conferences and materials for patients and their care givers.

Clinical and Research Programs

The PDCMDC is dedicated to clinical research in disorders of the nervous system that impairs normal motor control. The clinical application of scientific discoveries depends on a coordinated effort of basic scientists and clinical researchers. To this end, the Parkinson Disease Center integrates three essential components:

  1. Movement Disorders Clinic, focusing on patient evaluation and treatment
  2. Movement Disorders Research Laboratory, focusing on quantitative assessment and neurophysiologic studies of movement disorders
  3. Experimental Therapeutics Center, focusing on medical and surgical therapies

Movement Disorders Clinic

Drawing from a large referral population, the Movement Disorders Clinic has become one of the most active facilities for evaluation and treatment of movement disorders in the world. This robust clinical base facilitates the conduct of extensive clinical trials, epidemiologic and genetic studies, and other clinical research projects. There are currently over 10,000 patients with various movement disorders in the Clinic's database.

In addition to providing a comprehensive care of patients with a variety of movement disorders, there are several specialty clinics, such as the Botulinum Toxin Clinic. This specialized approach provides not only for expert care, but it also facilitates patient education, an important component of the Movement Disorders Clinic. Patients receive valuable educational materials and videotapes that describe their specific condition and current treatment options. They are encouraged to obtain additional information and newsletters from local and national support groups and other organizations.

Movement Disorders Research Laboratory

The Movement Disorders Research Laboratory, equipped with computers, video studio, and neurophysiologic instruments, is involved in various projects designed to measure and study physiologic variables affecting normal and abnormal motor control. The Laboratory also provides quantitative assessments of the effects of various therapeutic interventions.

Experimental Therapeutics Center

The primary research focus of the PDCMDC has been on experimental therapeutics of Parkinson's disease and other movement disorders. The research targets new therapeutic approaches designed to improve symptomatic therapy and to develop novel neuroprotective strategies. The Center has participated in various independent clinical trials as well as collaborative studies conducted by the Parkinson Study Group and other consortiums of academic clinical researchers. Studies are also under way to explore the potential benefits of different types of botulinum toxin, a procedure first pioneered at the PDCMDC in the early 1980's. There are many other experimental therapeutic protocols being conducted at the PDCMDC and planned for the anear future.

There has been a resurgence of interest in surgical treatment of Parkinson's disease and other movement disorders. Building on long-term experience of Baylor's neurosurgical team in stereotactic functional surgery, we have incorporated the newest computer-controlled imaging technology coupled with advanced methods of intraoperative brain recordings to further refine the neurosurgical treatments of Parkinson s disease, tremor, dystonia, and hemiballism. These techniques have been used to better localize the appropriate brain target site and applied in thalamotomy, pallidotomy and deep brain stimulation. Besides pallidotomy, the Center is one of a few selected to investigate the effects of stimulating electrodes implanted in the thalamus, the subthalamic nuclei, and other brain targets for the control of tremor and other parkinsonian symptoms including gait and balance problems, and L-Dopa induced dyskinesia.

Basic Research Program

A fruitful collaboration has been established with basic scientists at Baylor and other institutions in the Texas Medical Center. The major focus of this collaborative effort is to pursue questions related to basic mechanisms of cell death that may be relevant to Parkinson s disease and other neurodegenerative disorders. In addition, an ongoing collaboration with the molecular geneticists at the National Institutes of Health, Baylor and Duke University is designed to uncover potential genetic mechanisms for the common and unusual movement disorders. Our genetic studies of large kindreds with essential tremor will hopefully lead to the finding of gene markers or the actual gene mutations in patients with essential tremor, a disorder that may increase the risk for the development of Parkinson's disease.

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