Decoding the mystery of Parkinson’s disease

For more than 200 years, no one has been able to solve the Parkinson puzzle. While the exact cause of the disease remains a mystery, dedicated researchers at The Ottawa Hospital are gaining ground—determined to solve the puzzle.

Dr. Michael Schlossmacher
Dr. Michael Schlossmacher in his lab at The Ottawa Hospital.

For more than 200 years, no one has been able to solve the Parkinson puzzle. Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s. It affects approximately 100,000 Canadians—8,000 here in Ottawa. The national number is expected to double by 2050. Each day, many of those patients face uncontrolled trembling in their hands and limbs, the inability to speak loudly, loss of sense of smell, and pains from stiffness.

While the exact cause of the disease remains a mystery, dedicated researchers at The Ottawa Hospital are gaining ground—determined to solve the puzzle. Ottawa is a recognized centre for neuroscience research. Dr. Michael Schlossmacher is the director of the Neuroscience program at The Ottawa Hospital and while he admits Parkinson’s is complicated and complex, there is hope.

“I strongly believe we can solve that riddle. We have the expertise to make a major contribution to a cure for this disease.” Dr. Michael Schlossmacher

Predicting the risk of Parkinson’s

For Schlossmacher, a step forward in unravelling the mystery of this disease came when he was struck by the idea of a mathematical equation, which could potentially foreshadow the disease before it develops. “I’m convinced that by entering known risk factors for Parkinson’s into this model, it is indeed possible to predict who will get the disease.”

Risk factors for Parkinson’s disease include:

  • age
  • chronic constipation
  • reduced sense of smell
  • family history
  • chronic inflammation such as hepatitis or types of inflammatory bowel disease,
  • environmental exposures
  • head injuries
  • gender, as Parkinson’s affect more men than women

Dr. Schlossmacher and his team of researchers are currently combing through data to test the accuracy of their theory to predict Parkinson’s.

To date, Dr. Schlossmacher and his team have analyzed more than 1,000 people, and the results are promising. “The surprising thing so far is the prediction formula is right in 88 to 91 percent of the cases to tell us who has Parkinson’s and who doesn’t—and this is without even examining the movements of a patient.”

The goal is now to expand to field testing in the next two years. According to Dr. Schlossmacher, should the results show the mathematical equation works, this could allow doctors to identify patients who have high scores. “We could modify some of the risk factors, and potentially delay or avoid developing Parkinson’s altogether.”

Partners Investing in Parkinson’s Research

Team PIPR RFR
Team PIPR co-captain Karin Fuller, left, with Elaine Goetz and fellow co-captain, Kristy Shortall-Cain.

Research is costly and community support is vital to help unleash new discoveries. In 2009, a group of investment advisors came together to create Partners Investing in Parkinson’s Research, more commonly known as PIPR. Each year, the group participates in Run for a Reason and raises money as a part of Tamarack Ottawa Race Weekend. In 11 years, the group has raised $1.4 million for The Ottawa Hospital’s researchers and clinicians.

PIPR has not only helped to fund research toward better treatment and hopefully a cure for Parkinson’s, but the group has also brought much-needed attention to the disease. For Dr. Schlossmacher, funding for research from groups like PIPR, means more hope for the future. He is quick to add that PIPR has galvanized the momentum in our community because they see how committed The Ottawa Hospital is to making a difference.

“This investment by PIPR into research at The Ottawa Hospital has been a total game-changer for us. It has allowed us to pursue projects that otherwise would not yet be funded.”

Donor dollars translate into results

Dr. Sachs practicing the use of 3D technology
Dr. Adam Sachs practicing the use of 3D technology for neurosurgery.

PIPR’s support helped bring deep brain stimulation surgery (DBS) to The Ottawa Hospital. For someone like Karin Fuller, co-captain of team PIPR, she knows the positive impact this type of technology can have. “When my dad had that surgery he had to go to Toronto, which meant going back and forth for the appointments. It was a lot for him and for our family. Helping to bring DBS to our community is a tangible example of what we’ve been able to do as a group to support The Ottawa Hospital,” says Karin.

Also developed at The Ottawa Hospital is the world’s first 3D virtual reality system for neurosurgery. It is being used to increase the accuracy of DBS surgery for patients with Parkinson’s. Our neurosurgeons are the first in the world to use this technology in this way and the goal is to improve the outcome for patients.

Promise for the future

It’s also expected that one day 3D technology could be in every department throughout the hospital. The possibilities for this technology are endless and, in the future, it could help countless patients, beyond Parkinson’s disease.

When Dr. Schlossmacher looks at the puzzle of Parkinson’s, which he’s been investigating for 20 years, he sees promise.

“At The Ottawa Hospital, we think outside the box and that’s how we’re able to unravel mysteries through our research. Research which we hope will one day be transformational.”   Dr. Michael Schlossmacher

He also has sheer determination in his eyes. “To the chagrin of my wife, I will not retire until I put a dent into it. The good news is, I may have 20 years left in the tank but, ultimately, I’d like to put myself out of business.”

The Ottawa Hospital is a leading academic health, research and learning hospital proudly affiliated with the University of Ottawa.

We need your help to fund research into diseases like Parkinson’s at The Ottawa Hospital and to provide more hope for patients in the future.

More Inspiring Stories

Recovered COVID-19 patient will always be grateful for his extraordinary care
Diagnosed with COVID-19, and fearful, Fr. Alex Michalopulos will be forever grateful.
Tapping into the good feeling of giving during COVID-19
COVID-19 is inspiring individuals, groups, and businesses to support The Ottawa Hospital and share their message of giving.
Nanji family donates $100,000 matching gift to help combat COVID-19.
Nanji family donates $100,000 matching gift to help combat COVID-19

3-D virtual reality helps neurosurgeon treat Parkinson’s

World’s first 3-D virtual reality system for neurosurgery, developed at The Ottawa Hospital, will be used to increase the accuracy of deep brain stimulation surgery for patients with Parkinson’s.

A bystander only sees neurosurgeon Dr. Adam Sachs wearing large goggles, looking at the air between the two wands he moves back and forth in front of him. What Dr. Sachs sees is a three-dimensional image of a patient’s brain, with its electrical activity superimposed. This isn’t a video game. It’s the cutting-edge of deep brain stimulation and neurosurgery technology.

Wearing virtual reality goggles, Dr. Sachs can view an accurate, computer-generated 3-D image of a patient’s brain with Parkinson’s disease, created using the patient’s own MRIs. The patients’ brain activity recorded from microelectrodes can be visualized in this virtual world. With the two wands, or joysticks, he can move the three-dimensional brain around, seeing it from all angles. He can also remove layers of the brain to look inside at the exact spot where he will place a DBS electrode during deep brain stimulation (DBS) surgery. He is hoping to soon use this technology in the operating room.

Dr. Adam Sachs
Neurosurgeon Dr. Adam Sachs is planning to use 3D virtual reality in his deep brain surgery for patients with Parkinson’s.

This medical 3-D virtual reality system was developed at The Ottawa Hospital, and is expected to be the first of its kind in the world to be used for deep brain stimulation surgery. Drs. Justin Sutherland and Daniel La Russa are clinical medical physicists in the hospital’s radiation oncology department. The two used their imaging expertise to develop a virtual reality system that combines a patient’s MRIs and CT scans to create a 3-D image of a patient’s organ or body part to give surgeons a detailed, accurate representation of the surgical area.

Historically, medical virtual reality programs were used by patients mainly for rehabilitation. Patients would wear VR-goggles to help relearn how to move through and cope with different environments. Until recently, the technology wasn’t good enough to create images of organs or tissue that could be used by clinicians in a manner that improves on current practice.

“What we are trying to do in our virtual reality lab is come up with new ways to leverage technology to help doctors and nurses, or any medical professional, do what they do better.  And how better than with 3-D visualization,” said Dr. Sutherland who is also an assistant professor in the University of Ottawa’s Department of Radiology. “We think the technology has only reached that point now. We’re now at a place where we want to pursue the avenue of clinicians-as-users.”

“Nowhere else in the world are they using virtual reality in this fashion.”

One Ottawa Hospital surgeon interested in using 3-D virtual reality was Dr. Sachs, who performs deep brain stimulation surgery for people with Parkinson’s. During this procedure, a microelectrode, no wider than a human hair, is implanted into a very specific area of the brain. The microelectrode then records activity from and stimulates that part of the brain and alleviates some of the patient’s symptoms, such as tremors and akinesia or the loss of ability to move their muscles voluntarily. The virtual reality system allows the electrical activity, stimulation effects and the MRI to be visualized together.

“In deep brain stimulation surgery, because the target is very small and in the middle of the brain this leaves the surgeon with the problem of how to visualize the person’s brain to understand the area and where to put the electrode,” said Dr. Sachs.

Dr. Adam Sachs holding 3D virtual reality wands.
Neurosurgeon Dr. Adam Sachs uses virtual reality wands to manipulate a 3D image of the brain.

He said neurosurgeons use MRIs and brain atlases to get a mental image of what the patient’s brain looks like. The problem is these atlases are maps created from many different people’s brains, but each patient’s brain is unique. As well, the brain atlases are only two-dimensional, while the brain is three-dimensional. This makes it difficult to place the microelectrode in the exact spot in the patient’s brain where it will have the best chance of halting or reducing the Parkinson’s tremors.

Dr. Chadwick Boulay, a senior research associate in the neuroscience program, understands the challenges faced by neurosurgeons when implanting an electrode at the optimal position in the brain. When Dr. Boulay learned about the 3-D virtual reality technology being developed at The Ottawa Hospital, he realized the potential this had for increasing the accuracy of deep brain stimulation surgery. He and Dr. Sachs worked with Drs. Sutherland and La Russa to develop a virtual reality program that would enable them to see the patient’s brain in three dimensions.

“This is really exciting,” said Dr. Sachs. “The deep brain stimulation electrodes will be more precisely placed because we’ll be able to integrate accurate images from the patient’s anatomy and visualize it in three dimensions,” said Dr. Sachs.

He anticipates that the resulting precision of the placement of the electrode will improve outcomes for patients with Parkinson’s disease, but this will be confirmed through research. About 15 people undergo deep brain stimulation surgery at The Ottawa Hospital every year.

“We’re excited about working with the Sachs Lab because it is a perfect clinical example of using 3-D visualization to better understand a spatial problem,” said Dr. Sutherland. “In this case, actually seeing a target for deep brain stimulation removes the burden on the surgeons of trying to create a 3-D model in their head.”

Drs. Daniel LaRussa, Justin Sutherland, and Chadwick Boulay
Drs. Daniel LaRussa, Justin Sutherland, and Chadwick Boulay have teamed up to design a 3D virtual reality program for Dr. Adam Sachs’ deep brain stimulation surgery.

Dr. Sutherland foresees that this 3-D virtual reality technology will one day be in every department throughout the hospital. He says the overall system is surprisingly inexpensive, as the computer that runs it and the goggles only cost a few thousand dollars. The possibilities for this technology are endless. He said it has huge potential for education—teaching medical anatomy—and for surgical planning. Dr. Sutherland sees Dr. Sachs’ endorsement of this system as a shining example of how doctors can use this technology to improve what they do.

“Nowhere else in the world are they using virtual reality in this fashion,” said Dr. Sachs.

The Ottawa Hospital is quickly being positioned as leaders in 3-D virtual reality technology and has already gained international attention. Drs. Sutherland and La Russa have given demonstrations and been invited to talk at large medical conferences, and other institutions have contacted them with interest in using this technology.


Help us invest in state-of-the-art technology. Innovation at The Ottawa Hospital is creating change now for better health tomorrow.

More Inspiring Stories

Decoding the mystery of Parkinson’s disease
While the exact cause of Parkinson’s disease remains a mystery, dedicated researchers at The Ottawa Hospital are gaining ground—determined to solve the puzzle.
Local activist donor pledges $500,000 to take on cancer
Gavin Murphy is unwavering when it comes to his desire to maintain a world-class health care system in our city. As a result, he’s willing to step forward and be an activist donor.
A new era in breast health at The Ottawa Hospital
Making world-first discoveries and pushing the boundaries of breast cancer care and research right here in Ottawa.