Dr. Oksana Suchowersky

April 2017
This is a follow up to our 2015 interview with Dr. Suchowersky. Her work allows Alberta to remain at the forefront of Parkinson's research and treatment. 
Parkinson Association of Alberta (PA): You’ve been involved in Parkinson’s disease treatment and research for over 30 years. What would be some of the highlights of your career?
Dr. Oksana Suchowersky (DOS): Certainly, my highlights are being involved with patients and being able to treat patients. Another highlight is the increase in the number of medications being made available and being involved in the research that has brought some of those medications to market.
Being involved with the Parkinson Study Group, which is a large international collaboration of clinicians and researchers looking at Parkinson disease, has been rewarding. It’s based in Canada and the US. They’re all involved in improving treatment and finding a cure for Parkinson disease. It’s been going on since 1987 and we’ve been doing multiple studies over the years to address those questions.
(PA): You have a background in genetics. How new is the theory that PD has a genetic component?
(DOS): When I started my practice some 30 years ago it was said that Parkinson’s is not genetic and everyone was looking for environmental causes. So it’s really only been over the past 10 or 20 years that it’s been increasingly recognized that there is a genetic component. In young onset Parkinson’s there’s a very strong genetic component but even in older people, we now understand that there’s probably a genetic predisposition and then the condition environmental conditions that you get Parkinson’s. The younger you are, the stronger the genetic influence, the older you are it’s probably a combination of genetics and environmental factors. It’s only been in the past 10 years or so that people have found the genes that are responsible so we now know the 20 genes that are involved in either minor or major factors resulting in Parkinson’s. 
(PA): Are the clinical trials of Duodopa still underway? Is there anything new to report there? 
(DOS): Yes, multiple trials are still underway. In Edmonton, we were the first in Canada to start a patient on duodopa, which is providing levodopa directly into the intestine so it’s better-absorbed. Since then we’ve brought duodopa into practice in Alberta. So now any patient can have access to duodopa. And I’m still continuing research into duodopa to see whether it treats motor symptoms vs non motor symptoms, what side effects people are having, and so on. So there are a variety of ongoing research trials, although the treatment is available as a clinical treatment now for anybody with advanced Parkinson’s. 
(PA): You’ve spoken about neuroprotective therapy. Are there currently any clinical trials for that? Are there new compounds that can slow the progression of PD?
(DOS): We have a trial underway through the Parkinson Study Group, called STEADY-PD which is using a drug that we think can slow down the progression of Parkinson’s. We also are looking at the potential of drugs that can decrease inflammation. 
One of the interesting theories is that as the cells are involved in the pathological process,  a lot of inflammation is occurring. So if we can decrease inflammation in the brain, it may decrease progression of Parkinson’s. Trials will be coming out related to anti-inflammatories. 
Another area we’re always interested in is exercise. There have been studies to show that if you exercise regularly, you may decrease your risk of getting Parkinson’s and you may slow down the progression of the disease. 
(PA): What other research are you anticipating the results of?
(DOS): One of the other interesting things is how you can predict if someone is developing Parkinson’s. So we now know that changes in the brain related to Parkinson’s may start in the nose or may start in the gut. And then gradually spread to the brain. People may be developing a sort of pre-Parkinson’s for about 10 years before they develop the motor symptoms of Parkinson's.
So I think an important area of research is trying to predict who is going to get Parkinson’s and intervene at that level. Because, of course, once you get Parkinson’s, the pathology is already developed in the brain, so how can we stop it from developing into Parkinson’s?
(PA): Just yesterday, we had a client at the Parkinson Association of Alberta Calgary office tell a group of clients, “Canada and specifically Alberta is the best place in the world to have Parkinson disease”. It’s an interesting way to put it, but would you agree with that statement?
(DOS): I really appreciate the compliment and I think that we do a very good job in Alberta of treating Parkinson’s. In both Calgary and Edmonton we have multidisciplinary clinics that look after people with Parkinson’s and I think that’s very important. The have the benefit of not only neurologists, but nurses, occupational therapists, physiotherapists, and social workers. Things like exercise programs that provide comprehensive, multi specialty care for people with Parkinson's, for example. We may call in geriatricians or urologists, or other specialists to come deal with the multiple facets of the disease.
(PA): How important is it to have people with Parkinson’s participate in clinical trials for research?
(DOS): It’s extremely important because that’s the only way we’re going to find out about what causes it, how to prevent it, and how to treat it better. Without research, we’re going to be stagnant.
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