Thank you.
I am happy to have this opportunity to present our research on the causes of neurological diseases.
What I'm going to talk about for the next ten minutes is our work in the area of what causes neurological disease in general. I'll refer to the slides I have, of which you have copies.
We're actually doing a systematic review of 14 different neurological conditions as part of the national population health survey of neurological conditions that the Public Health Agency is sponsoring. There are five institutions across the country, and we are the lead institution doing this work. You'll see in slide two a list of the institutions and in slide three some of the research team members, which includes a number of graduate students at different universities in Canada.
The next slide explains that the purpose of this project is to understand what we know about the causes of different neurological conditions. There are 14 in total.
Shown on the next slide is “Neurological Conditions of Interest”. One of the conditions you're particularly interested in is Parkinson's disease.
What I'd like to do is show you how we're doing this study. On the next slide you'll see a flow chart where step one is defining the disease terms for the condition. I'm going to talk about brain cancer briefly and I'll finish with what we've found so far on Parkinson's disease.
As you can see, we go through a very systematic approach. We identify where, which databases we're going to search--PubMED and others--and what search terms, so the review should be totally reproducible and done according to objective criteria. We quality-score all of the studies we look at to make sure we have relevant data.
The next slide gives you more information on how we search the data, which data base is used, which search terms.
The next slide begins with primary brain tumours. That's one of the three conditions we're doing at the University of Ottawa. So when we identify a relevant paper, we go through six levels of screening, extracting key information out of that paper.
The next slide points out that we actually have two people extracting the critical information and confirming that they're both getting the same results, so there's a little bit of quality control built in.
You'll see the next slide, called “Data Extraction Table for SR/MA”, is for brain tumours. This is the sort of information that we produce in summary form. We're literally looking at thousands of papers on brain cancer. We're looking at tens of thousands of papers on Alzheimer's disease. So you really need to be disciplined and structured about how you search through this literature.
The next little case study is Alzheimer's disease, for which, as I said, the literature is particularly voluminous, so I'll skip through the details. You can see some of the results we're finding in the slide that begins with “Data Extraction Table”.
There is a third condition we're studying at the University of Ottawa, which is ALS.
A lot of these neurological conditions have similar ideologies or share some ideologic factors. Through PrioNet Canada we've been pursuing for the last few years the hypothesis that protein misfolding may play a role in many of these conditions. I think we have some really great opportunities, if we pursue that scientific hypothesis in the future, to help address the burden of several neurological diseases, including Parkinson's.
I'll skip over the medical analysis, which we do when we have enough data to try to get a quantitative estimate of different risk factors, what agricultural chemicals, what risk they might propose for ALS. We're actually going to try to quantify that by combining the data from multiple research studies, and the same for heavy metals.
What I should tell you a little bit about, what you're most interested in, is what we are doing with Parkinson's disease. That condition is being led by the University of Toronto, and the team there was kind enough to give me some hints as to what they're finding initially. This is all not final yet, so we're looking at a whole series of dietary factors, fruits, vegetables, dairy products, alcohol, coffee, tea, junk food. We're looking at macro nutrients, micro nutrients, lifestyle factors such as coffee drinking, cigarette smoking, physical activity, family history of Parkinson's, personality characteristics, environmental factors, agricultural chemicals, farming, well-water drinking, living in a rural environment. We're looking at comorbidities, such as melanoma and diabetes, a whole series of genetic risk factors, target genes as well as polymorphisms, and a number of drugs that are used to treat Parkinson's disease, whether they have any, and a number of drugs that people may be taking, such as anti-hypertensives, and their role in the onset of Parkinson's.
When we have finished this very ambitious study we will have covered the world's literature through to the present time on what we know at this point in time about the causes of all these neurological conditions. Parkinson's is the one you're interested in, but we're going to do 13 others for the Public Health Agency of Canada.
We have a second question: what factors influence the progression of the disease once the disease has been initiated? We're targeting finishing this by about January of 2013 and presenting the final results at a national conference that the Public Health Agency will host in March of 2013. That's when I'll be able to tell you everything you want to know about what we know about what causes Parkinson's.
Thank you.