Health Committee on March 1st, 2012

[Inez Jabalpurwala]

Of course, yes, as supporting my previous comments, I would fully endorse putting that forward.

[Vanessa Foran]

NHCC would fully support 2014 as the year of the brain.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

I'm very cognizant of the time because I have to leave.

I'll ask Dr. Fry if she could join me up here. I have to go. I'll ask the question, if you could come here—

[The Chair, Conservative, Joy Smith]

Just ask the question and then you may leave.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

If there's a recommendation you could make to this committee regarding the need for a national brain strategy, could you be very clear in what that would entail? Should this be a recommendation that we need a national brain strategy?

[Vanessa Foran]

Yes, thank you.

We definitely need a national brain strategy. We really need it to include all the areas I mentioned, including integrated care, genetic fairness, caregiver support, research, prevention, and education. I think that's essential.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Should this be a recommendation in the report—that we need a national brain strategy?

[Vanessa Foran]

Absolutely.

Thank you for your question.

[The Chair, Conservative, Joy Smith]

Did you have another comment?

[Celina Rayonne-Chavannes]

I just wanted to add that within the national brain strategy and in putting together the year of the brain in 2014—just to pull together both of your questions—the national population health study on neurological conditions will be presenting a very robust report looking at....

I know that Mr. Harris in the last session spoke about the numbers and why we didn't have numbers related to neurological conditions. A lot of our studies or a good third of our studies are looking at the incidence and prevalence, looking at numbers for various neurological conditions. We need to understand the impact of neurological conditions in order to be able to move forward.

Once that information comes out in 2013-2014, that will be an excellent opportunity to build on current knowledge, to look at the gaps in the study, and to build on the research that will then have to go forward after that point.

[The Chair, Conservative, Joy Smith]

Thank you for your very astute answers.

I've asked Mr. Gill if he'd allow me to have a question, but I'll let him go first.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Go ahead with your question first.

[The Chair, Conservative, Joy Smith]

Thank you. Mr. Gill is such a gentleman.

We haven't said much about essential tremors today, and I know from the studies I've seen that there are a lot of essential tremors that are emerging, much more. I don't have the stats in front of me right now, but I was astounded to see the amount of misdiagnosis between Parkinson's and essential tremors. I was talking to a neurosurgeon the other day who deals with Parkinson's patients, and he says that some tremors can be very pronounced and be mistaken for Parkinson's, but that it doesn't progress. Parkinson's progresses, but the tremors stay.

Could you give some input on any possible solutions for people who have tremors? At the beginning of your presentation, you were saying earlier, our witness was saying, that there's no cure for these neurological diseases. We've studied these diseases at length. Everyone around the table is very passionate about them and wants to do the right thing to help these patients.

Have you any research on or any cures for pronounced essential tremors? Dr. Beaudet mentioned brain surgery but that was the only thing I heard this morning. Is there anything else?

[Dr. David Kaplan]

The only things that have been proposed are brain surgery and deep-brain stimulation, as two possibilities. As we're learning more about Parkinson's, we now have to start learning more about essential tremors. With Parkinson's, we felt, in the research community, that there was greater need because it is progressing. But I agree with you; we now have to turn our attention to essential tremors, because so many people are being diagnosed with it.

For us, then, what is the cause? Is there a cause? What's a possible treatment? Is it similar to that of Parkinson's or not? We're still right at the beginning, really, of a non-surgical intervention possibility.

[The Chair, Conservative, Joy Smith]

And what is that beginning?

[Dr. David Kaplan]

The beginning is to look at what are the causes, and how they are different from or similar to Parkinson's.

[The Chair, Conservative, Joy Smith]

Mr. Gill, can I ask another quick question?

[Parm Gill, Conservative, Brampton—Springdale, ON]

Absolutely. Take your time.

[The Chair, Conservative, Joy Smith]

I'm watching the time. I'm not cheating.

There are also some studies that are indicating, and they're not solid research....

My background is science and solid research, so I like to see the solid research. But these studies are suggesting that farmers and people working around herbicides are developing a large amount of Parkinson's cases and essential tremors.

Do you have any information about that? I found that extremely interesting, and the research keeps coming up. I wish I had time to do the research myself. It's mind-boggling to see the farmers who are sitting in front of neurosurgeons trying to deal with either Parkinson's or essential tremors.

Is there any connection there that you know of, or any new research?

[Dr. David Kaplan]

The research is on what the toxic compounds in the environment are that cause Parkinson's. Some of them that we use in Parkinson's models are ones that are traditionally used by farmers, for example, to clear fishing ponds. We have had hints all along that it could be very toxic to the brain among vulnerable populations, resulting in Parkinson's.

For us, then, how do we protect those populations from all the insults in our environment? And it's not just what farmers see, but what we see every day.

[Celina Rayonne-Chavannes]

I would just like to add that Dr. Krewski's team at the University of Ottawa is part of the national population group of studies. His work is looking at risk of onset and prognostic factors, and as Dr. Kaplan has said, has looked at environmental factors that influence diseases, looking at international literature reviews and at some newer studies related to that as well.

To go back to your previous question just briefly, with regard to misdiagnosis of Parkinson's versus essential tremors, three of our teams within the national study are looking at validating algorithms for case definitions for neurological conditions, looking at the ICD-9 and ICD-10 codes, and looking at the feasibility of having neurological conditions added to the Canadian chronic disease surveillance system.

So they're really looking at each of these codes and finding a good way to have these codes used by doctors correctly. They're finding that they're used a lot better at hospitals than they are within physicians' offices.

These studies are trying to find a good common way of making sure that those misdiagnoses don't happen and inflate incidence numbers.

[The Chair, Conservative, Joy Smith]

Thank you.

I'm feeling guilty, because Mr. Gill has been so generous.

Mr. Gill, go ahead.

[Parm Gill, Conservative, Brampton—Springdale, ON]

Thank you, Madam Chair.

I want to thank the witnesses for being with us.

I have a question for Brain Canada. As announced in budget 2011, the Government of Canada has formed a partnership with Brain Canada to establish a $100 million Canadian brain research fund that will be matched by other resources, I guess raised from Brain Canada's other partners.

How significant is this, and how will it help people who have neurological disorders on the ground?

[Celina Rayonne-Chavannes]

I'm sorry, I missed the last part of your question.

[Parm Gill, Conservative, Brampton—Springdale, ON]

How will this help people on the ground?