Thank you very much, Madame Chair. I am very happy to be here.
I'm Sutter professor at the University of Calgary, which is a unique position. It is jointly supported by the Parkinson's Society of Alberta, the university, and Alberta Health Services. I do both translational research in patients as well as basic research in the laboratory.
My interest in Parkinson's disease is about how sensory cues, particularly music, can be used to help Parkinson's patients recover their motor function. The interest originated from a phenomenon we know as paradoxical movement. Patients with Parkinson's can't move, but some of them can dance, and they dance well.
I assembled a team five years ago, and this is the only study funded by the Canadian Institutes of Health Research to study how music can be used to help Parkinson's patients regain their function. The scientific basis of Parkinson's disease--how and why they respond to music--was not very well understood five or six years ago. But now we have a pretty good idea about where the brain circuitry is that is possibly responsible for these actions.
One thing I want to highlight here is that Parkinson's disease is a chronic disease. However, if you look at the patient populations, there are patients who are extremely resilient: they walk in the room, they're 80 years old, and they don't look like they have Parkinson's. And there are the patients on the other extreme: they're extremely worse. The question is why some patients are doing extremely well and others are not. The second question is how can you prevent disease progression to a state where they've lost their functional independence?
In experimental research we have noticed, and many other people have noticed, that when you make animals Parkinsonian by injecting them with toxins, some of these animals spontaneously recover. They actually become symptom-free after a few months. When you look at their brain, there's a functional compensation. So you lose some parts of the brain, particularly the so-called dorsal striatum. The dopamine is depleted. But just beside this structure there is overgrowth. There is a part of the brain that is compensating. This is the part of the brain that responds to music.
The challenge has been if you want to use music and in what way you want to do it. I have worked with two Canadian start-up companies who have developed an app for the iPod Touch. This device came about eight months ago with very precise sensors that can measure step size. What happened with this device was that we had a long list of music, a play list, and a patient would put the device on his or her thigh so that when they walk they have to walk with larger steps in order to get the music to play.
I can give you a brief demonstration. If you push one button, you will see on the screen it will read directly the step size. When it's rotated it measures your step size and you will play the music. But if your step size becomes small, the music will stop. It reminds the patients to re-engage.
When this device was put on the patients, some of them did not walk at all. Now they walk about two kilometres a day. The 20 patients I have now have, as a group, accumulated 1,000 kilometres walking, 300 hours listening to music.
Does it work? This is a small population. What we have found is that actually some patients have some unique symptoms. For example, they were afraid of going on escalators, and now they can go up and down without any hesitation or freezing. They couldn't swing their arms, and now they swing very easily.
So I am very optimistic about the new technology and the new science behind its design. If we can help patients to engage self-care and make them more resilient, I think many patients can benefit not only from music but also from exercise. The exercise itself actually is the single most mentioned intervention, and it has been shown to reduce the mortality rate by 50% for an average person who walks half an hour a day.
So how do we make these people comply? Parkinson's disease is a good example. Parkinson's patients have a mobility problem. They are older. If we can mobilize this population to walk more, for the general population as a whole, I think this could work even better.
I will stop here and take your questions.