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Please note that clinic appointments may be virtual visits. The clinic team will let you know what type of appointment is appropriate for your care. Learn more about virtual visits at UHN »

What We Do

Movement Disorders involve problems with too much or too little movement because of neurological conditions. Some of these disorders are familiar, such as Parkinson's disease, but there are many others: Dystonia, tremor, Myoclonus, tics, ataxia and other inherited conditions.

Our clinic provides care for more than 9,000 visits a year. Our work includes botulinum toxin treatment, clinical trials and research that uses imaging of the brain, surgery, surveys, as well as the study of genetics and brain function.

Learn more about the Edmond J. Safra Program in Parkinson's disease and how we're improving the lives of those living with Parkinson's disease today and for the future.

Conditions Treated

All neurological disorders associated with hyperkinetic or akinetic-rigid (ie.​​ parkinsonism) movement disorders. For example:

  • Ataxias
  • Corticobasal syndrome
  • Dystonia (including Cervical, orofacial, segmental and generalized types)
  • Functional movement disorders
  • Multiple system atrophy
  • Myoclonus
  • Parkinson's Disease
  • Progressive supranuclear palsy
  • Spastic paraplegia
  • Spinocerebellar atrophy
  • Tardive dyskinesia
  • Tics
  • Tremors
  • Wilson's disease and other neurometabolic disorders causing movement disorders

Tests & Services

How to Prepare

Your first appointment can take 2 hours or more. After your visit to the clinic, you will likely go to the Blood Collection Lab for blood tests. Follow-up appointments usually take 30 minutes to 1 hour.

Learn more about what you can expect when you have a clinic appointment.​

Health Information

Materials and Resources to Help You

Resources from the Patient & Family Education Program PDF Icon

Our Team

Meet Our Team

Our Team Approach

The Movement Disorders Clinic was established in the 1980s and has grown from a single neurologist to the largest clinic of its kind in Canada, with eleven faculty neurologists working with a number of Fellows and nurses. Thanks to generous philanthropic support, we are now entitled as the Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic. We have also been awarded a Parkinson's Foundation Center of Excellence designation due to our international reputation for excellence in research, teaching and patient care.

Parkinson's Foundation Logo  

There's much more to movement disorders than tremors and unsteadiness. People with movement disorders can suffer personality changes, trouble sleeping and memory loss. Some disorders are very complex and can have a great impact on a person's life.

At Krembil Brain Institute, we want to change that. We want to restore a patient's health when it comes to their brain and slow the progress of their disease.

Director of the Movement Disorders Clinic: Dr. Anthony Lang. Visit Dr. Lang's research profile

Neurologists

Nursing

Mrs. Athea Tuitt
Phone: 416 603 5875

Ms. Yu Yan Poon
Phone: 416 603 5875

Mr. A. Valencia, Nurse Practitioner
Phone: 416 603 5800 ext. 2664​

Our Research

Clinical Research at the Movement Disorders Clinic

We are involved in a large number of clinical research trials including pharmacologic studies evaluating a number of drugs at various stages of Parkinson's disease and other Movement Disorders.

The Toronto Western Hospital Movement Disorders Program remains a world leader in the surgical management of Parkinson's disease including the evaluation of deep brain stimulation (DBS) in novel sites or for new indications and the use of MRI-guided Focused Ultrasound.

Collaborators in the surgical arm of the program include Dr. Alfonso Fasano and Dr. Renato Munhoz in neurology and Dr. Andres Lozano, Dr. Mojgan Hodaie and Dr. Suneil Kalia in neurosurgery.

Neuropsychological and imaging evaluations of patients participating in these studies represent an important component of our collaborative research. Additional neurophysiologic studies in surgical patients as well as in other movement disorders are carried out by Dr. Robert Chen.

Clinical trials are very active in the program. Dr. Susan Fox directs a program in clinical neuropharmacology and early proof of principle studies. Dr. Connie Marras conducts clinical epidemiological studies including evaluating families with genetic forms of various movement disorders and assessing risk factors that could contribute to diseases such as Parkinson's disease.

We have recently developed a specialty clinic in the ataxias directed by Dr. Elizabeth Slow and Dr. Renato Munhoz.

Neuroimaging is an important component of our program and Dr. Antonio Strafella directs a very active functional imaging research program using positron emission tomography and functional MRI.

Molecular and cell biology and clinical genetics of movement disorders including Parkinson's disease are areas of expanding interest with Dr. Lorraine Kalia in the Tanz Centre for Research in Neurodegenerative Diseases, Krembil Brain Institute.

Neuropathologist Dr. Gabor Kovacs and Dr. Naomi Visanji also work out of the Tanz Centre for Research in Neurodegenerative Disease, Krembil Brain Institute. Their work is supported by the Rossy Program for progressive supranuclear palsy research (PSP) led by Dr. Anthony Lang. Some of their work looks at identifying where the disease and the pathological accumulation of the tau protein starts in the brain, to better monitor patients and predict prognoses.

This broad-based research program is directed at attempting to solve the 'Parkinson puzzle' and other Movement Disorders at many levels including attempts at understanding the cause(s), improving the accuracy of diagnosis preventing/slowing the progression and treating the later stages more effectively.

We are committed to discovering causes of, and better treatments for, Parkinson's disease and other movement disorders through our extensive research program. Patients at our centre have the opportunity to participate in research and feel part of the process of finding answers. The participation of our patients and their families helps us to make progress in our understanding of the disease so that we can improve treatments or find cures. We have many studies going on at any one time.

Learn about Clinical Research and how taking part can help:

Consent to allow us to review your medical records and contact you about the possibility of participating in various research projects that we and our collaborators are conducting. This form does not commit you to participate in any research


Learn about: Research Studies that are currently recruiting »

Learn about Brain Donation Research:

UHN Research Initiatives

The Krembil Research Institute is the research arm of the Toronto Western Hospital The overall goal of Krembil's research program is to develop innovative treatments for chronic debilitating conditions that include chronic neurological disorders (e.g., Parkinson's disease, stroke, epilepsy, spinal cord injuries, dementia, concussion, pain and depression), ophthalmologic disorders (e.g., glaucoma, macular degeneration and retinopathy) and musculoskeletal system disorders (e.g., osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis. Learn more about Krembil Research Institute | UHN Research.

UHN's Research Institutes span the full spectrum of diseases and disciplines, including cancer, cardiovascular sciences, transplantation, neural and sensory sciences, musculoskeletal health, rehabilitation sciences, and community and population health. Learn more about Research at UHN | UHN Research.

Canadian Research Initiatives

International Research Initiatives

Research Studies that are currently recruiting

If you are interested in hearing more about any of our research studies please email mdcclinicaltrials@uhn.ca

Empowering Patients: Perspectives on Clinical Research

Our 3-part video series demystifies assumptions about clinical research and shows that the motivation for participating can be altruistic and empowering.

 

Empowering Patients: Perspectives on Clinical Research Playlist

Research Studies

Study Name:
Biomarkers
Study Focus:

Biomarkers in PD


Study Procedures:
  • Lumbar puncture
  • Skin biopsy
  • Blood and saliva
  • Questionnaires

Study Frequency:
    ​​
  • 1-2 visits​​

Special Requirements:
  • Patients taking blood thinners or with conditions predisposing to neuropathy will be excluded.
  • Looking for:
    • early untreated PD less than 2 years since diagnosis
    • advanced PD
    • MSA or PSP
    • RBD
    • Healthy participants
    ​​
Study Name:
Educational Study
Study Focus:

To provide additional education to DBS candidates and evaluate if the success of Deep Brain Stimulation (DBS) is related to the fulfillment of patients' expectations, than merely improvement of motor status

Study Procedures:
  • Two virtual educational sessions
  • Short questionnaire
​​
Study Frequency:
Not available
Special Requirements:
  • Diagnosis of Parkinson's disease
  • DBS candidates

Study Name:
FOG on Split-belt Treadmill
Study Focus:

To gain new insight into the mechanisms causing freezing of gait (FOG).​

Study Procedures:
  • Gait analysis​ on a treadmill
  • Questionnaires

Study Frequency:

One visit

Special Requirements:
  • PD diagnosis
  • Able to walk without pain or discomfort

Study Name:
Free-Viewing Eye Tracking
Study Focus:

Exploring eye movements as a novel biomarker for neurological disorders

Study Procedures:
  • Questionnaires
  • Eye tracking
  • Clinical assessments
​​

Study Frequency:
  • Single visit

Special Requirements:
  • Current diagnosis of PSP, MSA, CBS, parkinsonism, dystonia, ataxia, tic disorder, functional movement disorder or other movement disorder
Study Name:
Gait Adaptation
Study Focus:

By using a treadmill, researchers hope to learn more about the role of the cerebellum (a part of the brain) in different Neurological indications. The results could help develop new ways to assess brain function, find useful markers for diagnosis, and create better treatments to improve walking for people with these conditions.

​​​
Study Procedures:
  • Walking analysis on a treadmill
  • Neurological assessments

Study Frequency:
  • 1 visit or 2 visits depending on the condition

Special Requirements:
  • PD with or without DBS
  • ET with or without DBS
  • NPH before shunt

Study Name:
LRRK2 Biomarker Study
Study Focus:

Find markers of risk for Parkinson’s disease in people with variants in the LRRK2 gene

Study Procedures:
  • Questionnaires
  • Eye movement testing
  • Neurological examination and electrocardiogram
​​​
Study Frequency:
  • 1 visit

Special Requirements:
  • LRRK2 genetic mutation
​​
Study Name:
LUMA Study
Study Focus:

To assess the efficacy and safety of study drug to see if it may delay the progression of Parkinson's disease in people in the early stages of their condition

Study Procedures:
  • DaTscan (a brain scan to detect changes associated with Parkinson's disease)
  • Spinal Fluid collection
  • Urine and blood sample collection
  • Brief daily Assessments using an electronic device
  • ECG (to check heart rhythm)
  • Pulmonary function test (breathing tests)
  • Daily intake of study drug (tablets taken by mouth)

Study Frequency:
  • Multiple visits (study participation is a minimum of 48 weeks and may go up to 144 weeks with visits to the clinic occurring every 4-6 weeks)

Special Requirements:
  • 30 to 80 y/o diagnosed with PD within the last 2 years and currently NOT taking any PD medications

Study Name:
Pathophysiology of PD
Study Focus:

Changes in brain functions


Study Procedures:
  • TMS Brain Stimulation EEG
  • Clinical assessments

Study Frequency:
  • 1 to 4 visits
  • 4 hours
  • 3 months


Special Requirements:
  • Mild to moderate PD with STN DBS
  • DBS turned off for a portion of the visit


Study Name:
PD QoL Scales
Study Focus:

Study aimed at improving the tools used to measure quality of life in PD

Study Procedures:
  • Two virtual interviews
  • One Survey


Study Frequency:
  • 45 minutes to 1.5 hours
  • 3 virtual visits
  • 7-10 months


Special Requirements:
  • Individuals with Parkinson's disease
  • Able to recall and report on their PD symptoms
  • 18 years or older
  • Fluent in English


Study Name:
PDGENE
Study Focus:

Provide genetic testing for people with Parkinson's disease and contribute to a database and biobank for ongoing genetic research.

Study Procedures:
  • Cheek swab or blood draw
  • Survey
​​
Study Frequency:
  • Single visit
​​
Special Requirements:
  • Parkinson's disease diagnosis
​​
Study Name:
Percept
Study Focus:

Examining the Effects of Unblocking the Full Potential of Medtronic PerceptTM PC IPG on Symptoms of Individuals with Parkinson's Disease.

Study Procedures:
  • Programming
  • Questionnaires
​​
Study Frequency:


Special Requirements:
  • Diagnosis of PD with DBS
  • Had IPG replacement from Activa PC to Medtronic PerceptPC

Study Name:
PPMI
Study Focus:

Biomarker discovery in Parkinson's disease and people at risk for Parkinson's disease

Study Procedures:
  • Lumbar puncture (spinal tap)
  • Skin biopsy
  • Blood and urine
  • Questionnaires
  • DaTscan (A brain scan identifying the neurodegeneration seen in Parkinson's disease)
  • MRI

Study Frequency:


Special Requirements:


Study Name:
Sleep Study
Study Focus:
This study aims to improve our understanding of sleep stages and disorders. The goal is to provide better support for individuals with Parkinson's disease in the future.​
Study Procedures:
  • Questionnaire
  • Sleep test at Sunnybrook

Study Frequency:
  • 1 visit

Special Requirements:
  • PD with DBS
  • Percept IPG (Battery)

Study Name:
Brain plasticity and neuromodulation in Parkinson's Disease
Study Focus:

Changed brain activity in Parkinson's Disease


Study Procedures:
  • TMS Brain Stimulation
  • MRI

Study Frequency:
  • 2-4 visits
  • 4 hours
  • 3 months

Special Requirements:
  • PD patients with STN-DBS are eligible
  • No severe tremor or dyskinesia
  • No history of seizure


Study Name:
C-OPN
Study Focus:

Canadian Open Parkinson Network (C-OPN) is a national registry designed to unite and mainstream research efforts to more efficiently find ways to treat Parkinson's disease

Study Procedures:

Information about the study is here: https://copn-rpco.ca/

Interested participants can simply sign-up online here: https://copn-rpco.ca/participants/

Study Frequency:
Not available
Special Requirements:

People of any age living in Canada and diagnosed with Parkinson's disease or any Parkinson Plus Syndrome

Study Name:
LRRK2 Genetic Registry
Study Focus:

Gene mutations


Study Procedures:
  • Creating a directory of PD patients with gene mutations

Study Frequency:
  • Future research

Special Requirements:
  • Gene mutations causing PD

Study Name:
PD Diaries
Study Focus:

To monitor how well Parkinson's disease medications are working and if they are taken as prescribed

Study Procedures:
  • Questionnaires

Study Frequency:
  • 24 months, 7 visits

Special Requirements:
  • Diagnosed with Parkinson's disease
  • Have not gone under surgeries for PD (such as DBS)

Study Name:
Biomarkers
Study Focus:

Biomarkers - To develop a test to diagnose different neurodegenerative diseases

Study Procedures:
  • Lumbar puncture
  • Skin biopsy
  • Blood and saliva
  • Questionnaires

Study Frequency:
  • 1-2 visits

Special Requirements:
  • Looking for:
    • Early untreated PD less than 2 years since diagnosis
    • Advanced PD​​
    • MSA or PSP
    • RBD
    • Healthy participants
​​
Study Name:
C-OPN
Study Focus:

Canadian Open Parkinson Network (C-OPN) is a national registry designed to unite and mainstream research efforts to more efficiently find ways to treat Parkinson's disease

Study Procedures:

Information about the study is here: https://copn-rpco.ca/

Interested participants can simply sign-up online here: https://copn-rpco.ca/participants/

Study Frequency:
Not available
Special Requirements:

People of any age living in Canada and diagnosed with Parkinson's disease or any Parkinson Plus Syndrome

Study Name:
Free-Viewing Eye Tracking longitudinal arm
Study Focus:

Study Procedures:
  • Questionnaires
  • Eye tracking
  • Clinical assessments

Study Frequency:
  • Annual visit up to 10 years

Special Requirements:
  • Current diagnosis of undifferentiated parkinsonism

Study Name:
Imaging synaptic pruning in Parkinsonisms
Study Focus:

Using PET imaging scans to differentiate between neurodegenerative diseases

Study Procedures:
  • PET
  • MRI
  • Clinical Assessments

Study Frequency:
  • 1 visit
  • 6 hours

Special Requirements:
  • PSP/MSA/CBD movement disorders
  • No pacemaker
  • No claustrophobia
Study Name:
Prospective multidisciplinary analysis of imaging and outcome data from patients with movement disorders and/or cognitive impairment
Study Focus:
Additional MRI sequence​
Study Procedures:
  • MRI
  • Clinical assessments

Study Frequency:
  • Visit and follow-up are related to standard of care

Special Requirements:
  • 18 y/o and older patient with neurodegenerative disorder from MDC and Memory clinic that requires an MRI in relation to standard of care

Study Name:
Dystonia Coalition
Study Focus:

To better understand symptoms of dystonia

Study Procedures:
  • Blood Samples
  • Questionnaires
  • Videotaping
Study Frequency:

1 Visit – usually at same time as BTX visit (prior to injection):

  • 1.5 hour

Special Requirements:
  • Dystonia diagnosis
  • 18+ years old with last botox 2+ months prior

Study Name:
Free-Viewing Eye Tracking
Study Focus:
Exploring eye movements as a novel biomarker for neurological disorders​
Study Procedures:
  • Questionnaires
  • Eye tracking
  • Clinical assessments

Study Frequency:
  • Single visit​


Special Requirements:
  • Current diagnosis of PSP, MSA, CBS, parkinsonism, dystonia, ataxia, tic disorder, functional movement disorder or other movement disorder

Study Name:
Musician’s Dystonia
Study Focus:

Studying connections between the cerebellum and parts of the brain for musicians


Study Procedures:
  • TMS(cTBS) Brain Stimulation
  • MRI

Study Frequency:
  • 2 visits
  • 2 hours
  • 3 months

Special Requirements:
  • Musician's Dystonia diagnosis
  • No pacemaker
  • No claustrophobia
Study Name:
Writer’s cramp
Study Focus:

Cortical plasticity in Focal hand dystonia before and after botox injection


Study Procedures:
  • TMS Brain Stimulation
  • Writing assessment

Study Frequency:
  • 4 visits
  • 4 hours
  • 3 months

Special Requirements:
  • Right hand writer's cramp diagnosis
  • Receiving benefit from botox injection

Study Name:
Biomarkers
Study Focus:

Biomarkers - To develop a test to diagnose different neurodegenerative diseases

Study Procedures:
  • Lumbar puncture
  • Skin biopsy
  • Blood and saliva
  • Questionnaires
Study Frequency:
  • 1-2 visits

Special Requirements:


Study Name:
Brain connectivity in Musician's Dystonia
Study Focus:

Studying connections between the cerebellum and parts of the brain for musicians (with or without dystonia)


Study Procedures:
  • TMS brain stimul​​ation
  • MRI
Study Frequency:
  • 2 visits
  • 3 hours
  • 3 months

Special Requirements:
  • Play a musical instrument that uses the hand our mouth
  • No cardiac pacemaker or metal implanted in body
  • No claustrophobia
Study Name:
Brain Plasticity in Parkinson's Disease
Study Focus:

Comparing brain activity of healthy individuals age matched to patients with PD with two non-invasive brain stimulation techniques


Study Procedures:
  • TMS brain stimulation
  • LIFUS ultrasound
  • MRI

Study Frequency:
  • 4 visits
  • 5 hours
  • 3 months

Special Requirements:
  • 45-80 years of age
  • No neurological disease or disorder
  • No psychiatric disease or disorder
  • Not taking medication that has a neurological effect
  • No cardiac pacemaker or metal implanted in body
Study Name:
Effect of Low-intensity Focused Ultrasound (LIFUS) and neurological drugs on Brain plasticity in Healthy Individuals
Study Focus:

To look at how LIFUS applied to the brain changes how the brain works, in relation to the known effects of four well-studied drugs with neurological effects


Study Procedures:
  • TMS brain stimulation
  • LIFUS ultrasound
Study Frequency:
  • 5 visits
  • 5 hours
  • 3 months

Special Requirements:
  • 18-65 years of age
  • No major neurological disease or disorder
  • No major psychiatric disease or disorder
  • Not taking medication that has a neurological effect
  • No cardiac pacemaker or metal implanted in body

Study Name:
Gait Adaptation
Study Focus:
By using a treadmill, researchers hope to learn more about the role of the cerebellum (a part of the brain) in different Neurological indications. The results could help develop new ways to assess brain function, find useful markers for diagnosis, and create better treatments to improve walking for people with these conditions.​
Study Procedures:
  • Walking analysis on a treadmill

Study Frequency:
  • 1 visit

Special Requirements:
  • Healthy individuals

Study Name:
Walking analysis on Split-belt Treadmill and gait mat
Study Focus:

To understand typical walking characteristics in the general population

Study Procedures:
  • Walking analysis on a treadmill
  • Walking analysis on gait mat

Study Frequency:
  • 1 visit

Special Requirements:
  • Healthy individuals

Study Name:
Chronos
Study Focus:

Use of Chronos programming software in ET patients who just received DBS.

Study Procedures:
  • Speech Analysis
  • Tremor Scale
  • Walking Analysis
Study Frequency:
  • Six visits

Special Requirements:
  • ET DBS candidates
​​
Study Name:
Free-Viewing Eye Tracking
Study Focus:
Exploring eye movements as a novel biomarker for neurological disorders
Study Procedures:
  • Questionnaires
  • Eye tracking
  • Clinical assessments

Study Frequency:
  • Single visit

Special Requirements:
  • Current diagnosis of PSP, MSA, CBS, parkinsonism, dystonia, ataxia, tic disorder, functional movement disorder or other movement disorder

Study Name:
Tremor Habituation
Study Focus:

To understand DBS loss of benefits in ET patients

Study Procedures:
  • In clinic assessments

Study Frequency:

One visit, 4-hours

Special Requirements:
  • Undergone DBS surgery for Essential Tremor
  • Experiencing DBS loss of benefits

Research Studies Glossary

Biomarkers – an indicator of the presence or severity of a disease.

DBS – Deep Brain Stimulation

ECG or EKG – Electrocardiogram checks how your heart is functioning by measuring the electrical activity of the heart.

EEG – Electroencephalography measures electrical activity of the brain with the electrodes placed along the scalp.

ET – Essential Tremor is a neurological condition that causes involuntary and rhythmic shaking.

LIFUS – Low intensity focused ultrasound.

MCI – Mild cognitive impairment, in which people have more memory problems than normal for people their age.

MRI – Magnetic Resonance Imaging uses magnetic fields and radio waves to create pictures of the anatomy and the processes of the body.

MSA – Multiple System Atrophy, a neurodegenerative disorder that can mimic Parkinson's.

PD – Parkinson's Disease, a neurodegenerative brain disorder that can lead to shaking, stiffness, and difficulty with walking, balance, and coordination.

PET – Positron Emission Tomography is a nuclear imaging technique to create 3D colour images to see how your body's cell are working.

Phase 2 clinical trial – Studies a drug's effectiveness and determines risks and side effects in people with a disease or condition.

Phase 3 clinical trial – Compares a drug to standard therapies for a disease or condition.

Placebo – Substances that are made to resemble drugs but do not contain an active drug, they are usually a starch or sugar.

PSP – Progressive Supranuclear Palsy is an uncommon brain disorder that affects movement, walking and balance, speech, swallowing, vision, mood, behaviour and thinking.

RBD – REM Behaviour Disorder occurs when you act out vivid dreams when you are asleep.

snOH – Symptomatic Neurogenic Orthostatic Hypotension is a drop in blood pressure when standing up, changing positions, or standing for a long period of time.

TMS – Transcranial magnetic stimulation is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain.​

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