Dr. Oury Monchi


In this edition we speak with Dr. Oury Monchi.  Dr. Monchi is the Clinical Research Director for the Department of Clinical Neurosciences, and the Research Director of the Movement Disorders Program for the department, the Hotchkiss Brain Institute and the Cumming School of Medicine. He is also the Tourmaline Oil Chair in Parkinson’s disease. Dr. Oury Monchi has been appointed Professor (with tenure) in the departments of Clinical Neurosciences and Radiology, and at the Hotchkiss Brain Institute. 

Dr. Monchi obtained his Ph.D. in Computational Neuroscience at King’s College London, University of London, UK. He then pursued a postdoctoral fellowship at the Montreal Neurological Institute and at the Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal in neuroimaging and cognitive neuroscience applied to Parkinson’s disease.


Parkinson Association of Alberta (PAA):  Why did you choose to pursue research from a Parkinson’s perspective?


Dr. Ouri Monchi (DOM):  During my PhD, I was modeling circuits that are affected in Parkinson disease and also in schizophrenia, but in different ways.  I received a post-doctoral opportunity at the Montreal Neurological Institute where it was much easier to study Parkinson’s patients, so I decided to go fully into Parkinson’s research.


PAA:  What is the current research question that you are trying to address?

DOM:  We are trying to find sub-types of patients that will evolve cognitively differently with the main aim to identify early on those who are more likely to develop dementia and try to slow down the process.

PAA: What made you focus on that aspect or ask yourself that research question?

DOM: It’s an important question as Parkinson disease is possibly the second cause of neurodegenerative dementia after Alzheimer’s disease and we are finding now that the cognitive and psychiatric system, or at least the non-motor symptoms in general, affect the quality of life of a person with Parkinson disease as the motor symptoms do.


PAA: I think that is very true. We often hear from our clients across the province that it is often easier to deal with the motor symptoms, than the non-motor symptoms; especially the cognitive ones.

DOM: Unfortunately we don’t have much in terms of medications to deal with this issue.  We are trying more or less the same types of medications that have been used in Alzheimer’s; so in my research we are looking into some non-medication approaches.


PAA: What type of non-medication approaches?

DOM: This includes Transcranial Magnetic Stimulation (a noninvasive procedure that uses magnetic fields to stimulate small regions in the brain to improve symptoms of depression) and studying the effect of physical and mental training.  For example there is a study involving dance that we would like to start.  We also have a collaboration in Montreal where we are doing visuospatial cognitive training to see if it can help slow down the process.


PAA: What is visuospatial cognitive training?

DOM:  Visuospatial cognition enables people to perceive and interact with the visual world.  It includes everyday skills, for instance the ability to reach for and grasp an object or recognize and/or locate a familiar object, complete puzzles, etc.  From a training perspective it’s a specific task where, for example, you receive a tennis ball in three dimensions and you are asked to follow two or three of them as they keep moving.  In the end, you have to say where they are at.


PAA:  In your research do you work with a broad range of ages of people with Parkinson’s?  Or do you stick to a certain sub-set of age ranges like young onset?

DOM:   Most of my studies have been on people with idiopathic Parkinson disease or maybe some medical cases, but not young onset.  As a general rule, young onset Parkinson’s patients do not develop dementia for a very long time.

PAA: So then are you seeing that Parkinson’s related dementia happens further down the road in a diagnosis?

DOM:  Traditionally Parkinson’s dementia is thought to occur after at least five years of motor disorders; but what we are finding is that everything in between also exists.  It’s a very good question and one that we are trying to address in our research.

Having said that, it is more likely to occur after a while.  It is not going to happen directly, but it does correlate with age.  What our research is trying to understand is how much similarity there is between cognitive deficits of the prodromal stages of other dementia such as Alzheimer’s and those observed in the complex of Parkinson disease.

PAA: In the five and a half years since I’ve been with Parkinson Association of Alberta I’ve seen clients who are going through both physical and cognitive changes.  Does cognitive impairment always mean there will be dementia or could a person just experience some mild cognitive impairment and it stops there? And also you can have Parkinson’s and still get Alzheimer’s right?

DOM: Unfortunately it doesn’t necessarily stop there; we know that if you have mild cognitive impairment, you are much more likely to develop dementia—it is a possibility.  Part of what our research is looking into is this very idea, Parkinson’s dementia can occur for different reasons.

PAA:  And also you can have Parkinson’s and still get Alzheimer’s right?

DOM:  Good question. This is part of what we are studying as well. And while this is my own belief, I do think that it is accepted by many of my colleagues, and this is Parkinson’s dementia can occur for different reasons. 

In some patients it may be a neurodegenerative process link to Parkinson’s that is going faster than the average and affecting more regions of the brain.  In other patients, they may be concurrently developing at the molecular level pathophysiological processes that are close to Alzheimer’s dementia type.  Part of our study is trying to see if we can differentiate between those.

PAA: Alzheimer’s is not the same as Parkinson’s dementia correct?

DOM: It is not the same, but it is possible that having the neurodegenerative disease may increase your chance of starting another neurodegenerative process, not necessarily having the whole disease.

PAA: Any words of advice you would like to share with our readers?

DOM: Get engaged in research and fight to be as active mentally and physically as you can.  This doesn’t mean running a marathon or solving physics equations; it just means staying as active as you can on both of those fronts.


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