Emory’s Movement Disorders Program has led clinical trials for therapies pertaining to Parkinson’s disease, dystonia, essential tremor, and Huntington’s disease. For its research and clinical care in the areas of Parkinson’s disease, Huntington’s disease, and Lewy Body dementia, the program has been designated a Center of Excellence. Emory’s Movement Disorders Program is one of the foremost treatment and research centers for a broad spectrum of movement disorders, including dystonia, essential tremor (ET), Huntington's disease (HD), Parkinson's disease (PD), and Tourette's syndrome (TS). The program provides clinical evaluation and comprehensive care for more than 6,000 patients per year, nearly 50% of which suffer from parkinsonism. The program’s partnership with Emory’s Department of Neurosurgery makes it one of the largest functional neurosurgery programs in the US for these disorders.
Laboratory
A large space with desks accommodates 3 fellows in the Movement Disorders Program, the program’s video database library, and a 620-square foot motion capture lab. The motion capture room measures 19 x 32 ft with a 9-foot ceiling. The capture area measures 10 x 15 ft. The motion capture system is from Motion Analysis Corporation and includes 14 Osprey cameras with a resolution of 640 x 480. These cameras capture data at a rate of 120 frames per second. Eight are located near the ceiling and the remaining six are at waist height. The software is the latest version of Motion Analysis’ Cortex software version 7.2.6.1828. There are two computer stations within the lab for data collection and analysis. Overlapping fields of view of the IR-DVCs define the 150 m³ capture space. The motion capture system is capable of triangulating and recording, in real-time, the instantaneous 3-D coordinates of each IR reflective spatial marker attached to the subject’s skin or clothing prior to motor testing. We use an array of 60 of these spatial markers applied to a standardized set of bony landmarks (augmented Helen Hayes Full Body Marker Set). Each marker is an IR-reflective sphere with a diameter of either 12 mm for upper body placements or 19 mm for placements on the lower extremities. Each marker includes an attachment disk of comparable size. The markers are attached to the subject with medical-grade, disposable, double-stick adhesive disks. Marker coordinates are computed in real-time from the synchronized video recordings. Regardless of marker size, the motion capture system records the synchronous location of each marker’s spatial centroid at 120 Hz (frames/s), with calibrated error of < 0.7 mm in all 3 dimensions. Each marker is identified and tracked in real-time by matching its relative location within the moving cloud of 60 markers to a topological template of the subject’s own marker-clad body recorded immediately prior to motion testing. In this lab is also a gait mat, which is used to assess gait during clinic visits. The buidling at 12 Executive Park also includes a clinical laboratory and a touchdown room for clinicians, residents, and students.
Clinical
The Movement Disorders Clinic is on the 5th floor of 12 Executive Park, where it maintains 15,000 square feet of dedicated space. The program also maintains space on this floor for the administrative center of Deep Brain Stimulation, which includes space for two nurse practitioners. The movement-disorder space maintains 14 exam rooms. Four of these exam rooms are dedicated exclusively to research. The clinic maintains a nurse’s station with four 4 clinic nurses and a triage room. The patient reception area is large, approximately 600 square feet, and windowed. Within the building is an infusion center and physical, occupational, and speech therapy space on the fourth floor, along with the sleep lab and clinic and the office of the movement disorders social worker.
Office
The first floor features an educational suite for all residents, fellows, medical students, graduate students in the Brain Health Initiative, and this is where the movement disorders program has its biweekly case conferences, journal club, and deep brain stimulation case conferences. Three dedicated conference rooms suitable for team meetings and conferences are available on the 5th floor.
Other
Central Coordinating Center for Dystonia Coalition
Emory’s Movement Disorders Program serves as the Central Coordinating Center for the Dystonia Coalition (DC), a multinational consortium of academic centers that have special interest in dystonia research. As the Central Coordinating Center, Emory’s Movement Disorders Program encourages collaboration among 58 sites across North America, Europe, Asia, and Australia, facilitating an international consensus for the definition and classification of all dystonias. The coordinating center supervises the conduct and progress of dystonia’s main clinical research projects, its smaller pilot projects, and its career awards. The center also supervises the DC’s annual meeting and supports training webinars for recruiting sites. These webinars address protocol details such as recruitment goals, participant eligibility, inclusion/exclusion criteria, forms/questionnaires, data entry, and reimbursements. The central coordinating center also manages the financial aspects of paying other centers for specific activities. It uses a direct subcontract to reimburse sites for the effort it takes to manage large clinical research projects.
Deep Brain Stimulation Program
Emory University in Atlanta, Georgia, is one of the oldest and largest centers in the U.S. providing deep brain stimulation (DBS) surgery for treatment of movement disorders such as Parkinson’s disease, tremor and dystonia. Emory DBS clinical team is composed of 7 neurologists, 1 nurse practitioner, 3 neurosurgeons, a neurophysiologist, 2 neuropsychologists, and a psychiatry nurse practitioner. This team performs close to 100 implantations annually.
American Parkinson Disease Association (APDA) Center for Advanced Research
One of nine such centers in the country, Emory University home to an American Parkinson Disease Association (APDA) Center for Advanced Research. The Center is directed by Thomas Wichmann, MD, along with a comprehensive team of experts, and it supports a large research program, which includes numerous laboratory scientists (graduate students and PhDs) and practicing physicians (MDs, DOs) who work together to conduct research that will uncover the causes of PD or discover new or improved treatments for PD symptoms and signs. Projects range from pre-clinical research including studies on drug development, studies on brain circuit mechanisms underlying PD symptoms, to clinical research that directly involves patients.