• NIMHANS, Hosur Road, Bangalore, India – 560029

Brief history of movement disorders at NIMHANS

The NIMHANS Parkinson Disease and Movement Disorders Subspeciality (PDMDS) provides state of the art clinical services, manpower development and research in Movement Disorders (MD).  While this subspeciality has grown phenomenally over the past two decades, the foundation stone was probably laid by Prof. Raja Martanda Varma who joined the All India Institute of Mental Health (AIIMH) in 1958 as the first neurosurgeon and started the Department of Neurosurgery.  A year earlier, Dr. KS Mani started the Department of Clinical Neurology with the aid of the WHO experts.  Dr. Varma is credited to have started a unique percutaneous chemothalamotomy for patients with Parkinsonism tremors and movement disorders.  This method, later known as Varma’s Technique, could be completed under local anesthesia within 20 min.  Using his stereotaxy skills based on X-rays, he used the percutaneous skull base approach to Meckel’s cave to reach the thalamus and chemically ablate it.

While Prof. HS Swamy (1974-2001) had special interest in Wilson’s disease and offered dedicated services to these patients, the first organized speciality service in Movement Disorders at NIMHANS was started by Dr. Uday Muthane in 1994.  Dr. Muthane joined as an Assistant Professor in Neurology, after being trained as a Fellow in Movement Disorders at the Columbia Presbyterian Medical Center, USA (with Prof. Stanley Fahn).  He was the recipient of several research grants including “Is there a difference in the nigral numbers between different ethnicities?” from the Parkinson’s Disease Foundation, New York USA, and “The clonidine‑growth hormone stimulation test, and its comparison with standard autonomic testing, in the early diagnosis of Parkinson’s disease and multiple system atrophy” from the Wellcome Trust, London, UK. The latter grant helped in establishing the “Autonomic Function Laboratory” of the Neurology Department.  Dr. Muthane also worked extensively on the genetics of Parkinson’s disease, Huntington’s disease and other degenerative disorders.  Dr. Muthane’s strong belief in the critical role of brain banking in Parkinson’s disease research ensured that he enrolled some of the first patients for brain donation in the then newly commenced Human Brain Tissue Repository at NIMHANS.

In 2000, Dr. Pramod Kumar Pal joined NIMHANS as an Assistant Professor in Neurology, after his clinical fellowship with Prof. Donald Calne at the Neurodegenerative Disorders Centre, Vancouver, Canada (1997‑1999). Later, he obtained further expertise in Human Motor Physiology and Transcranial Magnetic Stimulation during clinical fellowship at Toronto Western Hospital, Toronto, Canada (2002‑2003), which helped him to set up the Human Motor Physiology laboratory in Neurology Department.  Together with Dr. Uday Muthane, he strengthened the MD program at NIMHANS.  Dr. Muthane resigned in 2008. In the same year Dr. Ravi Yadav who completed his DM training with Prof. Madhuri Behari at AIIMS, New Delhi joined NIMHANS as an Assistant Professor in Neurology. His deep interest towards the Movement disorders had been initiated by Prof. Behari.   His dedicated interest in MD helped Dr. Pal to further consolidate the PDMDS and in the year 2009 the NIMHANS Parkinson’s Disease and Movement Disorders Clinic (PDMD clinic) was started.  Dr. Dwarakanath Srinivas, a neurosurgeon who joined in 2007, spearheaded the functional neurosurgical treatments (lesional and deep brain stimulation) for Parkinson’s disease, tremor and dystonia.  More recently the PDMDS was further strengthened by joining of Dr. Nitish Kamble (2017) with a special interest in Motor Physiology and Dr. Vikram Holla (2019) with an interest in Genetics.  In addition, several faculty of the Dept. of Neurology continue collaboration, including Dr. M Netravathi (immune and infection related MDs), Dr. Rohan Mahale (sleep and MD) and Dr. M Pooja (Yoga in MD).

As a part of commitment for training and manpower development in Movement Disorders, the PDMDS started the postdoctoral fellowship program (PDF) in Movement Disorders in 2012.  At the same time, several PhD students and DM residents in Neurology were offered training and research topics for their dissertations in Movement Disorders.

Over years, the PDMDS developed rich collaborations with other specialities at NIMHANS including neurosurgery, neuroimaging, psychiatry, clinical psychology, psychiatric social work, physiotherapy and rehabilitation, genetics, neurochemistry, neuropathology, speech pathology, etc.  Outside NIMHANS, PDMDS continues to have research collaborations with the Institute of Genomics and Integrative Biology (CSIR-IGIB, Delhi), Indian Institute of Science (Bangalore), Institute of Bioinformatics (Bangalore), Symbiosis Center for Medical Image Analysis, (Pune) and Centre for Genetic Epidemiology, Tubingen, Germany.  Apart from strengthening multidisciplinary care for the patients, these collaborations have fostered training of students, research and publications.

PDMDS is actively involved in imparting service and conducting educational activities in MD outside NIMHANS.  Over the past 2 decades, PDMDS is working with the Parkinson’s Disease Society of Karnataka (PDSK), a PD support Group, to render better services to the patients with Parkinson’s Disease in the community.  In collaboration with the World Federation of Neurology (WFN) and Association of Parkinsonism and Related Disorders (IAPRD), PDMDS conducted the first Teaching Course in Movement Disorders (TCMD) for students and young neurologists in 2010 and later in 2012 at Goa.  Finally in 2014, Dr. Pal and Dr. Yadav played a significant role in the conceptualization and formation of the Movement Disorders Society of India (MDSI), which is the premier National body for educational activities in Movement Disorders in India. Dr. Pal has also been instrumental in the development of Annals of Movement Disorders, the Official Journal of the MDSI.  The first issue of which was published in December 2018.

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