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Neuroscience

Parkinson’s and Movement Disorders Center

Queen's
Neuroscience Institute
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The Queen’s Medical Center
Neuroscience Institute Outpatient Center
Physicians Office Building 3 (POB3)

550 South Beretania Street
Suite 503
Honolulu, Hawaii 96813

Phone:
808-691-8866

Fax: 
808-691-8865

Hours: 
Monday – Friday, 8am – 4:30pm

The Parkinson’s and Movement Disorders Center at The Queen’s Medical Center Neuroscience Institute provides a multi-disciplinary program dedicated to comprehensive diagnosis and treatment of movement disorders. We believe in a team-based approach, which includes highly trained movement specialists (neurosurgeons and neurologists), ancillary providers, and staff.

Parkinson's Foundation logo

Our Parkinson’s and Movement Disorders Center is Hawai‘i’s first and only Comprehensive Care Center that is accredited by the Parkinson’s Foundation and a part of their Global Care Network. The Parkinson’s Foundation recognizes medical facilities with specialized, multi-disciplinary teams that provide evidence-based PD care. Each center is required to meet rigorous care standards, professional training, community education, and outreach criteria.

Additionally, our Parkinson’s and Movement Disorders Center is one of 30 centers to carry the CurePSP Center of Care (CoC) distinction. The CurePSP CoC program is a network of specialized medical centers across the United States and Canada that enhances equitable access to accurate and early diagnosis, high-quality clinical care, and comprehensive support for progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and multiple system atrophy (MSA).

The Global Care Network and CurePSP Center of Care designations mean that patients in Hawai‘i do not have to travel to the mainland for advanced care for Parkinson’s disease and other movement disorders. We are able to provide all the services patients may need for the treatment of even the most complex movement disorders.

If you or your loved one is ready to explore treatment options for Parkinson’s and other movement disorders, contact the Queen’s Neuroscience department today at 808-691-8866.

What Are Movement Disorders?

Movement disorders include a wide range of neurological illnesses and conditions that affect the basal ganglia and movement circuit of the brain.

The best-known movement disorder is Parkinson’s disease, but there are many others:

  • Parkinson’s-like (Parkinson-plus) syndromes
  • Progressive supranuclear palsy (PSP)
  • Corticobasal ganglionic degeneration (CBGD)
  • Multiple system atrophy (MSA)
  • Drug-induced parkinsonism
  • Normal pressure hydrocephalus (NPH)
  • Huntington’s disease (HD)
  • Essential tremor (ET)
  • Dystonia
  • Tourette’s syndrome
  • Tardive Dyskinesia
  • Restless leg syndrome

Parkison’s and Movement Disorder Center Treatments and Services

The Queen’s Parkinson and Movement Disorder Center has the widest range of treatment for neurological movement disorders in Hawaii.

Our highly trained team of physical, occupational, and speech therapists work closely with community therapists to make appropriate referrals depending on your geographic location and treatment needs.

There are over 25 FDA-approved medications for Parkinson’s disease and other movement disorders.

But these medications can cause negative side effects. Dosages often need to be adjusted to help prevent complications. Medications for movement disorders also have a number of different delivery systems: tablets, capsules, dissolving tablets, skin patches, inhalers, subcutaneous injections, and dissolvable films.

For some patients with Parkinson’s and other movement disorders, it may be necessary to combine medications.

The complex medication management for your movement disorder is best handled by Queen’s neurologists who specialize in these disorders.

Botulinum toxin (botox) is a relaxant injected directly into your muscles. If you suffer from blepharospasm, hemifacial spasm, cervical dystonia, writer’s cramp and spastic hemiplegia, you will likely benefit from botox therapy.

Botox therapy is considered safe when performed by a doctor.

Duopa therapy is a continuous gel infusion of carbidopa/levodopa. Rather than taking a pill, dopamine is delivered through a tube into your intestine.

This therapy provides a smooth absorption of medicine and can reduce symptoms of motor fluctuations and dyskinesia if you have advanced Parkinson’s disease.

Deep Brain Stimulation Surgery

Deep Brain Stimulation (DBS) surgery is a procedure where a neurostimulation device (similar to a pacemaker) is implanted in your brain to deliver electrical pulses.

Electrodes are placed in specific areas of the brain in order to treat the symptoms of neurological movement disorders. Connected by non-invasive wires that travel under the skin and down the neck to a battery-operated stimulator under the collarbone, electrical pulses from your DBS device regulate and lessen abnormal movements associated with movement disorders.

DBS surgery was approved by the FDA for the treatment of essential tremor in 1997, and it was approved for Parkinson’s disease in 2002. Since 2002, Queen’s Parkison’s and Movement Disorder Center has been performing DBS surgery with great success.

Deep Brain Stimulation for Parkinson’s FAQ

  • DBS stands for Deep Brain Stimulation. It involves a surgical procedure that allows us to use electrical signals though electrodes in the brain to alter brain pathways and treat various symptoms of Parkinson’s Disease.
  • The surgery involves placing a thin, electrical lead into the brain, with the tip of the lead in a particular brain target (subthalamic nucleus or globus pallidus internus). The lead is then connected to a wire outside the skull and underneath the skin, which connects to a battery placed in the upper chest wall.
  • The battery continuously generates electricity that stimulates the brain tissue, and we can adjust the parameters of the electric signal to change its strength, location, and other features. The battery works like a “pacemaker” for the brain.
  • DBS is not a cure and will not change the underlying Parkinson’s disease.
  • DBS can treat several motor symptoms of PD, including:
    • Tremor
    • Slowness and stiffness
    • Dyskinesias and painful dystonias
    • Motor “on-off” fluctuations
  • DBS can allow us to lower the overall dosage of levodopa and other medications, which can also reduce the side effects and complications of medication therapy.
  • Most DBS candidates have moderate or advanced symptoms, have a history of good responsive to levodopa, and are either experiencing complications to medication, or not getting enough benefit from medications alone.
  • A good candidate should have good intellectual function, be healthy enough for surgery, and have reasonable day to day function. For example, someone who is working but has symptoms that put them on the verge of no longer working, may benefit from DBS and be able to work for longer.
  • A poor candidate may be someone with dementia, psychosis or other severe psychiatric symptoms, major medical problems that place them at high risk for surgery, unreasonable expectations, or severely disabled status. For example, someone who is wheelchair bound or in a nursing home would be unlikely to benefit from DBS.
  • Surgical complications:
    • There is a risk of bleeding, stroke, or infection (immediate or delayed).
    • Risk may be higher in patients with more complicated medical conditions, such as diabetes, hypertension, heart disease, or any condition requiring blood thinners.
  • Therapy side effects:
    • DBS can lead to worsening cognition or psychiatric symptoms.
    • At high parameters, DBS can also worsen speech or balance or lead to dyskinesias and dystonias. These effects are usually not permanent, but can limit the benefit of DBS.
  • Other important points:
    • DBS is a lifelong therapy and requires regular follow up and maintenance.
    • Patients will need battery replacements every 4-5 years (some batteries last longer depending on the model).
  • Step 1: Evaluation by DBS team
    • You will be seen and evaluated by each member of the multidisciplinary DBS team: movement disorders neurologist, neurosurgeon, neuropsychologist.
    • You will also undergo a detailed motor examination while on and off medications by the neurologist.
    • Multi-disciplinary team will meet to discuss each patient and make a decision regarding their candidacy for surgery.
  • Step 2: Surgery
    • Pre-operative visits and extensive education.
    • 2-step surgery: 1st surgery for the electrode placement in the brain (awake), 2nd surgery for the battery placement (under general anesthesia).
    • Easy recovery, typically with 1-night hospital stay, then discharge home.
  • Step 3: Initial and subsequent programming sessions
    • DBS is not turned “on” immediately after surgery, but is turned on during the 1st programming session, typically 2-4 weeks after surgery.
    • Some patients take some time and a few more sessions to receive symptom benefit. Maximal benefit of DBS is usually achieved within 4-6 months of surgery, although some patients may benefit from additional periodic programming sessions for years after their surgery.
    • Your neurologist may start to reduce medications in the first few months after surgery.
    • You should continue seeing your neurologist regularly for DBS battery checks and general maintenance for Parkinson’s disease. 

Robert Fitzgerald’s Story with Deep Brain Stimulation

Parkinson’s Research

The Parkinson’s and Movement Disorders Center at The Queen’s Health System Neuroscience Institute is engaged in cutting-edge research to better treat our patients.

Additionally, since 2001, we have hosted The Queen’s Movement Disorder Video Conference on a bimonthly basis. Partnering with movement disorder experts at the University of Virginia, we share our findings with people outside of Hawai’i.

TOPAZ

We are participating in the Trial of Parkinson’s and Zoledronic Acid (TOPAZ) to learn more about how to prevent fractures in those suffering from Parkinson’s.

Collaborating with researchers from such institutions as Duke University and the Parkinson’s Foundation, we seek to understand the effect of a single infusion of zoledronic acid-5 mg in preventing fractures.

Learn More about TOPAZ

Michael J. Fox Foundation Grant

Our research into racial and ethnic disparities in care for Parkinson’s among Asian American, Native Hawaiians, and Pacific Islanders will help ensure that these groups gain better access to high-quality care.

To facilitate this study, the Michael J. Fox Foundation recently awarded the Queen’s Parkinson’s and Movement Disorder Center a $387,000 grant.

Read About the Grant

Education

In partnership with Hawai’i Parkinson Association, our Center received a Hawai’i State grant to start a Movement Disorder Fellowship in 2023. We believe in educating the next generation of neurologists to become experts in assessment and treatment of movement disorders.

Patient Support and Outreach

We strongly believe in self-empowerment. Exercise and lifestyle are the most important therapies for Parkinson’s disease. It allows patients to maintain the highest level of function possible. We highly encourage the discussion of lifestyle (diet, sleep, and bowel habit) and exercise during visits as we tailor individualized programs.

Through collaboration with various organizations and coordination of care through Queen’s Clinically Integrate Physician Network (QCIPN) and Queen’s Geriatric Services, our goal is to help patients achieve the best quality of life while living with Parkinson’s disease or other movement disorders.

Some of our collaborative efforts include:

  • Hawai‘i Parkinson Association
  • Deep brain stimulation support groups and other support groups
  • The Annual Parkinson’s Symposium
  • The Annual Parkinson’s Walk
  • Various other community resources

And coordination of care through Queen’s Clinically Integrated Physician Network (QCIPN) and Queen’s Geriatric Services, our goal is to help patients achieve the best quality of life while living with Parkinson’s disease or other movement disorders.

A Guide For Parkinson's Disease
Frequently Asked Questions Guide

Have questions about Parkinson’s? Download this FREE guide from the Parkinson’s Foundation. 

Download

Meet our Parkinson's and Movement Disorders Center Team

View All Neuroscience Providers
Michiko Bruno, MD
(Medical Director)
Fay Gao, MD
Michon Morita, MD
Tracie Umaki, PsyD
Kyle Lumsden, APRN
Katie Wongthipkongka, PT, DPT, NCS
Erin Uehara, PT, DPT
Kari-Lyn Whitaker, OTR, OL
Joanne Kawahigashi Oshiro, M.S., CCC-SLP
Brittney Taoka, RN
(Center Coordinator)
Emma Krening, BS
(Research Coordinator)

Parkinson’s Foundation

Davis Phinney Foundation for Parkinson’s

The Michael J. Fox Foundation

Hawai‘i’s Best Hospital for Parkinson’s and Movement Disorder Treatment

If you or a loved one has Parkinson’s or another movement disorder, you are not alone. One of the major misconceptions about Parkinson’s is that it is hopeless.

With the right medication, exercise, and lifestyle, along with possible surgical interventions, you can live a full, rich life with Parkinson’s or any other neurological movement disorder.

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