In Context

www.thelancet.com/neurology Vol 10 November 2011 955

Jon Stoessl is a formidable fi gure in neurology—in 2007, he was named as a Member of the Order of Canada in recognition of his vast corpus of work, including a seminal study on the placebo response in Parkinson’s disease (PD) that had rami-fi cations far beyond his specialty of move ment disorders. And yet, paradoxically, remarks Ariel Deutch (Vanderbilt University Medical Center, Nashville, TN, USA) fondly, “he is not at all formidable: he is eminently approachable and typically relaxed, and indeed can seem mildly discombobulated”.

Any discombobulation could have been forgiven on the day The Lancet Neurology spoke to Stoessl at 6 am, before the sun had risen over Vancouver, where he is Director of the Pacifi c Parkinson’s Research Centre and National Parkinson Foundation Centre of Excellence and head of Neurology at the University of British Columbia (UBC). But he was already wide awake and surprisingly relaxed despite a late night editing the proofs for this issue’s Review of imaging in PD. “I normally get up this early, sometimes earlier”, he says cheerily—a sign of the prodigious work ethic Stoessl inherited from his father, of whom he is very proud. A refugee from Austria, Stoessl’s father arrived in England in 1939 at the age of 15 years, and trained at night school at the same time as working as a labourer. After getting his PhD in organic chemistry, he was then off ered a position in Canada when Stoessl was 4 years old, and the family swapped the hustle and bustle of London England for the relative tranquility of London Ontario in 1960.

Any traces of an English accent disappeared long ago to be replaced by Stoessl’s slow and gentle Canadian lilt, although his speech quickens noticeably when he remembers the moment he fi rst got hooked on neurology. He was studying combined physiology and psychology before medical school, and each week had to read the key papers in behavioural neuroscience. “There are a couple that I still remember reading”, he recalls enthusiastically, “one of which was Wilder Penfi eld describing his fi ndings in the operating room as he was stimulating the brain in preparation for surgery for epilepsy, and his descriptions were so intriguing it was like an epiphany to me, really. I still remember it vividly now, nearly 40 years on”.

Besotted as he was with the brain, Stoessl kept an open mind about choosing a specialty during medical school at the University of Western Ontario in London. So open, in fact, that his involvement in Amnesty International threatened to distract him from more academic pursuits. “There are a lot of interesting things that one comes into contact with along the way”, he says, “but I’ve always returned to neurology”. In 1979, armed with his MD, he returned to the University of Western Ontario for specialty training in neurology alongside Alastair Buchan (now Dean of the Medical School at the University of

Oxford in the UK) among others, in a department presided over by the great Canadian physician Henry Barnett.

“I think one of the things I’ve been very fortunate with through my career is that I’ve trained with real giants”, says Stoessl, “and it does have an impact because you really feel that you have some kind of a standard to live up to, even if you can’t quite make it to theirs”, he adds, with characteristic modesty. From Henry Barnett and Murray Barr during his residency, Donald Calne at Vancouver for his subspecialty train ing in movement disorders, where he fi rst became in volved with PET, to Leslie and Susan Iversen during a Canadian Medical-Research-Council-funded fellow ship at Merck Sharp and Dohme Neuroscience Research Centre in Harlow near London in the UK, Stoessl has trained with the best.

Stoessl speaks especially fondly of his 2 years in the UK in the late 1980s. Although an industry facility, the Neuroscience Research Centre “was actually a very academically free environ ment”, he says. Close cooperation between diff erent disciplines made the centre “a very interesting model of a place to work” says Stoessl, and fostering this kind of collaboration is exactly what the recently announced Centre for Brain Health at UBC is all about. Having been closely involved with planning the facility over the past 3 years, Stoessl is evangelical about the benefi ts of bringing together neurology, psychiatry, and translational neuroscience under one roof.

The ground-breaking ceremony for the new centre takes place as this issue goes to press, but it is breaking ground of a diff erent kind for which Stoessl is best known. In 2001, having taken up a professorship at UBC, Stoessl co-authored a paper showing that the placebo response to dopaminomimetic treatments for PD might be due to the anticipation of a benefi t. “Personally, I have not been to a movement disorder meeting where his papers on the role of placebo in PD have not been quoted”, says Antonio Strafella, of the University of Toronto. Although doing less work on placebo responses now, “I’m still asked to speak about the placebo eff ect, and that’s always a very fun topic because people have a general interest and it applies to areas outside of Parkinson’s”, Stoessl says.

One of the benefi ts of working in PD is the patients themselves, says Stoessl, because “they see themselves as part of the solution”. In 2013 Stoessl will co-chair with Stanley Fahn the third World Parkinson’s Congress in October 2013, one of the few scientifi c meetings to actively encourage attendance by patients and care givers. “It’s really something I’ve become quite excited about”, he says, and with Stoessl on board it is bound to be a success.

David Holmes

Profi leJon Stoessl: besotted with the brain

See Review page 987

For the study on placebo response see Science 2001; 293: 1164–66