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RESEARCH PROGRAMS |
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| The CASE Department of
Neurology has active clinical, basic, and translational
research programs in wide ranging disciplines of
neuroscience from application of electrophysiological
approaches to diagnosis of neuromuscular diseases to
functional electrical stimulation for rehabilitation of
stroke to development of novel therapeutic approaches
for Tay-Sachs and myasthenia gravis to genomic analysis
of the pathophysiology of muscular dystrophies. The
Brain Attack and
Neurointensive Care teams
are involved in ongoing studies to optimize use of
thrombolysis in acute stroke, post-stroke critical care,
and application of neuroprotective agents to acute
infarction. The
Movement Disorder team recently
applied surgical therapy for the first time in history
to an individual with Tourette’s syndrome and now is
planning a formal clinical trial of its general
applicability. CASE faculty with their residents were
among the first to characterize the clinical and
electrophysiogical findings of West Nile Disease. The
scientists of the
Memory & Aging Center were the
first to appreciate cell cycle arrest as a mechanism of
neuronal degeneration in Alzheimer’s disease. |
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A patient uses the Functional Neural Stimulation system
during ambulation on a treadmill. The FNS-IM system
simulator, battery belt, and finger switch are shown.
Investigator: Janis Daly, PhD
of the Cleveland VA Medical Center. |
| The success of the Department
may be measured in several ways. One is the ability of
its members’ ability to obtain research funding. In
2003, the Departments scientists received over 8 million
dollars of National Institutes of Health funding placing
the Department 13th among academic neurology programs.
Department members add over 2 million dollars in grant
support through the Department of Veterans Affairs. The
Faculty receives funds from numerous corporations,
associations, and foundations such as the Muscular
Dystrophy Association, the Mount Sinai Foundation,
Phillip Morris, and the Alzheimer’s Association. Every
year the neurology faculty publishes over 100
peer-reviewed publications and presents their work at
national and international meetings. Several faculty
serve on scientific review committees of the Departments
of Veterans Affairs and Defense as well as private
foundations and the NIH. |
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Among the world’s leading Centers in study of eye
movement, CASE investigators, based at the Cleveland
VAMC utilize sophisticated techniques ranging from
genomic analysis to recording of eye movements in
rodents. In 2001 Cleveland hosted its only New York
Academy of Sciences meeting, which was dedicated to eye
movement. |
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Graph shows comparison of gene
expression in extraocular muscle to limb and jaw muscles |
| Trainees at all levels add to the
vitality of the Department’s research efforts and have
been highly successful. Past residents and fellows have
won prestigious awards from the American Academy of
Neurology (Osama Zaidat, the Founder’s Award, Arthur
Dick, the Weir Mitchell Award). For many years, CASE
neurology residents have been selected to receive travel
awards to the American Neurological Association. Medical
students have received summer or travel fellowships from
the Myasthenia Gravis Foundation, American Heart
Association, and the American Neurological Association.
The Department faculty also trains graduate students and
post-doctoral fellows in their laboratories, and the
Department is one of the few in Neurology that hosts an
NIH-funded training program for that purpose. |
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Immunocytochemistry reveals the expression of various
cell cycle proteins in pyramidal neurons of the
hippocampus. CASE Memory & Aging
Center |
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| Cerebrovascular studies range
from basic studies of the role PPAR-gamma (Sophia Sundararajan), and neuronal injury to human clinical
trials, including novel investigations of albumin,
thrombolytics, and neural protection.
Faculty in the Department of Neurology are involved in a
broad range of research activity. Active laboratories
are present at three sites: School of Medicine,
University Hospitals of Cleveland (including the
Fairhill Center for the Elderly), and the Cleveland Veterans
Affairs Medical Center. In addition to clinical and
basic neuroscience research activities within the
Department of Neurology, there are over 40 laboratories
in the University involved in neuroscience research. One
may read below about the many different individual
faculty research efforts.
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Basic Science |
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CLINICAL |
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Autonomic Function
Dr. Thomas Chelimsky
has assembled a clinical laboratory able to carry
out a wide range of tests evaluating autonomic function
in humans. His central interests now are in the
evaluation of syncope and in the evaluation of autonomic
dysfunction associated with reflex sympathetic
dystrophy. |
Cerebrovascular
Disease
The University Hospitals Cerebrovascular Center is a
joint effort of the Departments of Neurology,
Neurological Surgery, and Radiology (Neuroradiology).
The group has established clinical protocols for rapid
diagnosis and intervention in acute stroke, including
the use of thrombolytic agents. The Center has initiated
an innovative program for pre-hospital care in acute
stroke, and has embarked on clinical research involving
neuroprotective agents, supported by grants from
pharmaceutical companies. This clinical research is
carried out in close coordination with the basic
research laboratories in the Departments of Neurology (LaManna,
Sundararajan) and
Neurological Surgery. |
Dementia
 The Memory and Aging Center of University Hospitals
(formerly the Alzheimer Center), directed by
Dr. Alan Lerner conducts a broad range of epidemiological,
behavioral, and pharmacological studies of dementing
illnesses. The core of this program is an NIA Center
grant, supporting an Alzheimer’s Disease Research
Center. In addition, the Center is studying several
pharmacological agents as therapeutic tools for control
of behavior in demented individuals, or amelioration of
the dementia. These basic and patient-based research
programs are supported by NIH grants, Foundation grants
and by pharmaceutical corporations.
The Laboratory of Neurogeriatrics, directed by
Dr. Robert Friedland,
is conducting a large Case Control Study in
collaboration with the Memory and Aging Center, to
examine environmental factors that may influence the
development of dementia. This work is supported
principally by a grant from the Phillip Morris
Corporation.
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Neuromuscular
Disorders
The Neuromuscular division is actively involved with
clinical treatment trials of peripheral neuropathy. In
addition, Dr. Barbara Shapiro
heads a large clinical trial in
the treatment of late onset Tay-Sachs disease. Several members of the
Division actively publish on various novel electrodiagnostic techniques and new aspects of clinical
neuromuscular disorders. |
Ocular Control
Three closely coordinated laboratories have studied
control of extraocular movements in patients, headed by
Dr. R. John Leigh,
Dr. John Stahl, and
Dr. Louis Dell’Osso.
These laboratories have attained nationally and
internationally recognized expertise in the clinical and
laboratory evaluation of patients with abnormalities of
eye movements. Extramural support includes funding from
the NIH and the VA. |
Rehabilitation
Cleveland boasts the largest and most successful program
in functional electrical stimulation, led by Dr. Hunter
Peckham and carried out at several institutions.
Dr. Robert Ruff provides
neurological expertise to the group, and is working on
the use of functional electrical stimulation to improve
recovery after ischemic stroke. He is joined at the VAMC
by Dr. Janis Daly, who also directs large-scale NIH-funded
studies of recovery after stroke and other neurological
injuries.
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BASIC NEUROSCIENCE
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Cerebral
Blood Flow and Metabolism
Dr. Joseph LaManna has
established an effective and nationally recognized
research program in cerebral metabolism, together with
his colleagues Dr. David Lust and Dr. Warren Selman in
the Department of Neurological Surgery. The collegial
interactions with individuals in the Department of
Neurological Surgery and the success of the individual
investigators has recently led to new efforts in
developing clinical investigative arms. The laboratories
are supported by grants from the NIH.
After having completed clinical fellowship training
in stroke here, Dr.
Sophia Sundararajan has established a NIH-funded
laboratory dealing with gene expression and the
inflammatory response in ischemic brain tissue. |
Neurogeriatrics
Dr. Robert Friedland
leads the
Neurogeriatrics
Laboratory,a team conducting a broad range of studies,
including nicotine binding in normal and demented
patients using positron emission tomography, and studies
of the distribution of a monoclonal antibody injected
into patients with dementing illnesses, detected with
SPECT. This work is supported by a grant from the
Phillips Morris Company. |
Neuromuscular
Function
Dr. Robert Ruff is
interested in the biophysics of voltage-grated channels
in muscle membrane, and uses an array of sophisticated
electrophysiological methods such as patch clamping. |
Ocular Function
Dr. John Stahl works on
the neural circuitry controlling gaze and the function
of extraocular muscles. He has developed a unique
facility for video monitoring of eye movements in
rodents, and has exploited this resource in his studies
of various transgenic mice. |
