2015

Message from the Chair

I am very pleased to be able to bring you up to date on funding ($10 million NIH)—a figure that doesn’t include the Michigan . Since the last edition of this newsletter recently awarded Udall (Parkinson’s) Center grant and the that was published in winter 2012, our department has Sudden Unexpected Death in Epilepsy (SUDEP) Center continued to grow. We now have 61 physician faculty, Without Walls grant highlighted in this issue. 18 residents and more than 20 post-residency trainees Having completed 10 years as chair, I am more aware than in subspecialties ranging from stroke and sleep to sports ever that a department is not a static entity, but a continuously neurology. evolving functional unit. With the formal installation of The growth in faculty is reflected in clinical activity. Last Hiroko Dodge, Ph.D. as the first Kevreson Research Professor year our faculty saw nearly 40,000 outpatient visits—almost this spring, we will have 14 endowed professorships that twice the number of patient visits recorded in 2007—and recognize the accomplishments of our more senior faculty, activity in all of the related laboratories including EMG, and 10 assistant professors with NIH-funded K (mentored EEG and the 28-bed sleep lab increased commensurately. career development) awards that recognize promise for the In the research arena, our faculty has continued to be future leaders of the field. These 24 faculty are only part of very successful, even in the face of a challenging funding our group of clinicians, educators and researchers. In an environment. In the 2013-2014 academic year, Neurology uncertain and rapidly changing environment, Michigan faculty published 291 articles in peer-reviewed journals Neurology is ready to face the future with optimism! and secured more than $17 million in external grant

Endowed Bottom row (left to right): Hank Paulson, Groff Professor; Eva Feldman, DeJong Professor; David Fink, Brear Professor; Ann Little, Albers Collegiate Professor. Top row (left to right): Ben Segal, Holtom-Garrett Professor; Roger Albin, Professors Young Collegiate Professor; Bill Dauer, Levine Professor; Brian Callaghan, Dush Professor; Peter Todd, Harris Professor; Judy Heidebrink, O’Connor Professor; Kelvin Chou, Brown Professor; Ron Chervin, Aldrich Collegiate Professor Hiroko Dodge to be Installed as the Lakritz Gift Jump Starts Program First Kevreson Research Professor to Study Chorea Acanthocytosis This spring we will celebrate the establishment of the Kevreson Research Professorship with This October, a generous $1.1 million dollar gift from Bill and Liz Lakritz established a multidisciplinary the installation of Hiroko Dodge, Ph.D. as the first Kevreson Research Professor. research effort focused on chorea acanthocytosis and related neurodegenerative disorders.

Dr. Dodge is an internationally known expert in Alzheimer’s disease. She has active research Chorea acanthocytosis is a rare inherited neurodegenerative disease that disrupts programs in dementia prevention, in distinguishing normal cognitive aging from pathological many aspects of movement and thinking, in addition to causing epilepsy. The cause cognitive decline, and in applying demographic methods to clinical studies including cross- of the disease is a mutation in the gene coding for VPS13a, a protein essential for national comparative studies of healthy cognitive aging in collaboration with researchers of normal trafficking of proteins in neurons. Bill Dauer, Elinor Levine Professor, will the Okinawa Centenarian Study. direct the effort. Robert Fuller, Ph.D., professor of biological chemistry in LS&A, Since joining the Michigan Alzheimer Disease Center (MADC) team Dr. Dodge has taken an whose lab first identified VPS13a in 1997, will pursue fundamental studies of active role in the data management, improving data collection and distribution, and fostering VPS13a function in yeast. Dr. Dauer’s lab will create and study a mouse model collaboration among the MADC investigators. Dr. Dodge has more than 75 publications of the chorea acanthocytosis. In complementary studies, Jack Parent, professor of and is regularly invited to give seminars and presentations in Japanese universities, as well neurology and co-director of the epilepsy program, will use skin cells from as international conferences. She is also involved with an extensive network of dementia patients with the disease to create -derived neurons in order to study researchers worldwide. their functional properties.

On the national level, Dr. Dodge served on the Scientific Review Committee for the National This is the first such multidisciplinary research team ever assembled to study Alzheimer’s Coordinating Center (NACC), and currently serves as a member on the NACC chorea acanthocytosis, and the team’s efforts will synergize with those supported Neuropsychological Tests Working Group. She is the chair of the Data Core Steering Committee by the Protein Folding Diseases Initiative. Abnormalities of the protein trafficking at NACC, and also chairs the statistical subcommittee. Dr. Dodge is an exceptional addition to network involving VPS13a are found in Parkinson’s and Alzheimer’s disease. Studies our faculty, and an important contributor to our Alzheimer Disease Center. Hiroko Dodge (left) and Hank Paulson that compare and contrast these different disorders may therefore provide clues of Bill and Liz Lakritz with Bill Dauer broad importance for understanding and treating neurodegenerative disease.

NIH Awards $11.5 Million to Fund a Udall Neurology Multidisciplinary Clinics: Parkinson’s Disease Center at Michigan The Future is Now! At the end of September, Department of Neurology clinician- Because varenicline (known commercially as Chantix) is already researchers, led by William Dauer, director of the UMHS Movement available by prescription to help people stop smoking, advancing Neurology has a long history of multidisciplinary clinics for patients and working with the patients and caregivers to identify community Disorders program and the Elinor Levine Professor, were awarded the treatment to patients would be relatively straightforward if the whose condition requires additional expertise outside the purview resources as the need for support increases. Language and speech a five-year, $11.5 million grant from the National Institute of investigators were to find that it is effective in PD. The education and of neurology. Among the established clinics, perhaps the best pathologist Karen Kluin, assistant professor, sees patients on the Neurological Diseases and Stroke to establish a Morris K. Udall outreach component of the Udall Center will be led by Kelvin Chou, known are the multidisciplinary sleep clinics under the direction of day of the visit to provide a comprehensive evaluation and Center of Excellence in Parkinson’s Disease Research. The Udall William Brown Professor and co-director of the Surgical Therapies Ron Chervin that involves physicians from Pediatrics, Pulmonary recommendations regarding speech and swallowing difficulties. Center grant will fund three interrelated projects designed to better Improving Movement (STIM) deep brain stimulation program for Medicine, ENT and Psychiatry in addition to Neurology, with close The availability of these services further enhances the quality of care understand the role of the cholinergic system in falls, focusing on Parkinson’s disease. collaboration with the Department of Oral and Maxillofacial Surgery, that can be provided for patients with ataxia and balance disorders. the effect of lost cholinergic neurons in the basal forebrain and the and the multidisciplinary ALS clinic, under the direction of Brian The Center is an interdisciplinary collaborative effort that includes And Sindhu Ramchandren, assistent professor, recruited to Neurology pedunculopontine nucleus (PPN). Callaghan, Dush Professor, and Stephen Goutman, assistant professor, neuroscientist Martin Sarter, Ph.D., the Charles M. Butter Collegiate from Wayne State, has taken over direction of the transitional/adult that includes respiratory therapy, physical therapy, occupational In patients, Nicolaas Bohnen, M.D., Ph.D., professor of radiology Professor of psychology in LS&A, who will further develop a rodent Muscular Dystrophy Clinic and the Charcot-Marie-Tooth (CMT) therapy, speech therapy, nutrition services, a social worker, and a and neurology, will use a new method of PET scanning developed model of falling in PD, and a team of biostatisticians and data clinic for children and for adults. The CMT Association recognized wheelchair specialist. at Michigan to link specific problems of gait and cognition to management specialists led by Ivo Dinov, Ph.D., professor in the the Michigan CMT Clinic as one of 10 Centers of Excellence in degeneration of these cholinergic pathways. In a related project, School of Nursing and Cathie Spino, Sc.D., research associate professor In the last two years, two new multidisciplinary clinics have been clinical and research care in the United States, and Dr. Ramchanden Roger Albin, Anne Young Collegiate Professor, will determine if of biostatistics in the School of Public Health. The biostatistical and added to the roster. Vikram Shakkottai, assistant professor, and expects to receive a similar designation from the Parent Project it may be possible to increase cholinergic traffic and improve gait data management team will help design and analyze the results of the Peter Todd, Patti and Bucky Harris Professor partnered with physical Muscular Dystrophy for the Duchenne clinic. The pediatric and using the already-approved cholinergic modulating drug varenicline. center’s experiments, using advanced digital tools to parse the massive therapy, social work, and language and speech pathology to establish adult Muscular Dystrophy Clinic has been supported over the years amounts of data the work will produce. a Multidisciplinary Ataxia Clinic. Services offered include by gifts from the Erwin family, long-time advocates of the University providing the best current protocol for balance therapy to promote of Michigan Muscular Dystrophy program, and from friends of the independence, facilitated planning for care as symptoms progress, Erwin family.

2 3 Hank Paulson Multiple Sclerosis Clinical Programs and Co-Directs $9.3 Million Clinical Research Continue to Expand The Multiple Sclerosis (MS) program in the department has grown observation, the group has initiated the first-ever novel trial of ‘Protein Folding Disease’ substantially since the recruitment of Ben Segal, Hotom Garrett extracorporeal photopheresis in secondary progressive MS. In Professor six years ago. In the last year, the MS Center provided 2014, we were pleased to receive a gift from the Sarnes family multidisciplinary care for more than 3,000 patients with MS. to David Irani, associate professor that will help accelerate clinical Fast-forward Initiative research in progressive MS. The Michigan MS Center, supported for more than a decade In the last year Hank Paulson, Lucile Groff Professor and director Andy Lieberman (left) and Hank Paulson by generous gifts from Marge and Dick Garrett and from of the Alzheimer disease program in the department, along with David Garrett, has been designated a Center of Excellence for Significant accomplishments from the Michigan co-director Andrew Lieberman, Gerald B. Abrams Professor of Comprehensive MS Care by the National Multiple Sclerosis Society, in support of the successful application to establish a Udall Parkinson Pathology, was awarded a Fast Forward grant from the medical school is staffed by five neurologists with subspecialty expertise in MS, Neuroimmunology research team: Disease Center of Excellence here, and is integrally related to the to establish a multidisciplinary Protein Folding Disease Initiative a clinical fellow, a nurse practitioner and dedicated clinical trial • The demonstration, in animal models of MS, that clinically Michigan Alzheimer Disease Center that Hank also directs. (PFDI). PFDs are disorders of abnormal protein accumulation and coordinators. An MS clinical fellowship program was established similar forms of demyelinating disease can be driven by aggregation, often associated with perturbations in “protein quality In its first year the PFDI supported four small molecule screens in 2007 to train neurologists in the specialized care and diagnosis distinct cellular and molecular pathways that translate into control”, that represent one of the largest (more than 100 PFDs are through the Center for Chemical Genomics; proteomics studies by of patients with MS and related disorders. Three fellows have different responsiveness to disease modifying modications successfully completed the program, with two (assistant professors recognized) and most vexing categories of human disease. In the seven laboratories; and, in silico protein folding analyses by seven • The discovery that immune dysregulation is evident in Tiffany Braley and Rob Pace) now on our faculty and a third Alzheimer’s and Parkinson’s disease are common investigators. PFDI is in the process of developing a collaborative individuals in the secondary progressive, as well as in in practice in Minneapolis. The fourth fellow in the program is PFDs, and the PFDI that includes 65 faculty from several departments effort with the Department of Computational Medicine & relapsing remitting, stages of MS across the institution has already played an important role in five Bioinformatics to expand bioinformatics support necessary to currently in training. recently awarded RO1 grants, was an important institutional resource better investigate these diseases. • The finding that obstructive sleep apnea is highly prevalent This year, Yang Mao-Draayer, associate professor (with Ben Segal, in people with MS and is a significant contributor to fatigue Holton Garrett Professor as co-investigator) was funded by the NIH to direct a clinical project as part of the newly awarded U-M Autoimmunity Center of Excellence, and based on a clinical Jack Parent to Direct $3.5 Million NIH- Lesli Skolarus Directs NIH Funded Funded SUDEP ‘Center Community-based Stroke Program in Flint Lesli Skolarus, assistant professor, has partnered with Elder Without Walls’ Project Sarah Bailey and Bridges into the Future, an African American faith-based organization in Flint, Michigan to create and test Sudden unexpected death is up to 24 times higher in patients with Jack Parent and Lori Isom a faith-based, peer-led intervention to increase awareness of epilepsy than it is in the general population, responsible for an stroke warning signs and the importance of calling 911 among estimated 2,750 deaths in the U.S. annually. The problem was given of the second Center for SUDEP Research to study SUDEP mechanisms African American youth and adults. The project, entitled PRAISE a name 20 years ago: sudden unexpected death in epilepsy (SUDEP) in Dravet Syndrome, a childhood epileptic encephalopathy caused by (Preparing to ReACT Immediately to Stroke through Education), and studies of SUDEP mechanisms point to a complex pathology mutations in voltage-gated sodium channels, with an increased risk of is funded by an NINDS K23 Mentored Patient-Oriented Research involving peri-ictal abnormalities in brainstem and autonomic sudden death. Career Development Award to Dr. Skolarus. In addition to function, heart rate and rhythm, or respiration. The Michigan group will test whether the mutant sodium channels, PRAISE, and in response to the community’s request for primary To address the problem, the NIH has begun funding Centers Without which are expressed in heart as well as brain, predispose to arrhythmia. stroke prevention, Dr. Skolarus, her community partners and Walls for Collaborative Research in the Epilepsies to bring together Patient-derived cardiac myocytes and autonomic neurons will be Devin Brown, professor, designed and are testing a text messaging scientists and physicians with expertise in molecular , genetics, generated from skin biopsies using the induced pluripotent stem cell intervention to reduce blood pressure among African Americans. histopathology, electrophysiology, brain imaging and data analysis method. Findings from patient-derived cells will be analyzed along In this study, participants are enrolled after church services by to investigate SUDEP. This year, a team led with clinical data, including continuous peri-ictal ECG monitoring Michigan physicians, nurses, residents and medical students by Jack Parent, professor of neurology and Lori Isom, Ph.D., interim during seizure recordings, and data from transgenic mouse and with the help of the church health teams. The prevention study chair of pharmacology, was awarded a $3.5 million NIH grant as part rabbit Dravet Syndrome models. is funded by the University of Michigan Cardiovascular Center Back row: Doris Allen, Lesli Skolarus, Sister Brenda, Mackenzie Dome, Linda Turner. Front row: Sarah Bailey, Gloria Moses-Colon, Marsha Hill Inaugural Fund.

4 5 Zach London Creates ‘Boot Camp’ NIH K Awardees We are again proud to report that this year, of our 11 assistant professors on the instructional for PGY1 Neurology Trainees (tenure-seeking) track, 10 are recipients of K08 or K23 mentored career development awards This year the core neurology residency became a categorical program basic familiarity with the recognition and management of the most from the NIH. This puts us among the top neurology departments nationwide in number of so that all residents in the program complete their PGY1 year (the common neurologic disorders and those that require emergent K awardees, and almost certainly highest in ratio of K awardees to assistant professors. training year formerly known as internship) in the internal medicine intervention. A teaching workshop trains residents to be engaging program at Michigan. Taking advantage of this opportunity and to educators and gives them practice giving and receiving feedback. The Sami Barmada, M.D., Ph.D. Vikram Shakkottai, M.D., Ph.D. facilitate the transition of our trainees from medicine to neurology, boot camp curriculum also includes neurology-based games, exercise Elucidating the mechanisms underlying mutant Targeting physiologic changes as a route towards Zach London, associate professor and director of the residency classes, and other team-building activities to enhance rapport and TDP43-induced (Paulson) therapy for degenerative ataxias (Paulson) training program created “Neurology Boot Camp”. trust among residents. The feedback from the 2014 participants was Jim Burke, M.D. Lesli Skolarus, M.D. uniformly positive, and Dr. London is excited to refine the curriculum Working with the department of medicine, he coordinated the Using outcomes analyses to inform implementation A community partnership to treat stroke (Morgenstern) for the 2015 class, with our senior residents and last year’s campers schedule so that all of the PGY1 trainees are free of clinical of NINDS clinical trials (Morgenstern) helping to lead many of the educational sessions. William Stacey, M.D., Ph.D. responsibilities during the final month of their internship, and then Brian Callaghan, M.D. Modeling seizure precursors and antiepileptic brought them into neurology for one month of focused training. The The impact of the metabolic syndrome on brain stimulation (Parent) neuropathy (Feldman) boot camp curriculum is primarily non-clinical, with an emphasis on In the 2014 Doximity/USNWR rating, the Peter Todd, M.D., Ph.D. case-based and self-directed learning, communication workshops, Michigan Neurology residency was ranked Dan Leventhal, M.D., Ph.D. Pathogenic mechanisms in fragile X tremor ataxia and skill workshops. Through these interactive sessions, residents #10 nationally, #2 among public hospital programs. Neuronal oscillations and dysregulated motor syndrome (Paulson) develop a fundamental approach to localizing lesions within the learning in parkinsonian rats (Albin) Darin Zahuranec, M.D. central and peripheral nervous system, and practice using this Sindhu Ramchandren, M.D. Prognosis and end-of-life decision making in information to generate a differential diagnosis. They also develop Validation of a disease-specific instrument for intracerebral hemorrhage (Morgenstern) pediatric inherited neuropathy (Feldman) 2014 Major National Awards & Honors Eva Feldman, M.D., Ph.D. Lewis Morgenstern, M.D. DeJong Professor, was one of 6 UM faculty elected to the Professor of Neurology, received the 2014 William E Feinberg lnstitute of Medicine of the National Academies Award for Excellence in Clinical Stroke (Lifetime Achievement The Institute of Medicine is unique in its structure as both an Award) from the American Heart Association honorific membership organization and an advisory organization. Dr. Morgenstern spent seven years on the faculty at UT Houston where Election to the IOM is considered one of the highest honors in he began the Brain Attack Surveillance in Corpus Christi (BASIC) project. the fields of health and medicine and recognizes individuals who BASIC is currently in its fourth, 5-year NINDS cycle and has resulted in have demonstrated outstanding professional achievement and over 65 publications, 5 R-level spin-off grants, several career development commitment to service. New members are elected by current active awards and has served as the foundation for training graduate students, members through a selective process that recognizes individuals who medical students, residents and fellows about health disparities research. have made major contributions to the advancement of the medical The project has made fundamental contributions to our understanding sciences, health care, and public health. of disparities, cultural contexts of medicine and clinical observations of – National Academies of Science stroke in a “real world” non-academic community. – American Heart Association David Fink, M.D...... Robert Brear Professor and chair, received the 2014 Department of Veterans Affairs Paul B Magnuson Award for Excellence in Rehabilitation Research 2014 Michigan Medical School Awards In recognition of his (Dr. Fink’s) pioneering investigations to Ron Chervin, M.D. develop and test viral gene therapy for intractdable pain, peripheral 2014 MICHR Distinguished Clinical and Translational neuropathy, and spinal cord injury. Dr. Fink has made bold advances Research Mentor Award Top row (left to right): Peter Todd, Harris Early Career Professor; Bill Stacey; Brian Callaghan, Dush Professor; based on meticulous laboratory studies to deliver novel treatments Sami Barmada; Dan Leventhal; Darin Zahuranec; Jim Burke Lewis Morgenstern, M.D. to patients with diseases of the nervous system. 2014 Medical School Clinical & Health Services Bottom row (left to right): Lesli Skolarus; Vikram Shakkottai; Sindhu Ramchandren – Department of Veterans Affairs Research Award Linda Selwa, M.D. 2014 Medical School Local Community Service Award

6 7 National, Regional Roger Albin and Service Roles Richard Keep to Many of our senior faculty members serve in leadership positions in regional and national Direct ‘Clinical specialty and subspecialty organizations. Neuroscientist Roger Albin, M.D. Chair, NIH NINDS NSD-B Study Section Larry Charleston IV, M.D. Training Program’ Chair, American Headache Society Underserved Populations in Headache Medicine Special Interest Section (NINDS R25) Ron Chervin, M.D. This year, Roger Albin, Anne Young Collegiate Professor and Richard Board of Directors, American Academy of Sleep Medicine Keep, Ph.D, Crosby-Kahn Collegiate Professor of neurosurgery Board of Directors, American Sleep Medicine Foundation Board of Directors, Associated Professional Sleep Societies competed successfully for an R25 grant from the NINDS to establish Vice President, International Pediatric Sleep Association the University of Michigan Clinical Neuroscientist Training Program. Deputy Editor, SLEEP The UMCNTP will offer two years of mentored research experience for trainees in neurology, neurosurgery or neuropathology beginning Bill Dauer, M.D. Chair, NIH NINDS CDIN Study Section during residency and continuing during the immediate post- residency year. Neurosurgery resident Kevn Chen, is the first R25 Eva Feldman, M.D., Ph.D. trainee, and he will be joined by neurology resident Andrew Sas in Immediate Past President, American Neurological Association the 2015-2016 academic year. The R25 program nicely complements Member (newly inducted), Institute of Medicine of the National Academies of Sciences the Neurology Research Training Grant (NINDS T32) directed by Eva Feldman, DeJong Professor and Devin Brown, professor that has David Fink, M.D. supported additional post-doctoral research training in clinically- President, Association of University Professors of Neurology relevant in the department since 1982. Board of Directors, American Neurological Association Board of Directors, United Council of Neurologic Subspecialties Larry Junck, M.D. President, Washtenaw County Medical Society LEADERSHIP OF THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM Michael M.E. Johns, M.D., Interim Executive Vice President for Medical Affairs Jeff Kutcher, M.D. Thomas Campbell, Associate Vice President of Strategic Planning and Chair, American Academy of Neurology Sports Business Development Neurology Section Paul Castillo, C.P.A., Chief Financial Officer, University of Michigan Health System Associate Editor, Frontiers in Sports Neurology T. Anthony Denton, J.D., M.H.A., Acting Chief Executive Officer, and COO, Co-Director, AAN Sports Concussion Conference University of Michigan Hospitals and Health Centers Denise A. Gray-Felder, A.P.R., Chief Communication Officer, University of Jack Parent, M.D. Michigan Health System Secretary, American Neurological Association Kara Morgenstern, J.D., M.P.H., Interim Associate Vice President and Deputy Board of Directors, American Epilepsy Society General Counsel, Office of the U-M Vice President and General Counsel Associate Editor, Epilepsy Currents David A. Spahlinger, M.D., Senior Associate Dean for Clinical Affairs, Executive Co-Chair, 2014 Gordon Conference on Epilepsy Director, Faculty Group Practice University of Michigan Medical School Quinta Vreede, Chief Administrative Officer, UMHS Chief of Staff, Office of Ben Segal, M.D. the EVPMA Chair, Scientific Advisory Board, MS Centers of James O. Woolliscroft, M.D., Dean, University of Michigan Medical School Excellence – East Co-Chair, Program Committee, Americas Committee for THE REGENTS OF THE UNIVERSITY OF MICHIGAN Treatment and Research in Multiple Sclerosis (ACTRIMS) Mark J. Bernstein, Julia Donovan Darlow, Laurence B. Deitch, Shauna Ryder Diggs, Denise Ilitch, Andrea Fischer Newman, Andrew C. Richner, Sayyed Sohrab, M.D. Katherine E. White, Mark S. Schlissel, ex officio Fellow, European Board of Neurology (the first and currently ©2015 Regents of the University of Michigan, Ann Arbor, Michigan 48109 only American neurologist who has earned this designation) NEWSLETTER DEVELOPMENT Michelle Davis, Associate Director of Development,

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