CINCINNATI—The University of Cincinnati Neuroscience Institute (UCNI) celebrated its 10th anniversary today by announcing its arrival at a national benchmark with accreditations, certifications, or national association memberships in 13 of 14 important neuroscience specialties.

The accreditations and memberships denote excellence in sub-specialty neurological care and research and are highly coveted by academic health centers throughout the United States.

The UC Neuroscience Institute, first envisioned by John M. Tew, M.D., began with an intention to create a national benchmark in neurological care while leading the advance in humanity’s understanding of the brain. It was established in 1998 by neuroscience specialists at UC Health -- University Hospital, the Mayfield Clinic, and the UC College of Medicine. Initial funding for the venture came from the Health Alliance.

During the 10-year span, the Institute has achieved the following distinctions – all of which are publicly available -- from objective, nationally recognized organizations:

1. Primary Stroke Center; designated by the Joint Commission
2. Level I Trauma Center; verified by the American College of Surgeons
3. Level 4 Epilepsy Center; designated by the National Association of Epilepsy Centers
4. Neurocritical Care Fellowship Training; designated by the United Council of Neurologic Subspecialties
5. Morris K. Udall Center for Parkinson’s Disease Research; designated by the National Institute of Neurological Disorders and Stroke
6. Certified Member of the National MS Consortium
7. Membership in the Acoustic Neuroma Association
8. Membership in the Pituitary Tumor Network
9. Membership in the Trigeminal Neuralgia Association
10. Member Clinic of the Muscular Dystrophy Association
11. Charter Member of the National Network of Depression Centers
12. Member of the Specialized Programs of Translational Research in Acute Stroke (SPOTRIAS)
13. Member of the Neurological Emergencies Treatment Trials (NETT)

The UC Neuroscience Institute's Alzheimer's Center, its 14th specialty area, is under development.

By comparison, the Cleveland Clinic and Ohio State University have achieved similar distinctions in 4 of these 14 neuroscience specialties; the Mayo Clinic and University of Pittsburgh have achieved 8; Johns Hopkins University has achieved 10; Massachusetts General has achieved 9; and the Barrow Neurological Institute has achieved 5.

The UC Neuroscience Institute is thanking supporters who have played an important role in the Institute’s accomplishments this evening at the new CARE/Crawley Building on the UC Academic Health Center campus.

“In developing the Neuroscience Institute we wanted to create a sense of trust and confidence in our community that would allow people to know that they did not have to go to another place for neurological care,” says Dr. Tew, the Institute’s Clinical Director and a neurosurgeon with the Mayfield Clinic. “We wanted people to know that, whether you have a problem that is simple or complex, you can come to us from all walks of life and know with confidence that we’ll provide you with best care available anywhere in the world.”

The Institute grew with the recruitment of pre-eminent physicians, researchers, and nursing specialists. Today it includes more than 100 faculty members in multiple neuroscience specialties, including neurosurgery, neurology, otolaryngology – head and neck surgery, radiology, emergency medicine, ophthalmology, physical medicine and rehabilitation, and psychiatry. The Institute treats thousands of patients each year, many of whom travel to Cincinnati from around the United States and the world. In fiscal year 2008, the Institute recorded 3,893 inpatient and 35,307 outpatient visits.

“University Hospital is proud to be the medical home for the UC Neuroscience Institute,” says Lee Ann Liska, University Hospital’s Executive Director and Senior Vice President. “We are the region’s primary site of tertiary care for the sickest patients and most complex cases. Our advanced technologies include intraoperative MRI, continuous, 24-hour EEG monitoring, mobile CT scanning, a Level 4 epilepsy monitoring unit, and Lycox monitoring of brain temperature and oxygenation.”

“Patients come to the UCNI because of our terrific team of highly specialized physicians, nurses, and other healthcare providers,” says Joseph P. Broderick, M.D., Research Director at the Institute and Chair of the Department of Neurology. “We have a great passion to provide the best clinical care for those patients. And we share that passion with our referring physicians. But the reason they refer to us is because we have highly specialized physicians. Not just a neurologist, but a neurologist highly trained in epilepsy; not just a neurosurgeon, but a neurosurgeon who does the most difficult spine cases in the world. They also refer to us because we collaborate. We have five weekly subspecialty conferences where the most challenging cases are discussed. And they refer to us because we’re not satisfied with the standard care. Our frustration that we can do better is what fuels our research efforts.”

The Institute comprises seven centers of excellence, which are focused on brain tumors, cerebrovascular disease, epilepsy, disorders of the senses (swallowing, voice, hearing, pain, taste and smell), multiple sclerosis, neurotrauma, and Parkinson’s disease. A center for Alzheimer’s disease is in development.

“The future of the College of Medicine will be based more and more on developing centers of excellence in which we can provide ‘added value’ care, research and education for patients in our region and beyond,” says David Stern, M.D., Dean of the College of Medicine. “The UC Neuroscience Institute has been at the forefront in developing highly differentiated programs that meet our patients’ needs and push the field of neuroscience forward. Whether it is our world-renowned stroke program, or the programs in Parkinson’s disease and multiple sclerosis, or the more recently launched brain tumor program, each of these initiatives has great potential to contribute to reducing morbidity and mortality for patients with neurological disorders in our region.”

Other major accomplishments celebrated by the UC Neuroscience Institute include:

• An international role in the development of tPA for the treatment of stroke and a continuing international role in the research and treatment of stroke.
• Recruitment of leading physicians, researchers, and staff from around the United States.
• Major gifts that support two of the institute’s seven centers of excellence: the James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders and the Virgilee and Oliver Waddell Center for Multiple Sclerosis.
• The creation of public symposia that educate patients and caregivers who confront Parkinson’s disease, brain tumors, and epilepsy.
• Community leadership, including a Board of Advisors led by William Burleigh, retired Chairman of the E. W. Scripps Company, and community-supported fundraising events, including the Sunflower Revolution and Celebrating Research Innovations for an Epilepsy Cure, that have raised millions of dollars for individual programs.

Ron Koetters, center, and his wife, Florence, receive the Every Victory Counts Award from John M. Tew, MD

CINCINNATI–Cincinnati business leader Ron Koetters and his wife, Florence, were honored at Sunflower Revolution VI festivities on Sept. 12 in Milford, Ohio. They were presented with the “Every Victory Counts Award” by John M. Tew, M.D., Clinical Director of the University of Cincinnati Neuroscience Institute, for their leadership in the search for a cure for Parkinson’s disease.

The Sunflower Revolution supports research at the James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders at the UC Neuroscience Institute. The event is a collaboration involving the Institute, the University Hospital Foundation, the Mayfield Clinic, the Historic Milford Association, and the Davis Phinney Foundation, based in Boulder, Colo.

Ron Koetters, who has enjoyed a long career constructing commercial, industrial, and institutional buildings, is Chairman and CEO of Monarch Construction Company. In 2007 Monarch was awarded the coveted Construction Excellence Award by the Air Combat Command of the US Air Force for work performed at the National Air and Space Center.

Ron Koetters is currently a trustee of the Cincinnati Museum Center and the Cincinnati Art Museum, and he and Florence are active volunteers and supporters of numerous charities. In 2008 Ron Koetters chaired the Sunflower Corporate Steering Committee, helping to raise more than $200,000.

The 2009 Sunflower event included a streetfest, an educational symposium for patients and caregivers that drew more than 700 participants, and bike rides that drew more than 900 cyclists. Barb and Dale Ankenman served as honorary chairs, while Dave Szkutak chaired the Corporate Steering Committee. The presenting sponsor was Cintas.

The Neuroscience Institute, a regional center of excellence at University Hospital and the University of Cincinnati, is dedicated to patient care, research, education, and the development of new treatments for stroke, brain and spinal tumors, epilepsy, multiple sclerosis, trauma, Parkinson’s disease, and Alzheimer’s disease.

The Mayfield Clinic, which is affiliated with UC’s Department of Neurosurgery, includes 21 neurosurgeons and treats 20,000 patients from 35 states and a dozen countries in a typical year. Mayfield's neurosurgeons are active participants in important clinical trials and have pioneered surgical procedures and instrumentation that have revolutionized the medical art of neurosurgery for brain tumors and neurovascular diseases and disorders.

CINCINNATI--How does a physician approach a complex medical condition that may or may not be what it appears? That is the challenge offered by the bi-monthly Movement Disorders Video Rounds, a collegial, academic exercise at the James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders at the University of Cincinnati Neuroscience Institute. The video rounds, which feature video of patients with ambiguous or complex diagnoses, are the brainchild of Alberto Espay, M.D., Assistant Professor in the Department of Neurology.

“During video rounds we get together and discuss challenging cases,” Dr. Espay says. “These are patients who have come to us with atypical presentations, and we have had a difficult time diagnosing them. They are not the bread-and-butter presentations for any of the conditions.

“During the sessions we think about these cases from the ground up,” Dr. Espay continues. “We consider the patient, the videotape of the examination, pertinent data and the patient’s medical history. Then we all brainstorm. Of course, the person who is presenting the case has more information, because presumably a number of investigations have already been undertaken to try to determine the diagnosis. And of course, therapy has been delivered to the patient.”

The goal of video rounds, Dr. Espay says, “is to learn one or two things about movement disorders that you didn’t know coming into this session.”

Dr. Espay, who came to UC in 2005, started the video rounds in 2006 as an enjoyable way for physicians and residents to better educate themselves about the spectrum of movement disorders, which is vast and dotted with rarities and exceptions. The field of movement disorders is by its nature highly visual, with patients experiencing a range of symptoms or side-effects related to movement, including balance problems, freezing of gait, stiffness, loss of coordination, tremor, and involuntary movements. Gardner Center neurologists routinely acquire video of patients to preserve a benchmark prior to treatment or disease progression.

Because video rounds are held at the end of the day, and because attendance is voluntary, Dr. Espay offers a little wine and cheese to help the medicine go down. “It’s very informal,” Dr. Espay says. “No one has high brows about this.”

Last year Dr. Espay took the video rounds concept a step further, by inviting the University of Louisville and the Medical College of Georgia and turning it into the Tri-State Movement Disorders Competition, a CME-accredited educational session sponsored by an unrestricted educational grant from TEVA Pharmaceuticals.

During the competition, each team presents two or three cases, which the opposing schools then strive to think through and diagnose. “The test is to show that your thinking process is logical,” Dr. Espay says. “The answer is the diagnosis. It is a nurturing experience for all of us.”

The Gardner Center team triumphed in 2008 and 2009, and Dr. Espay proudly displays the official trophy in his office.

This year’s most difficult case is likely to be submitted for publication as a case study. It involved the diagnosis of a patient who developed a parkinsonian syndrome in her mid-teens. Dr. Espay, who first saw her in her late teens, disagreed with the initial diagnosis of dopa-responsive dystonia because of inconsistent features of her disease, including disease progression and prominent dyskinesias of the face. Although he had seen only one case like hers before, he correctly postulated that she was suffering from a rare condition known as neuronal intra-nuclear inclusion disease (NIID). A brain biopsy eventually affirmed Dr. Espay’s diagnosis. The patient, he says, “became only the sixth reported case of juvenile parkinsonism and only the second presenting in a way that, early on, was indistinguishable from dopa-responsive dystonia, but that eventually revealed other features that were not consistent with that condition.”

Physicians are not the only ones who benefit from seeing video of patients with movement disorders. “All of our patients are videotaped, and we review these videos with them,” Dr. Espay says. “If patients come back three years after their first assessment and wonder what they were like before, we can show them. It’s a great tool for us, and our patients really appreciate this resource.”

CINCINNATI–A $51,000 grant will enable University of Cincinnati (UC) researchers to determine whether sophisticated new imaging technologies can help them achieve pinpoint placement of deep-brain stimulation electrodes in patients with Parkinson’s disease. George Mandybur, MD, a neurosurgeon with the Mayfield Clinic and the UC Neuroscience Institute, is leading the pilot study, which will take place at University Hospital.

Mandybur and his team will use a 3-Tesla MRI scanner with high-resolution sequences, along with diffusion tensor imaging fiber tracking, in an attempt to quickly and accurately predict the size and position of the subthalamic nucleus, a small area deep within the brain. The size and location of the subthalamic nucleus can vary significantly from patient to patient.

Physicians have long known that by stimulating the subthalamic nucleus they can alleviate symptoms and improve the lives of some patients with Parkinson’s disease. Traditionally, surgeons have located the target by using standard medical atlases and multiple preoperative and intraoperative imaging techniques, including 1.5-Tesla MRI. “But current methods have drawbacks,” Mandybur says. “The borders of the subthalamic nucleus can be indistinct, to the extent that sometimes we cannot visualize the nucleus well.”

To be certain that the electrodes are in the right place, surgeons have relied on electrophysiological confirmation, stimulating the target while the patient is awake and often making multiple passes through brain tissue. When surgery is prolonged in an effort to define the target, the risk of complications can increase.

In their study, Mandybur and his co-investigators will use new imaging modalities, including the more powerful 3-Tesla MRI and diffusion tensor imaging, which provides a map of critical white-matter tracts in the brain. White-matter tracts are electrical connections that should not be surgically disrupted.  

The study will involve 20 patients at the James J. and Joan A. Gardner Center for Parkinson’s Disease and Movement Disorders at the UC Neuroscience Institute. Funding comes from the Sunflower Revolution, an annual fundraiser and bike ride held in Cincinnati. The Sunflower event is a collaboration among the UC Neuroscience Institute, the University Hospital Foundation and the Davis Phinney Foundation of Boulder, Colo.

Mandybur’s co-investigators are Gregory Toczyl, MD, a neurosurgeon and the 2008-2009 Davis Phinney-Donald Krumme Fellow in Parkinson’s Disease and Movement Disorders; Jim Eliassen, PhD, and Jing-Huei Lee, PhD, of the UC Department of Psychiatry; Fredy J. Revilla, MD, of the UC Department of Neurology; and James Leach, MD, of the Department of Radiology at Cincinnati Children’s Hospital Medical Center.

The UC Neuroscience Institute, a regional center of excellence at UC and University Hospital, is dedicated to patient care, research, education, and the development of new treatments for stroke, brain and spinal tumors, epilepsy, traumatic brain and spinal injury, Alzheimer’s disease, Parkinson’s disease, disorders of the nerves and muscles, disorders of the senses (swallowing, voice, hearing, pain, taste and smell) and psychiatric conditions (bipolar disorder, schizophrenia and depression).

The Mayfield Clinic is recognized as one of the nation's leading physician organizations for clinical care, education and research of the spine and brain. Supported by 20 neurosurgeons, three neurointensivists, an interventional radiologist and a pain specialist, the clinic treats 20,000 patients from 35 states and 13 countries in a typical year.

CONTACT:
Cindy Starr  (513) 558-3505
cstarr@mayfieldclinic.com

CINCINNATI--A fun-filled Sunflower Streetfest will highlight a new format for the region’s largest and most important fundraiser for Parkinson’s disease research and wellness, Sunflower Revolution organizers announced today.

The sixth-annual Sunflower Revolution will take place September 11, 12 and 13. The event is a collaboration involving the University Hospital Foundation, the UC Neuroscience Institute, the Mayfield Clinic, the Historic Milford Association, and the Davis Phinney Foundation, based in Boulder, Colo.

Sunflower Revolution VI will showcase:

• the first Sunflower Streetfest, Sept. 11-12, in downtown Milford, Ohio;
• a free educational symposium for patients, families and caregivers, Sept. 12, at the Savannah Center in West Chester, Ohio
• and fundraising bike rides of 100K, 40K and 20K, Sept. 13, in Milford

Since 2004 the Sunflower Revolution and related events have raised $1.3 million for Parkinson’s disease research and wellness programs at the UC Neuroscience Institute at University Hospital.

Sunflower organizers also announced that Barb and Dale Ankenman (above) of Florence, Ky., will serve as the event’s honorary chairs. Dale Ankenman, who was diagnosed with Parkinson’s disease at age 46, is a cyclist and Parkinson’s advocate. Major sponsors include Reece-Campbell Construction, University Hospital, Kroger Company, the City of Milford, and Local 12.

Organizers will kick off the Sunflower season with a wine-tasting benefit from 6:30 to 8:30 p.m. Tuesday, May 5, at the Miami Township Kroger. The wine-tasting benefit will feature award-winning wines from the 2009 International Wine Festival. Tickets are $40 each; call (513) 584-0695.

The cost of the Sept. 13 bike ride is $80 per cyclist. The 100k ride includes a Platinum Challenge for serious cyclists, while the 20k family ride includes a scavenger hunt along the Little Miami Bike Trail. New this year is the Peloton Club, which welcomes individual riders, rider teams, and donors who raise $1,000 or more, with special admission, VIP activities and custom jerseys.

For more information about the Sunflower Streetfest, educational Symposium, and bike rides, please visit www.sunflowerrev.org.

The Sunflower Revolution was founded in 2004 by Kathleen Krumme, a Cincinnati bicycle shop manager whose late father suffered from Parkinson’s disease, and cycling legend Davis Phinney, a former Tour de France stage-winner who was diagnosed with Parkinson’s disease at age 40. Phinney’s 18-year-old son, Taylor, is world cycling champion in the 4-kilometer individual pursuit.

Scientists at The Gardner Center for Parkinson's Disease and Movement Disorders recently received research grants totaling $153,000 from the annual Sunflower Revolution fundraiser. Professor Kim Seroogy, Ph.D., director of the Selma Schottenstein Harris Laboratory for Research in Parkinson’s, received $53,000 to study the effects of exercise therapy on stress-induced depression in an animal model. Professor Timothy Collier, Ph.D., received $50,000 to investigate the ability of antidepressants to protect dopamine neurons that are lost in the disease in an animal model. And associate professor Caryl Sortwell, Ph.D. received $50,000 to study the mechanism that may underlie some of the therapeutic benefits of deep brain stimulation in patients with Parkinson’s disease.

The Davis Phinney Foundation is dedicated to supporting research aimed at understanding, preventing, and treating Parkinson’s disease. The Foundation also seeks to find ways to improve the lives of individuals challenged by the disease.

The UC Neuroscience Institute, a regional center of excellence, is dedicated to patient care, research, education, and the development of new treatments for stroke, brain and spinal tumors, epilepsy, traumatic brain and spinal injury, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, disorders of the senses (swallowing, voice, hearing, pain, taste and smell), and psychiatric conditions (bipolar disorder, schizophrenia and depression).