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emotional effects of stroke. He assesses
neurobehavior in patients with focal
cerebrovascular lesions and vascular dementia.
Jeffrey L. Bennett, MD, PhD
Optic Neuritis.
Optic neuritis (ON) is the most common
clinically-isolated
demyelinating syndrome, and is the presenting
feature in approximately 25% of
individuals with multiple sclerosis (MS). Dr.
Bennett is attempting to identify the
primary target of the humoral immune response in ON
and MS. His laboratory
utilizes a RT-PCR protocol to amplify the expressed
variable-region sequences of
single B-lymphocytes and plasma cells isolated from
ON CSF by fluorescence-
activated cell sorting. The B-lymphocyte and plasma
cell heavy- and light-chain
pairings found in vivo are reconstituted
in vitro to produce a panel of recombinant
monoclonal antibodies (mAbs) whose specificity is
determined by
immunocytochemistry, immunoblotting, and screening
of white matter and random
peptide expression libraries. Since many patients
with ON do not develop MS, these
studies will allow identification of clinical and
molecular risk factors that may point
to the ultimate cause of human demyelinating disease
and allow physicians to
identify at-risk individuals, to diagnose MS at the
earliest stage of disease and to
treat patients with therapies designed to modify or
even cure disease.
Occult Chorioretinal (OC) Disorder.
Acute zonal occult outer retinopathy, multiple
evanescent white dot syndrome, acute macular
neuroretinopathy, acute idiopathic
blind spot enlargement syndrome, multifocal
choroiditis, punctate inner
choroidopathy and diffuse subretinal fibrosis
syndrome are a group of chorioretinal
inflammatory disorders of unknown etiology that
mimic optic neuropathy. These
disorders possess common clinical features, and
affected individuals may evolve
from one condition to another. Dr. Bennett’s
laboratory has identified clones in a
human uveoretinal cDNA expression library and a
random peptide library whose
products react with serum or immunoglobulins from OC
patients. Using molecular
biologic techniques, the lab screens candidate
antigens with sera from OC and
control patients to characterize disease-relevant
clones. Identification of OC-
specific markers will help classify occult
chorioretinal disorders as a specific
nosologic entity.
Patrick J. Bosque, MD
Dr. Bosque’s research is directed at chronic wasting
disease, Creutzfeldt-Jakob
disease and other prion disorders of human and
animals. Dr. Bosque also studies
the role of protein misprocessing in various
neurodegenerative diseases.
Mark P. Burgoon, PhD
Dr. Burgoon’s research investigates the unknown
etiology of multiple sclerosis (MS)
by examining the humoral immune response in the CNS
of MS patients. The
persistence of increased IgG in the brains and CSF
of MS patients, observed as
intrathecally synthesized oligoclonal bands,
suggests a continuous antigen-driven
immune response. The IgG response in the brain and
CSF MS patients is being
dissected to determine the antigenic targets in
archival acute plaques. These
unbiased studies of the intrathecal humoral response
can potentially identify an
antigen in MS and ultimately the cause of disease.
Dr. Burgoon’s laboratory also
uses recombinant antibodies and biopanning
techniques to analyze molecular
features of the IgG response in subacute sclerosing
panencephalitis (SSPE), a proof
of principle model in which the antigen-driven
humoral response is directed against
measles virus, the cause of the disease.
Penny Clarke, PhD
Using reovirus infection of the mouse CNS and heart,
Dr. Clarke studies viral-
induced apoptosis and signaling pathways. Apoptotic
and cell signaling pathways
involved in reovirus-induced pathogenesis are
identified and studied in vitro using
primary neuronal and myocyte cultures and other
established cell lines. The lab has
demonstrated that reovirus-induced regulation of the
transcription factor nuclear
factor kappa B (NF-kB)
is required for apoptotic cell death in
virus-infected cells.
Reovirus-induced apoptosis requires both activation
of NF-kB
early after infection
and at a later phase of regulation when activation
of NF-kB
is blocked. The lab has
also shown that activation of both c-Jun N-terminal
kinase (JNK) and the JNK
dependent transcription factor c-Jun are associated
with reovirus-induced cell death,
and that reovirus-induced apoptosis is mediated by
members of the tumor necrosis
factor family of death inducing ligands, which bind
to cell surface death receptors
resulting in Fas activated death domain (FADD)-dependent
activation of cellular
caspases. By inhibiting signaling pathways required
for virus-induced cell death, it
may be possible to reduce virus-induced injury and
disease. Finally, Dr. Clarke's
studies have shown that reovirus sensitize cells
derived from various human cancers
to TRAIL-induced apoptosis by a mechanism that
involves an increase in activation
of caspase 8. These studies demonstrate a potential
to use reovirus and TRAIL as
combination therapy for human cancer.
Randall J. Cohrs, PhD
Varicella zoster virus (VZV) is a ubiquitous
neurotropic alphaherpesvirus that
typically causes childhood chickenpox, becomes
latent in cranial nerve, dorsal root
and autonomic nervous system ganglia, and
reactivates during a declining T-cell
response to produce shingles. Dr. Cohrs studies the
molecular mechanism by which
VZV latency is established and maintained, and the
steps involved in virus
reactivation. Dr. Cohrs’ laboratory uses
state-of-the-art techniques including
genomics (expression microarrays) and proteomics
(protein identification) as well as
more standard cDNA analysis by RT-PCR to investigate
the state of virus
transcription in latently infected human ganglia.
After latently transcribed VZV
genes have been identified, their regulation and
function of the encoded protein is
analyzed. A more complete understanding of virus
latency will aid in development
of steps to prevent virus reactivation.
John R. Corboy, MD
Dr. Corboy's research involves immunotherapies for
multiple sclerosis (MS) patients.
These studies utilize FDA approved therapies in
novel settings and experimental
agents. He also studies the role of anti-oxidants,
especially uric acid, as it relates to
progression of MS.
Denise M. Damek, MD
Dr. Damek clinical research interest focuses on
experimental drug therapy of CNS
tumors. Ongoing clinical trials in the neuro-oncology
program include investigation
of novel drugs, new combinations of chemotherapy
agents, innovative methods of
drug delivery, innovative approaches of radiation
therapy, immunotherapy to
enhance T-lymphocyte stimulation, and gene therapy
using retroviral gene transfer.
Christopher M. Filley, MD
Dr. Filley is the Interim Director of the
Alzheimer’s Disease and Cognition Center
(ADCC), established in 2006, and in this capacity he
oversees research projects on
functional MRI of normal cognition, early diagnosis
of AD using functional MRI,
and pioglitazone therapy for mild cognitive
impairment in patients with metabolic
syndrome. He is the author of the textbook
Neurobehavioral Anatomy, now in its
second edition, and currently participates in
research on cognitive aspects of
systemic lupus erythematosus and traumatic brain
injury. A unifying theme of Dr.
Filley's research is the behavioral neurology of
cerebral white matter, including
neurologic, psychiatric, neuropsychological,
neuroimaging, and neuropathological
aspects of disorders such as toluene
leukoencephalopathy and multiple sclerosis. He
has formally proposed the concept of "white matter
dementia" to call attention to
cognitive deficits attributable to white matter
involvement, described in his second
book The Behavioral Neurology of White Matter.
Lauren C. Frey, MD
Dr. Frey is interested in the prediction of epilepsy
after traumatic brain injury (TBI).
Only ~20% of people who survive severe TBI develop
epilepsy. Developing a method
to predict which survivors will develop epilepsy
offers clues about changes in brain
structure necessary for epilepsy. It will also allow
physicians to identify and
aggressively treat TBI survivors at highest risk of
developing epilepsy.
Donald H. Gilden, MD, Chairman
Varicella Zoster Virus/Simian Varicella Virus.
The neurovirology laboratory studies
the physical state of varicella zoster virus (VZV)
nucleic acid and viral gene
expression during latency in human ganglia.
Studies include state-of-the-art
technologies such as polymerase chain reaction, cDNA
preparation and microarray
to analyze VZV transcription. Interaction of VZV
proteins with other virus and
cellular proteins are also being examined. In
parallel, a model system of varicella in
primates produced by simian varicella virus (SVV) is
used to study pathogenesis and
latency. Finally, the neurovirology laboratory uses
diagnostic tests to understand
and treat the neurological complications of
zoster, including postherpetic neuralgia
and other complications of VZV reactivation such as
myelopathy and vasculopathy.
Multiple Sclerosis.
Dr. Gilden directs the multiple sclerosis (MS)
laboratory. His
laboratory uses molecular immunology techniques to
determine the cause of MS.
Cutting-edge methodologies have been developed to
examine the antigenic targets
of the IgG antibody present in MS brain and CSF. The
techniques include single cell
PCR to identify IgG sequences utilized in MS brains,
synthetic antibody production,
and phage-displayed library panning to isolate
high-affinity antibodies and antigens
from brain. Subacute sclerosing panencephalitis (SSPE)
is being used as an
experimental paradigm to demonstrate these new
techniques and to develop the
sensitivity required for studies of MS.
Deborah A. Hall, MD
Dr. Hall's studies the etiology, diagnosis and
treatment of cerebellar ataxia. She is
currently studying genetic mutations in movement
disorders, particularly mutations
in the fragile X mental retardation gene. Her goal
is to define the prevalence of
mutations of the FMR1 gene in populations
with tremor, ataxia, and/or parkinsonism.
She collaborates on studies which investigate the
role of exercise and physical
therapy in Parkinson disease, and also participates
in large, multi-center clinical trials
in various movement disorders.
Richard L. Hughes, MD
Dr. Hughes has participated in multiple clinical
trials on acute stroke resuscitation,
secondary prevention of stroke and the detection of
intracranial aneurysms. Current
trials include treatment of intracerebral hemorrhage
with activated Factor VII, the use
of warfarin and aspirin in heart failure, and
treatment of insulin resistance to reduce
stroke. He works with the Colorado Department of
Heath and Environment to
establish a statewide registry to help design and
implement a statewide stroke
system in Colorado.
Benzi M. Kluger, MD, MS
Dr. Kluger’s research involves the application of
neuropsychological testing,
transcranial magnetic stimulation (TMS) and
magnetoencephalography (MEG) to
understand the pathophysiology of the non-motor
symptoms of movement disorders
and other neuropsychiatric illnesses.
His research currently focuses on
understanding the
neurophysiologic basis of
fatigue, particularly as it affects
patients with
Parkinson’s disease. Other interests of
Dr. Kluger include behavioral
neurology, volitional
action and conscious perception.
Maureen A. Leehey, MD
Dr. Leehey studies the etiology and treatment of
neurodegenerative disease. She
and her collaborators recently discovered the
Fragile X Associated Tremor/ Ataxia
Syndrome, which affects about 1 in 10,000 men over
age 50. Dr. Leehey directs
multiple clinical trials designed to offer novel
medical therapy and to uncover the
etiology and genetics of various movement
disorders. As a Lead Investigator for
the
Parkinson’s Study Group, she is working to identify
susceptibility genes that
contribute to the
development of Parkinson’s disease. Dr. Leehey
collaborates with
Dr. Curt Freed, a neuroscientist
who directs the UCHSC Parkinson’s Disease (PD)
Neurotransplantation Program, which has contributed
greatly to our current
knowledge of the effects of
neurotransplantation in PD. Dr. Leehey and her
colleagues recently uncovered the genetic etiology
(a prion mutation) of a large
family with a rare
neurodegenerative disease. She works with other
collaborators to
elucidate neuropsychological
changes in Huntington’s disease.
Ravi Mahalingam, PhD
Dr. Mahalingam’s laboratory studies varicella
pathogenesis and latency. Studies
include the use
of state-of-the-art technologies such as polymerase
chain reaction,
cDNA analysis and array analysis to
study varicella transcription and the location of
varicella within the ganglia during latency. A
cosmid-based approach is also used to
generate
mutant varicella virus in an animal model.
Finally, the laboratory uses
diagnostic tools to
understand neurological complications of zoster
including
postherpetic neuralgia.
Hans E. Neville, MD
Dr. Neville enrolls ALS patients into clinical
trials. This multi-center research project
evaluates the efficacy and tolerability of early
versus late non-invasive positive
pressure
ventilation in ALS patients.
Bjorn Oskarsson, MD
Dr. Oskarsson participates in clinical trials to
study diagnostic and therapeutic
strategies for ALS.
Gregory P. Owens, PhD
Multiple sclerosis (MS) is a CNS inflammatory
disease of unknown cause. Dr.
Owens’ research
investigates the role of B cell immunity in the
pathogenesis of MS.
To better understand the nature
of this response, they have used
fluorescence-
activated cell sorting and single cell PCR to analyze the B and plasma cell populations
infiltrating the CNS of MS patients. The features
of the B cell repertoire are indicative
of a
targeted and antigen driven response in MS. They
have generated a panel of
monoclonal recombinant
antibodies from plasma cell clones identified in MS CSF and
are using recombinant antibodies for
immunological screening to identify disease-
relevant
MS antigens.
Victoria S. Pelak, MD
Dr. Pelak’s research investigates cortical visual
processing, with a particular interest
in the effects of aging and dementia on visual
motion processing. She is exploring
new methods to diagnose and track cortical visual
dysfunction in early
Alzheimer’s
disease (AD). Traditionally, it is believed
that visual processing deficits occur in the
middle or late stages of AD. Recent studies from her Visual Perception Laboratory
have demonstrated that visual processing
deficits (as detected by a novel virtual task
of kinetopsic 3D object processing developed by her
research group) may be readily
detectable in the very early stages of AD; this may
have implications for predicting
progression from mild memory impairment to AD. Additional
ongoing investigations
include studies of the effects of testosterone on
visual motion/object/spatial
processing and studies of visual hallucinations
associated with degenerative
disorders and vision loss. Methods
of assessment include psychophysical testing
using immersive virtual reality technology in her
Visual Perception Laboratory and
functional MRI techniques at the UCHSC Brain Imaging
Center.
Dianna Quan, MD
Dr. Quan is involved in clinical trials to study
postherpetic neuralgia, ALS, and
neuromuscular dysfunction in critical illness.
Steven P. Ringel, MD
Dr. Ringel’s current investigative activities
include the development of an economic
model to
perform cost-effectiveness analyses of tests and
treatments in ALS,
outcome studies in ALS using a
national ALSCARE community database, and a
randomized trial to evaluate the effect of
non-invasive ventilation in ALS. He is also
currently analyzing the results of a Community
Tracking Study Physician Survey
which explores
factors that influence physician attitudes and
performance.
Yvonne D. Rollins, MD, PhD
Dr. Rollins is a principal investigator for ALS
clinical trials of CoQ10 and minocycline,
early
intervention with NIPPV and Pompe compassionate use
of Myozyme, a
recombinant enzyme therapy.
Archana Shrestha, MD
Dr. Shrestha’s studies medically refractory epilepsy
and epilepsy surgery. She also
is interested in
women’s issues in epilepsy and the influence of
female hormones on
seizures and epilepsy.
Mark C. Spitz, MD
Dr. Spitz’ clinical research includes epilepsy that
begins in the elderly, psychiatric
aspects of
epilepsy and physical injuries that occur from
seizures. Dr. Spitz is
involved in several
ongoing medication trials.
Laura Strom, MD
Dr. Strom’s studies autonomic dysfunction and apnea
in patients with refractory
epilepsy and its
correlation with sudden unexpected death in
epileptic persons
(SUDEP). She is an active member
of the SUDEP task force which studies
populations at
risk. Her research also includes outcome measures
in patients after
temporal lobectomy, and a
developing study on the effects of Lamictal
withdrawal.
Kenneth L. Tyler, MD
Dr. Tyler’s laboratory uses both in vivo and
in vitro models to study the molecular
and
genetic basis of viral pathogenesis and
viral-induced cell death. A major
research effort
investigates the mechanisms by which viruses induce
apoptosis.
Current projects include: (1)
investigating the role played by specific viral
genes and
the proteins they encode in triggering
apoptosis; (2) identifying the role of apoptosis
in
mediating virus-induced tissue injury in various
target organs, including the CNS
in vivo (3)
defining the cellular pathways by which apoptosis is
induced in virus-
infected cells. Studies of
cellular mechanisms of apoptosis currently involve
investigations into virus-induced alterations in MAP kinase and other signal
transduction pathways,
transcriptional activators including c-Jun and NF-kB,
the
use of genomic microarray and proteomic
technology to identify genes and proteins
altered
during viral infection of target cells, and
identifying death-receptor and
mitochondrial caspase
signaling pathways. Further details about specific
personnel
and their projects can be found on the
Tyler lab web site at:
http://www.uchsc.edu/sm/neuro/tylerlab.
Ongoing clinical research includes
projects
sponsored by the Collaborative Antiviral Study
Group, the AIDS Clinical
Trials Group, and the Neurologic AIDS Research Consortium in areas of West
Nile
virus infection, herpes encephalitis, and the
neurological complications of HIV
infection.
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