The autonomic disorders group conducts research focused on dysautonomias associated with pain such as functional abdominal pain, irritable bowel syndrome, interstitial cystitis, postural tachycardia syndrome, fibromyalgia, and cyclic vomiting syndrome. The aims of current studies are to ascertain the co-morbidities of these disorders, the familial occurrence patterns, and ultimately understand the genetic, epigenetic and environmental changes that influence their emergence across individuals. Another aim of the group is the study of structural disorders of the autonomic nervous system such as diabetic autonomic neuropathy and multiple system atrophy.
Current Autonomic Disorders Research
“Interstitial Cystitis Elucidation of Psychophysiologic and Autonomic Characteristics (ICEPAC)” - T Chelimsky, PI; R01-DK083538 NIH NIDDK. Co-Investigators: Buffington CAT, Janata, J, Chelimsky G, Hijaz A, Sanses T
The goal of this project is to determine the autonomic changes co-morbid with interstitial cystitis, compared to “generic” pelvic pain typified in the entity of myofascial pelvic pain. The underlying hypothesis is that interstitial cystitis is a member of the larger family of painful dysautonomias characterized by an aberrant stress response. The putative etiology of this aberrant response lies in epigenetic changes produced by an early life stress such as drug abuse during pregnancy or sexual abuse at a young age.
“Electroconvulsive therapy (ECT) in multiple system atrophy (MSA)” - T Chelimsky PI. CTSC grant from Case Western Reserve University
The hypothesis of this project is that patients with mid-course MSA will show reversal of their progression when treated with ECT. The putative mechanism of this improvement would be generation of glial-derived neurotrophic factor (GDNF), known to be absent in a mouse model of MSA and nearly undetectable in patients with MSA, and known to be the best correlate of depression response (rise in GDNF) to ECT.
Funding is being sought to study the role of estrogen in POTS (MCW medical student Rachel Sullivan), and to study fMRI aspects of painful autonomic disorders.
Established by Dr. Piero Antuono in 1985, the Dementia Research Center provides comprehensive diagnostic, follow-up, and research services through its Memory Disorders Clinic, the Brain Autopsy Program, and several study protocols. The Memory Disorders Clinic serves approximately 650 new and/or established patients annually. The multidisciplinary team includes three neurologists, faculty in psychiatry and neuropsychology, a medical social worker, and several nurses who specialize in dementia care and drug study protocols. Dr. Malgorzata Franczak, a graduate form our program has been working with Dr. Antuono in establishing clinical research protocols for several years and has a special interest in mild cognitive impairment (MCI).
The Center's research programs include fMRI in Alzheimer's Disease and Mild Cognitive Impairment, and MR spectroscopy in Alzheimer's Disease and Frontal Lobe Dementia. The Center's physicians and nurses are participating in the Nun Study, a collaborative project with the University of Kentucky to determine early life risk factors for dementia. Several drug trials with memory enhancing agents are currently underway for the prevention as well as treatment of Alzheimer's Disease.
The Dementia Research Center provides educational opportunities for the community, and physicians through an on-site caregiver support group, local workshops and seminars as well as presentations at national and international conferences. Specialized training in Dementia is also provided for geriatricians, neurologists, psychiatry residents, and medical students.
Links of Interest
National Alzheimer's Association
Alzheimer's Association - Southeastern Wisconsin Chapter
Wisconsin Alzheimer's Institute
Investigators in the Comprehensive Epilepsy Center conduct research focused on early detection and prevention of epilepsy, fMRI studies of brain mapping for surgical management of epilepsy, clinical trials of anticonvulsant medications, and basic research on epilepsy mechanisms using computational models and cortical slice preparations.
Drug trials and imaging research are employed to help those with Alzheimer’s Disease, Mild Cognitive Impairment and other Memory Disorders.
Neurology faculty conduct clinical trials of pharmacological agents for slowing the progression of Amyotrophic Lateral Sclerosis (ALS) and other neuromuscular diseases.
The Neuro-Oncology program carries out clinical trials of chemotherapeutic and other experimental treatments for brain cancer, as well as fMRI studies of tumor angiogenesis aimed at improving early detection. Clinical trials are conducted by Mark Malkin, MD and Jennifer Connelly, MD.
The Neuropsychology Brain Tumor Lab, directed by David Sabsevitz, PhD, conducts patient-centered research that seeks to better understand how brain tumor treatment affects cognitive processes and brain neurophysiology. Current research in the lab, funded by a pilot grant from the Froedtert Foundation, examines the effects of whole brain radiation on brain morphology using standard clinical and advanced imaging techniques (e.g., diffusion tensor imaging), developing models to predict cognition outcome following brain radiation, and examining the relationship between changes in functional connectivity and cognitive changes following brain radiation. This research involves collaborations with Dr. Joseph Bovi from Radiation Oncology and Dr. Peter LaViolette from Radiology.
Movement disorders specialists participate in a variety of therapeutic trials of pharmacological agents and deep brain stimulation techniques for the treatment of Parkinson's Disease, Huntington’s Disease, Essential Tremor, Dystonia and other movement disorders.
Neurocritical care services provided by neurointensivist Dr. Ann Helms, and advanced interventional neurology served by Dr Brian-Fred Fitzsimmons, and Dr. John Lynch in the Stroke and Neurovascular Center conduct clinical trials of treatments for acute stroke and stroke prevention, as well as basic research on mechanisms of brain ischemia.
Dr. Michael McCrea’s research focuses primarily on the acute and chronic effects of traumatic brain injury (TBI). He is the principal investigator on several studies that use a multitude of modalities to research the natural course of clinical and physiological recovery after TBI. One of his main areas of interest is the effect of sport-related concussion on athletes competing in contact and collision sports at all competitive levels. More recently, he has been involved in studying the effects of concussion and traumatic brain injury in soldiers serving in the wars in Iraq and Afghanistan.
Current Traumatic Brain Injury Center Research
"An Independent, Head to Head Study of the Reliability and Validity of Neurocognitive Test Batteries for the Assessment of Mild TBI" - M. McCrea, PI; funded by the Walter Reed Army Institute for Research (WRAIR)/ Medical Research Material Command (MRMC); Brooke Lerner, PhD, Thomas Balkin, PhD, Co-Investigators
"Acute Effects and Recovery after Concussion in Athletes: A Quantitative Brain Electrical Activity Study Using BrainScope" - M. McCrea, PI; funded by DonJoy Orthopedics, Inc.; Alison Brooks, MD, Co-PI
"National Sports Concussion Outcome Study (NSCOS)" - M. McCrea, PI; funded by the National Collegiate Athletic Association (NCAA); Steven P. Broglio, PhD; James T. Eckner, MD; Christopher Giza MD; Kevin M. Guskiewicz, PhD; and Jeffrey S. Kutcher, MD, Co-Investigators