Monday, Aug. 12, 2013
Neurological disorders, ranging from traumatic brain injury to Parkinson’s disease, epilepsy and Alzheimer’s disease, affect up to 1 billion people worldwide, causing an estimated 6.8 million deaths annually, according to the World Health Organization. At Virginia Commonwealth University, experts in neuroscience research and clinical care are working together to find ways to effectively reduce mortality and improve functional outcomes of patients.
“The sheer scope of the interdisciplinary neuroscience program at the VCU Medical Center is truly impressive,” said Sheldon Retchin, M.D., CEO of the VCU Health System and senior vice president for Health Sciences at VCU. “From the Traumatic Brain Injury Center and the Department of Physical Medicine and Rehabilitation to the Parkinson’s and Movement Disorder Center, psychiatry programs and the Virginia Treatment Center for Children, our cadre of internationally renowned physicians and investigators offer outstanding patient care and are working to accelerate discoveries through translational research for tomorrow’s treatments.”
VCU Traumatic Brain Injury Center
Groundbreaking traumatic brain injury research at VCU spans several decades, including pioneering work done in the Departments of Neurosurgery by Harold F. Young, M.D., and Anatomy and Neurobiology by John Povlishock, Ph.D., and their faculty collaborators.
The VCU Traumatic Brain Injury Center works to maximize the quality of life of persons with brain injury through the use of rehabilitation services. The program offers acute inpatient brain injury rehabilitation, comprehensive interdisciplinary evaluations and opportunities for research and participation in clinical trials.
This program works in close collaboration with the Veterans Health Administration and the Hunter Holmes McGuire VA Medical Center in Richmond, which is one of only seven VHA or military sites that comprise the Defense and Veterans Brain Injury Center (DVBIC). This partnership provides an integrated system that ensures all military personnel and veterans with brain injury receive specialized evaluation, treatment and follow-up care.
“As a lead center for brain injury rehabilitation within the VHA, our collaborative program with the McGuire VA Medical Center serves as a referral center and cooperates with multiple other acute, sub-acute and post-acute facilities to ensure persons receive necessary services at the appropriate state of their recovery,” said William C. Walker, M.D., professor and vice chairman of the VCU Department of Physical Medicine and Rehabilitation. “Through this program, we assist individuals and their families with getting access to available resources, based on the recommendations of the interdisciplinary treatment team.”
Walker is also the medical director of the Rehabilitation and Research Center and director of the Concussion Care Clinic at the VCU Medical Center. He is active on multiple clinical research grants involving persons with TBI, including a large epidemiology study of mild traumatic brain injury caused by blast exposure during Operations Iraq Freedom and Enduring Freedom.
VCU Center for Rehabilitation Science and Engineering
The VCU Center for Rehabilitation Science and Engineering (VCU-CERSE) is a comprehensive, interdisciplinary rehabilitation research center of excellence. VCU-CERSE brings together researchers, clinicians, rehabilitation specialists and academicians from the VCU schools of Medicine, Allied Health, Education and Engineering as well as the McGuire VA Medical Center and the Virginia Department of Rehabilitative Services to promote research, education, physical medicine and rehabilitation services, and clinical care for veterans, as well as children and adults with disabilities.
The Mid-Atlantic research site for the new national consortium funded by a $62.2 million federal grant to study TBI will be led by Steven West, Ph.D., associated professor in the VCU Department of Physical Medicine and Rehabilitation, who is the associate director of VCU-CERSE. His research focuses on access to care, particularly substance abuse care, for person with disabilities as well as on aspects of TBI rehabilitation. David Cifu, M.D., the consortium director and principal investigator for the federal grant, is the executive director of VCU-CERSE. Cifu is also the chair of the VCU School of Medicine’s Department of Physical Medicine and Rehabilitation.
In 2001, the Veterans Health Administration created six specialized national Parkinson’s Disease Research, Education and Clinical Centers (PADRECC) in an effort to improve care for veterans suffering from Parkinson’s disease and other movement disorders and to pursue a cure.
One such center of excellence is the Southeast PADRECC, located at the McGuire VA Medical Center. This center serves the southeastern region of the United States as a referral center, providing comprehensive care to patients with Parkinson’s disease and other movement disorders. PADRECC services include multidisciplinary assessment and treatment, clinical trials, physician consultation, medical management, surgical interventions, neuropsychological services, physical and occupational therapy, speech therapy, caregiver resources, patient and family support groups and projects and educational materials. In collaboration with the VCU Medical Center, participation in PADRECC clinical research is also available to non-veterans with Parkinson’s disease.
VCU Parkinson’s and Movement Disorders Center
The VCU Parkinson’s and Movement Disorders Center combines research, clinical evaluation and treatment as well as education and outreach to provide a coordinated approach for developing strategies to combat movement disorders and neurodegenerative disorders.
“We are a translational, laboratory-based research program that focuses on developing therapies that we hope will slow down or stop Parkinson’s disease and other movement disorders,” said James Bennett Jr., M.D., Ph.D., founding director of the VCU Parkinson’s Disease and Movement Disorders Center and professor and chair of the VCU Department of Neurology. “Our clinical multidisciplinary diagnostic and therapeutic program provides multidisciplinary clinical diagnosis and care for Parkinson’s and related movement disorder patients.”
The center provides a seamless experience for the movement disorders community by providing access to clinicians from a variety of disciplines. Experts available through the center include neurologists, clinical neuropsychologists, physical therapist, psychiatrist, speech therapist and genetic counselor. The comprehensive center provides care for the full spectrum of movement disorders, including dystonia, essential tremor, Huntington disease, multiple system atrophy, Parkinson’s disease, Tourette’s syndrome, Wilson disease, dyskinesias and others.
Deep Brain Stimulation Program
Deep brain stimulation (DBS) is a surgical intervention used to treat movement disorders such as dystonia, essential tremor and Parkinson’s disease when the regimen of existing medications and the various rehabilitation strategies become less effective in managing symptoms.
DBS administers a well-controlled electrical current into the target areas of the brain. This electrical current functions as an “off switch” by disrupting the abnormal brain signals responsible for the abnormal physical movement. The disruption helps restore normal activity in the brain, thus enabling more controlled movement. The electrical impulses are generated from an implanted battery and then pass through the lead and into the target area. This entire system is implanted under the skin.
Kathryn Holloway , M.D., professor of neurosurgery and program director of the DBS program at VCU, and her team provide evaluation for DBS and surgery. Holloway is an expert in DBS having completed more than 300 surgeries. She is part of the team that developed and researched the frameless DBS technology. Holloway is also the neurosurgical director for the Southeast PADRECC.
Epilepsy Center of Excellence
In yet another partnership with the McGuire VA Medical Center, VCU physicians and researchers collaborate with the VA Medical Center’s Epilepsy Center of Excellence. The McGuire VA is one of four Regional Epilepsy Centers of Excellence. Core epilepsy services provided by the center include comprehensive outpatient and inpatient care, video-EEG monitoring, neuroradiology, surgery, rehabilitation and educational services. Clinical staff members diagnose and treat potential seizures in patients who have suffered a traumatic head injury.
The epilepsy center is also linked to the VCU-affiliated VA Polytrauma Care Center, which is one of five lead centers in the country. Polytrauma refers to injuries to multiple body parts and organ systems that may cause long term impairments and functional disabilities. One of the most common injuries includes TBI. Other injuries include fractures, burns, spinal cord, hearing loss or damage, visual impairments or blindness and post-traumatic stress disorder.
VCU Department of Psychiatry
The Department of Psychiatry at the VCU Medical Center is a leading contributor to mental health research, teaching and clinical services. Faculty members see patients of all ages who suffer from a variety of mental illnesses, from mood disorders and psychosis to personality and addictive disorders. Recent research suggests that individuals who have suffered a mild TBI are at increased risk for addiction-related disorders.
In early 2013, VCU welcomed F. Gerald Moeller, M.D., as the new division chair of addiction psychiatry. Moeller is a preeminent researcher with a focus on braining imaging in addiction medicine.
“As a clinical and translational investigator, Dr. Moeller adds a new dimension to VCU’s exceptional research base in the neurobiology and genetics of drug and alcohol addiction,” said Jerome F. Strauss III, M.D., Ph.D., dean of the VCU School of Medicine.
Virginia Treatment Center for Children
Research has shown that children who have suffered a mild TBI are at increased risk for psychiatric illness. Virginia Treatment Center for Children (VTCC) is a child and adolescent psychiatric program of Children’s Hospital of Richmond at VCU. Established in 1962, the VTCC provides inpatient acute care crisis stabilization and a full spectrum of outpatient mental health services for children and adolescents.
The Child Mental Health Resource Center, founded by VTCC and opened in March 2011, is a collaborative effort with the VCU Department of Psychiatry and a coalition of organizations and individuals in the Greater Richmond community who came together with the goal of making it easier to navigate the complex system of mental health care for children.