The Behavioral Neurology Section, established in 1991 to represent the study of brain-behavior relationships, is directed by Dr. Filley while Dr. Anderson serves as Associate Director. Clinical expertise is broad, and includes the dementias, focal neurobehavioral syndromes, traumatic brain injury, neuropsychiatric disorders, neurobehavioral aspects of movement disorders, and higher visual dysfunction. Research is conducted by all section members, extensive educational opportunities are regularly available, and a fellowship is offered for interested residents. Our combined academic efforts recently led to publication of a comprehensive textbook: Behavioral Neurology & Neuropsychiatry, Cambridge University Press, 2013.
The major project of the section now underway is the expansion of our national presence in Alzheimer’s Disease (AD). Dr. Woodcock joined the faculty in 2012 and is directing the clinical component of this program, in close collaboration with Huntington Potter, PhD, whose innovative investigations of the neurobiological links between AD and Down Syndrome will be the foundation of research. The goal is to build upon existing strengths in clinical care for AD and other dementias by developing unique research expertise that will enable application for an AD center funded by the National Institute on Aging.
Behavioral Neurology faculty:
Christopher M. Filley, MD
C. Alan Anderson, MD
Jonathan H. Woodcock, MD
Benzi M. Kluger, MD, MS
Victoria S. Pelak, MD
Hal S. Wortzel, MD
The Epilepsy section and its faculty offer both state-of-the-art clinical care and cutting edge research opportunities to patients with epilepsy and seizures from a six-state referral region. As a Level 4 Epilepsy Center, we provide comprehensive outpatient care and neurodiagnostic testing, as well as expert inpatient diagnosis and characterization of seizures in our 6-bed Epilepsy Monitoring Unit. Our multidisciplinary Epilepsy Surgery Program offers both pre-operative and post-operative care for patients undergoing brain surgery or implantation of neuromodulatory devices to control their seizures and combines the expertise of faculty epileptologists, neurosurgeons, neuroradiologists and neuropsychologists. The Neurofeedback Clinic offers an additional option for seizure management for those patients with medically-refractory seizures.
Epilepsy education at the University of Colorado Hospital is designed to provide residents and fellows with didactic and experiential training in all aspects of clinical epileptology and EEG, including: diagnosis and management of epilepsy and its comorbidities, outpatient EEG, inpatient ICU continuous EEG-monitoring, presurgical evaluation of patients with epilepsy, vagus nerve stimulation and Wada testing. In addition, collaborations with the Pediatric Epilepsy Fellowship Program at Children’s Hospital Colorado and the Sleep Medicine Fellowship at National Jewish Hospital allow additional exposure to pediatric epilepsy, EEG and sleep medicine topics.
Epilepsy faculty are involved in multiple arenas of clinical research that range from multisite clinical trials studying new potential anti-seizure medications to investigator-initiated studies of the effects of behavioral interventions on seizure control. Other projects have also focused on lowering rates of electrode-related skin irritation in the EMU and on lowering times to treatment and clinical resolution in cases of status epilepticus.
Mark C. Spitz, MD
Cornelia N. Drees, MD
Lauren C. Frey, MD
Pearce J. Korb, MD
Chantal M. O'Brien, MD
Scott Pearson, MS, PA-C
Archana A. Shrestha, MD
Laura A. Strom, MD
The General Neurology service at the University of Colorado is a consulting service delivering diagnostic expertise and providing a complete care plan which may be executed by the referring physician. If studies for diagnostic purposes are required at the time of consult, a follow up visit will be arranged to complete the diagnostic process.
The neurologists in the general neurology section have individual subspecialty expertise including epilepsy, stroke, neuro-oncology, sleep disorders, neuro-infections, head and face pain. Any patient requiring further sub-specialty care will be appropriately referred as needed. Within the general neurology group there are two physicians and one physician assistant who provide continuity of care for complicated and refractory headache patients, with a complete treatment approach including Botox injections.
The University of Colorado Movement Disorders Center (MDC) provides state of the art interdisciplinary clinical care and community outreach to patients and families in the Rocky Mountain Region, pursues research to treat and prevent movement disorders and educates the next generation of clinicians and researchers in this field. The University of Colorado has a distinguished history of excellence including the first and largest trial of cell transplantation for Parkinson’s disease, development of the most widely used specialized speech therapy for Parkinson’s disease, ground-breaking work in the description of Fragile-X Tremor Ataxia Syndrome, development of the first palliative care clinic in the United States focused on movement disorders and one of the largest deep brain stimulation surgery centers in the country. More than 3,000 movement disorders patients are served by the University of Colorado Hospital MDC clinics annually - by far the Rocky Mountain Region’s largest referral center for these conditions. In addition to outpatient visits, our practitioners also provide specialized services such as Deep Brain Stimulation surgery (DBS), botuliunum toxin injections (Botox), physical therapy, occupational therapy, speech therapy, neuropsychological testing and psychiatric services. University of Colorado Movement Disorders investigators are conducting 30-50 research studies at any time, funded by the National Institutes of Health and other governmental agencies, Michael J. Fox Foundation and other private foundations and industry. These studies include: basic research, translational and clinical trials; multi-center and investigator initiated trials; and collaborations across our department, medical school, campus, and local, national, and international institutions. Our faculty engages students and graduates of all levels in these research projects.
As well as educating students in research, our faculty teaches health care students and professionals locally, nationally and internationally. The MDC sponsors a monthly campus multidisciplinary lecture series and co-sponsors a quarterly video rounds and an annual CME event for local physicians and neurologists. MDC members have an educational conference every other week, which includes journal club, lectures and video rounds. Further, the MDC actively participates in and educates community lay movement disorders groups.
Movement Disorders Center faculty:
Maureen A. Leehey, MD
Benzi M. Kluger, MD, MS
Brian D. Berman, MD, MS
Olga S. Klepitskaya, MD
Christen Epstein, MS
Carol Hennessy, MSN4
Division Chiefs and Co-Directors,
Rocky Mountain MS Center
The Neuroimmunology group of the Department of Neurology at the University of Colorado is comprised of seven physicians, four physician assistants, three RNs and a host of associate staff. The physicians include two relatively unique subspecialties, a pediatric MS specialist and a neuroimmunologically trained hospitalist, both among a select few in the country. We provide clinical care at four sites in Denver and the surrounding region, with the bulk of patients seen at the University of Colorado Hospital. This year we will complete over 8,000 patient visits for multiple sclerosis and other immunological conditions affecting the central nervous system. We provide state-of-the-art care, and partner with dedicated experts in numerous related fields including neuro-ophthalmology, neuro-radiology, neuro-urology, physical therapy, neuro-otology, neurosurgery, neuropsychology and many others. Through an affiliation with a longstanding patient advocacy organization, the Rocky Mountain Multiple Sclerosis Center, we offer local, regional, national and international education for patients, their families, and their providers (through professional education).
In addition, we have a robust basic and translational science program dedicated to a greater understanding of MS and related conditions, with several labs within the department of Neurology and related departments. We run the Rocky Mountain MS Center Tissue Bank, providing CNS tissues to international researchers for over 30 years. Our clinical research program is one of the largest in the U.S., with over 40 active clinical research projects focused on both clinical trials as well a greater understanding of these conditions.
John R. Corboy, MD
Tim L. Vollmer, MD
Anastacia Wall, PA
Enrique Alvarez, MD, PhD
Julie Berk, PA-C
Melissa Butler, MS, PA-C
Augusto A. Miravalle, MD
Teri L. Schreiner, MD, MPH
Kendra Yale, MMedSci, PA-C
The neuromuscular clinic at the University of Colorado Hospital (UCH) continues to serve as a regional referral center for the six-state area with 500 new patients and 1500 follow-up visits annually. The clinic and neuromuscular program are directed by Steven P. Ringel, MD
and includes Dianna Quan, MD
, director of the Electrodiagnostic laboratory, Teerin Liewluck, MD
, Debra O’Reilly, PA, and a neuromuscular fellow. The clinic has a close working relationship with the neuromuscular clinic at Children’s Hospital of Colorado (CHCO) so that children with chronic neuromuscular conditions can seamlessly transition to adult care.
We interpret 275 muscle/nerve biopsies annually and refer 250 patients/year for electrodiagnostic (EMG/NCVs) studies. Our multidisciplinary ALS clinic includes physical, occupational and speech therapy, a dietician and durable medical equipment vendors. The clinic is sponsored by the Muscular Dystrophy Association (MDA) and an MDA patient representative participates. All patients are discussed in a weekly staff meeting.
The neuromuscular program and research center have been in existence for more than 50 years and has made major educational and research contributions in a variety of diagnostic and therapeutic areas. We founded the Western ALS (WALS) Study group and continue to participate in multi-university trials with this consortium as well as with the NEALS consortium.
is director of the fellowship and neuromuscular educational programs. Our fellowship program is ACGME approved and includes rotations at UCH and CHCO. Fellows are required to complete a performance improvement project and are given the opportunity to participate in clinical research. Over the years, some have conducted independent research in a second year of fellowship and are now academic physicians at other universities. Our pediatric and adult neuromuscular faculty physicians attend a monthly neuromuscular research conference and are integrated into all of the educational programs of the Department of Neurology.
Steven P. Ringel, MD
Dianna Quan, MD
Teerin Liewluck, MD
Vera Fridman, MD
Debra O'Reilly, PA7
The Neuro-Oncology program at the University of Colorado is the regional tertiary referral base for the Rocky Mountain Region, serving a six state region of Colorado, Wyoming, Montana, Nebraska, Oklahoma, and New Mexico. The University of Colorado Cancer Center is an NCI-Designated Comprehensive Cancer Center and a National Comprehensive Cancer Network (NCCN) Member Institution. We offer the latest advances in care for adult patients with tumors of the brain, spinal cord, or meninges, genetic disorders that cause tumors within the nervous system such as neurofibromatosis, as well as neurologic complications of systemic cancer and its treatments.
Medical Neuro-Oncology works closely with a multi-disciplinary team including neurosurgeons, radiation oncologists, neuropathologists, and neuroradiologists to create a comprehensive treatment plan unique to each individual patient taking into account the patient’s and family’s needs while providing state-of-the-art care and access to new developments and appropriate clinical trials. Neuro-Oncology patients are additionally supported by the availability of dietician, social work, physical medicine, and neuropsychological services.
A major mission of our Neuro-Oncology Program is to contribute to advances in treatment of brain tumors through clinical trials. We offer our patients access to a range of clinical trials for various types and stages of brain and spinal cord cancers. We have participated in clinical trials of the following types of treatments:
• Radiation in unusual doses or schedules
• Radiation-enhancing or sensitization drugs
• Experimental chemotherapy drugs
• Chemotherapy drugs known to be effective against other tumors, but experimental for brain tumors
• Immunotherapy treatment using a vaccine directed against tumors
• Targeted therapies designed to attack specific molecular abnormalities in the tumor
• Angiogenesis inhibitors
• Electrical field based therapy, an anti-mitotic therapeutic device that exploits the mechanical properties of dividing cells
The Neuro-Oncology program actively participates in the education of medical students, residents, and fellows with both didactic lectures and outpatient clinical rotations. We anticipate designation as an United Council for Neurological Subspecialties (UCNS) certified Neuro-Oncology Fellowship program in 2013.
• Rusthoven KE, Olsen C, Franklin W, Kleinschmidt-Demasters BK, Kavanagh BD, Gaspar LE, Lillehei K, Waziri A, Damek DM
, Chen C. Favorable Prognosis in Patients with High-Grade Glioma with Radiation Necrosis: The University of Colorado Reoperation Series. Int J Radiat Oncol Biol Phys. 81(1):211-217, 2011.
• Fields EC, Damek D, Gaspar LE, Liu AK, Kavanagh BD, Waziri A, Lillehei K, Chen C. Phase I Dose Escalation Trial of Vandetanib With Fractionated Radiosurgery in Patients With Recurrent Malignant Gliomas. Int J Radiat Oncol Biol Phys. 82(1):51-57, 2012.
• Khalil A, Serracino H, Damek DM, Ney D, Lillehei KO, Kleinschmidt-DeMasters BK. Genetic characterization of gliomas arising in patients with multiple sclerosis. J Neurooncol. 2012;109(2):261-72 [Epub 2012/05/02].
• Reddy K, Damek D, Gaspar LE, Ney D, Waziri A, Lillehei K, Stuhr K, Kavanaugh BD, Chen C. Phase II trial of hypofractionated IMRT with Temozolomide for patients with newly diagnosed glioblastoma multiforme. Int J Radiat Oncol Biol Phys. 2012;84(3):655-60 [Epub 2012/04/10].
• Schmidt Y, Kleinschmidt-DeMasters BK, Aisner DL, Lillehei KO, Damek DM. Anaplastic PXA in adults: case series with clinicopathologic and molecular features. J Neurooncol. 2013; 111(1):59-69. [Epub 2012/10/25].
• Reddy K, Gaspar LE, Kavanagh BD, Waziri A, Damek DM, Ney D, Lillehei KO, Chen C. Prospective evaluation of health-related quality of life in patients with glioblastoma multiforme treated on a phase II trial of hypofractionated IMRT with temozolomide. J Neurooncol. 2013; 114(1):111-6. [Epub 2013/6/2]
Denise M. Damek, MD
Douglas E. Ney, MD
The Division of Neuro-Ophthalmology is focused on the advancement and delivery of care to patients with vision problems due to disorders of the nervous system. In the clinic, Drs. Victoria Pelak and Jeffrey Bennett deliver highly specialized subspecialty care to patients with optic nerve disorders, visual field loss, double vision, higher-order visual dysfunction, orbital diseases, and unexplained vision loss. In addition to individual care, clinical research in optic neuritis, neuromyelitis optica, and visual-cognitive function is performed through participation in multicenter and investigator-initiated clinical trials. Outside of the clinic, the division of neuro-ophthalmology has active translational research and educational programs. Dr. Bennett conducts research on the pathophysiology of neuromyelitis optica and multiple sclerosis, and Dr. Pelak investigates cortical visual processing, with a particular focus on the effects of aging and dementia on visual motion processing. Dr. Pelak directed the Neurology Residency program from 2007-2013, and both Dr. Bennett and Dr. Pelak are actively involved in training residents and medical students. Neuro-ophthalmology education is offered during numerous resident education seminars in the neurology and ophthalmology departments, grand rounds, and elective and required outpatient clinic rotations.
Tradtrantip, L., Zhang, H., Saadoun, S., Phuan, P.W., Lam, C., Papadopoulos, M.C., Bennett, J.L., Verkman, A.S.: Anti-Aquaporin-4 Monoclonal Antibody Blocker Therapy for Neuromyelitis Optica. Ann Neurol. 71(3):314-322, 2012.
Levin, M. H., Bennett, J. L., and Verkman, A. S. Optic neuritis in neuromyelitis optica. Prog Retin Eye Res, 36:159-171, 2013.
Mathias M., Nagel M.A., Khmeleva N., Boyer P.J., Choe A., Durairaj V.D., Bennett J.L., Mandava N., and Gilden D. VZV multifocal vasculopathy with ischemic optic neuropathy, acute retinal necrosis and temporal artery infection in the absence of zoster rash. J Neurol Sci, 325:180-182, 2013. 24.
Jin M, Pelak VS, Cordes D. Aberrant default mode network in subjects with amnestic mild cognitive impairment using resting-state functional MRI. Magn Reson Imaging; 30:48-61, 2012.
Jin M, Pelak VS, Curran T, Nandy RR, Cordes D. A preliminary study of functional abnormalities in aMCI subjects during different episodic memory tasks. Magn Reson Imaging; 30:459-470, 2012.
Nanji AA, Klein KS, Pelak VS, Repka MX. Nonarteritic anterior ischemic optic neuropathy in a child with optic disk drusen. J AAPOS; 16(2):207-209, 2012.
Victoria S. Pelak, MD
Jeffrey L. Bennett, MD, PhD9