I am a member of the Division of Multiple Sclerosis and Autoimmune Neurology. My research interests involve three main areas: 1) the clinical behavior, natural history, and management of central nervous system inflammatory demyelinating diseases, especially neuromyelitis optica (NMO) and multiple sclerosis (MS); 2) multiple sclerosis-related fatigue; 3) outcome measure development for multiple sclerosis clinical trials.
My Mayo Clinic colleagues and I have worked for more than a decade to better understand NMO, a severe, relapsing central nervous system disease that causes optic neuritis, transverse myelitis, and other neurological symptoms. We have developed new diagnostic criteria for the disease, which provide the basis for clinical diagnosis and research. Neuromyelitis optica is strongly associated with NMO-IgG, an autoantibody that targets the water channel aquaporin-4 and was discovered in Dr. Vanda Lennons's laboratory at Mayo Clinic.
Collectively, our work aims to understand the pathophysiology of this distinct disease and to develop more effective therapies. For example, Dr. Sean Pittock and I direct a novel therapeutic protocol examining whether eculizumab is effective in preventing relapses and disability.
Fatigue is the most common symptom of MS, but it is difficult to measure and to treat. I am the principal investigator of a three-site Mayo Clinic therapeutic protocol funded by the National Multiple Sclerosis Society in which we are examining the effects of aspirin on MS-related fatigue and also studying the relationships between subjective fatigue, cognitive function, motor performance, and immunological markers.
Progress in MS therapeutics could be faster if we had valid, reproducible, and objective measures of irreversible disease progression. I am collaborating with investigators in the Bioengineering Department at Arizona State University to develop objective measures of gait and motor function that predict future neurological deterioration before it is clearly evident on our routine clinical examination. Our goal is to develop instruments and techniques to detect these early changes and then use them as outcome meausures in pilot studies of interventions that aim to slow or arrest disease worsening in progressive forms of MS.
See my publications
- Consultant, Department of Neurology
- Director, Division of Multiple Sclerosis and Autoimmune Neurology, Department of Neurology
- Chair, Department of Neurology
- Professor of Neurology
- MSc - Health Research Methodology and Clinical Epidemiology McMaster University
- Fellow - Clinical Neuroimmunology/Multiple Sclerosis University of Western Ontario
- Fellow - Clinical Neuroimmunology Mayo Graduate School of Medicine, Mayo Clinic College of Medicine
- Resident - Neurology Mayo Graduate School of Medicine, Mayo Clinic College of Medicine
- Resident - Preliminary Internal Medicine Mayo Graduate School of Medicine, Mayo Clinic College of Medicine
- MD - with Great Distinction University of Saskatchewan
- BScMD - Thesis: Effects of acute (-)-deprenyl administration on dopamine metabolism in an animal model of Parkinson's disease. Advisors: AV Juorio, PhD; IA Paterson, PhD; AH Rajput, MD Neuropsychiatric Research Unit, College of Medicine, University of Saskatchewan
- BSc - Magna cum laude University of Saskatchewan