Brian G. Weinshenker, M.D., has several research interests related to inflammatory demyelinating diseases of the central nervous system (CNS).
Fulminant demyelination and neuromyelitis optica (NMO). Dr. Weinshenker investigates the classification and treatment of fulminant demyelinating diseases of the CNS and co-developed diagnostic criteria and characterized the natural history of neuromyelitis optica (Devic's disease), including the recent International Panel for NMO Diagnosis, the recommendations of which were published in 2015 and serve as the standard for diagnosis of this condition.
Dr. Weinshenker was a member of the team whose research led to the discovery of NMO-IgG, a highly specific and moderately sensitive new antibody biomarker for neuromyelitis optica and other restricted types of inflammatory demyelination — including longitudinally extensive transverse myelitis and recurrent optic neuritis. He demonstrated that aquaporin-4 is highly expressed in the optic nerve and spinal cord relative to other regions of the central nervous system that, in part, explains the unique topography of lesions of neuromyelitis optica.
- Multiple sclerosis (MS). Dr. Weinshenker has characterized the natural history of MS in a series of papers based on an evaluation of a large population- and clinic-based series in London, Ontario. This work has facilitated the design and interpretation of clinical trials to evaluate new treatments for MS. He also conducted investigations to identify susceptibility genes for MS and neuromyelitis optica.
- Rescue treatments for attacks of MS. Dr. Weinshenker conducted a randomized, sham-controlled trial of plasma exchange in fulminant demyelinating disease and showed that it can salvage neurological function in patients who have severe deficits refractory to corticosteroid therapy. This treatment has become the international standard of treatment in this clinical situation.
- McArdle's sign. Dr. Weinshenker investigated a poorly recognized phenomenon called McArdle's sign and, using a torque measurement device to quantitatively measure it, demonstrated that its presence can be used to specifically diagnose MS when compared to patients with other myelopathies. These results were published in Mayo Clinic Proceedings in 2019. Dr. Weinshenker is now pursuing other studies of McArdle's sign.
Significance to patient care
The research conducted by Dr. Weinshenker will lead to improved diagnostics and therapies for patients with demyelinating diseases.
- Listed, Highly Cited Researchers, Clarviate Analytics, 2016, 2017
- Editorial board member, Neurology, 2014-2017
- Listed, The World's Most Influential Scientific Minds, Thomson Reuters, 2014, 2015
- Editorial board member, Multiple Sclerosis Journal, 2008-2013
- Recipient, John Dystel Prize for Multiple Sclerosis Research, American Academy of Neurology and the National Multiple Sclerosis Society, Annual Meeting of the American Academy of Neurology, Honolulu, Hawaii, 2011