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September 16, 2004

Research Notes

NIH recognized Parkinson’s program

The School of Medicine’s Parkinson’s disease research program has become the 12th center in the nation to be named a Udall Center of Excellence by the National Institute of Neurological Disorders and Stroke (NINDS), one of the National Institutes of Health (NIH).

The designation includes more than $5 million over a five-year period.

There are 18 principal investigators studying Parkinson’s disease at the University. Together with 50 other faculty members, Pitt receives more than $16 million in grant funds each year from NINDS. Additional investigators study neurodegenerative diseases with funds from other agencies, including those concerned with mental health and aging. As a result, the university’s research effort in this area is one of the largest in the world.

Michael Zigmond, professor of neurology, psychiatry and neurobiology at the School of Medicine, is director of the center. Also involved in directing the program are Nicolaas Bohnen, assistant professor of neurology; Robert Y. Moore, professor of neurology; Amanda D. Smith, assistant professor of neurology; Karoly Mirnics, assistant professor of psychiatry and neurobiology, and Chester A. Mathis, professor of radiology. Additional participants include faculty from Wake Forest School of Medicine and the University of Texas, Austin.

Research at Pittsburgh’s Udall Center focuses on its recent novel finding that exercise can protect the brain against toxins that normally produce a Parkinson’s-like syndrome. The investigators also are working to develop ways to detect Parkinson’s disease in its earliest stages so that potential protective therapies can be applied before there are any major neurological deficits. A program also exists for physicians and researchers interested in advanced training in research on neurodegenerative disorders such as Parkinson’s.

Pittsburgh already has been designated as a National Parkinson Foundation Center of Excellence by the National Parkinson Foundation (NPF), co-directed by Moore and Zigmond. That center, partnering with the Movement Disorder Clinic, is involved in clinical care as well as research. The NPF Center has close ties with the Parkinson’s Chapter of Greater Pittsburgh, a lay group, affiliated with the NPF, providing services to patients and raising funds for research and treatment.

The Parkinson’s Disease Research Centers of Excellence program was developed in honor of former Congressman Morris K. Udall, who died in 1998 after a long battle with Parkinson’s disease. At least one million people in the United States suffer from Parkinson’s disease, a degenerative neurological disease that affects nerve cells in the brain, especially those that produce the chemical dopamine, and are important in the control of movement. The major early signs of Parkinson’s disease include slowness of movement, an abnormal increase in muscle tone and tremor. Many patients also experience disruptions of the sleep/wake cycle and can exhibit changes in mood and cognition. The disease is chronic and progressive.

CDC awards Pitt center $5 million

U.S. Centers for Disease Control and Prevention (CDC) awarded Pitt’s Center for Public Health Preparedness more than $5 million in grant funding for distribution over the next five years from the).

The center, part of the CDC’s national network of Academic Centers for Public Health Preparedness based in schools of public health, trains the public health workforce to respond to threats to the nation’s health from bioterrorism, infectious disease outbreaks and other health emergencies. Training is competency-based and delivered either on-site or through distance learning. Training sessions also are offered through continuing education programs and university courses and seminars.

Margaret A. Potter, associate dean of the Graduate School of Public Health (GSPH) and principal investigator, said: “This award affirms our existing partnership with the CDC, and endorses the strategic relationships we have enjoyed with state and local public health and emergency agencies across Pennsylvania in delivering university-based preparedness and response training and continuing education.”

The center will use the new funding to focus on its three areas of specialty: rural preparedness, legal preparedness and surge capacity, while continuing to deliver training and continuing education. Additionally, the center will work closely with the UPMC Center for Biosecurity and other Pitt partners to advance the translation of public health preparedness science and policy into practice.

Launched in July 2002, the Center for Public Health Preparedness aims to support efforts to build a public health workforce that is competent in disaster and emergency response and integrates the public health system with public safety, health care and emergency management systems.

UPMC Sports Medicine doctors caution high school athletes, parents and coaches about dangers of “mild” concussions

About one in 10 local high school athletes in contact sports will sustain a concussion during this fall sports season. And, many athletes, coaches and parents do not know how serious the effects of a seemingly mild concussion can be. That lack of awareness may result in allowing an athlete to return to play too soon following initial injury, placing him or her in danger of further, more serious injury, according to doctors at the UPMC Sports Medicine Concussion Program.

“Our biggest concern is that some people may take the effects of what might appear to be a mild concussion too lightly,” said Mark R. Lovell, a neuropsychologist and director of the UPMC program. “Too often we hear people trivialize the injury and refer to it as ‘just a bell ringer’ or ‘a ding,’ not realizing its actual severity and that it is not safe to return such athletes to play during that particular game.” Lovell’s concerns are based on recent UPMC clinical research showing that even seemingly mild concussions can have long-term serious effects on some of the brain’s neurocognitive functions and that the effects of multiple concussions can be cumulative.

“We’ve been seeing 30 to 40 high school athletes each week in our sports concussion clinic during this fall sports season while doing an additional 100 or so consultations by phone with athletic trainers and team or family physicians,” said Lovell.

“Most importantly for everyone to know is that the best way to prevent problems with a concussion is to properly manage it from the beginning. Generally, an athlete who sustains an initial concussion can fully recover as long as they do not sustain a second concussion before the brain has had time to heal from the first one. Research has shown that returning a mildly concussed athlete to play too soon before the brain has healed puts him or her at greater risk for a second concussion and more severe, longer-lasting neurocognitive damage.”

Michael Collins, assistant director of the UPMC program, said: “We know and respect the fact that competitive athletes want to play through injury, but because the symptoms of mild concussion can be so subtle, we see many athletes who may not realize that by continuing to play with this injury, they are risking their season or even more by allowing themselves to be more susceptible to further, more serious injury.”

The UPMC program has published eight clinical studies examining the effects of concussions specifically in high school athletes.

Here is what Lovell and Collins say that all high school athletes, coaches and parents need to know about concussions:

A concussion is any change in mental status that results when the brain is violently rocked back and forth inside of the skull due to a blow to the head, neck or upper body. Symptoms may include amnesia, confusion, disorientation, “not feeling right,” fogginess, headache, nausea, uncoordinated hand-eye movements and, in some cases, loss of consciousness. Symptoms are not always definite and vary in severity and longevity.

An athlete with a suspected concussion should NEVER return to play during the practice session or game at which he or she was injured, no matter how mild the injury appears and regardless of the severity or longevity of symptoms.

A concussed athlete should NEVER return to practice or play until all symptoms have disappeared and are not present during physical exertion and at rest.

Recovery time varies with each individual. Each concussed athlete should be evaluated individually rather than with traditionally used general evaluation and return-to-play guidelines.

An athlete with a suspected concussion should always be evaluated by an athletic trainer, team or family physician, or neuropsychologist before returning to play or practice. Athletes, coaches and parents should never self-diagnose or self-evaluate a concussion, regardless of how mild the injury or symptoms appeared to be or to have been.

The Sports Medicine Concussion Program is an ongoing clinical service and research program that focuses on the diagnosis, evaluation and management of sports-related concussions in athletes of all levels. UPMC doctors over the past decade have developed the first computerized concussion evaluation tool called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing), which objectively measures actual neurocognitive brain function along with reported symptoms to help determine injury severity, recovery and when it is safe to return to play. ImPACT is used by more than 400 high schools, 180 colleges and universities, 18 NFL teams, several major league baseball teams and numerous other organizations.

Filed under: Feature,Volume 37 Issue 2

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