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UCTV: Why did you decide to focus your professional life on clinical care and research on Parkinson’s disease?

Michael J. Aminoff: Parkinson’s disease is a chronic, disabling disorder that—when I was an intern—had no effective medical treatment. In those early days, to watch patients respond to a newly discovered therapy with levodopa was both inspiring and touching.

UCTV: The Parkinson’s Disease Clinic and Research Center at UCSF is described as a comprehensive treatment center. What does that mean and why is it important to take a comprehensive approach?

MJA: Parkinson’s disease is a disorder that affects many parts of the nervous system, and thus the body. In addition to disturbances of movement, characterized by slowness, stiffness, and tremor, the disease may cause postural imbalance, intellectual decline, depression, anxiety, disturbances of bladder and bowel functions, disturbances of sweating and blood pressure control, loss of the sense of smell, and other problems. Thus, a comprehensive approach to its management is mandatory. It includes physical, speech, and occupational therapies as well as cognitive assessment and treatment, urological management, and social support. Some patients will also need neurosurgical treatment. The staff at our center has extensive experience with many of these different aspects and has established referral links to help patients receive the multidisciplinary care that they require.

UCTV: What type of interactions do clinicians treating patients have with the researchers doing studies at the center?

MJA: We have a close interaction with translational and basic scientists. Indeed, one of the functions of our center is to bring to the clinic advances made in the laboratory. For example, Dr. Bankiewicz, in his laboratory, developed a form of gene therapy for animals with an experimentally induced type of parkinsonism, and in collaboration with him, we then tested this in humans with Parkinson’s disease. The encouraging results that we obtained will, we anticipate, lead to further and more extensive studies of this approach. Our physicians and scientists meet regularly to discuss clinical or scientific advances and their implications for patients with Parkinson’s disease.

UCTV: Much of the center’s research involves clinical trials. What is the value of a clinical trial and how can people get involved?

MJA: Clinical trials allow participants to receive otherwise unavailable treatments. The aim is to establish whether a particular treatment is beneficial for patients. It is only too easy for physicians or patients to believe they are being helped by a novel therapy, if only because they want to see a beneficial response. Clinical trials provide an objective means of determining whether benefit occurs to a particular treatment, and usually involve comparing the response to active treatment or placebo. Our web site lists current studies in progress at UCSF, and a national web site lists trials throughout the country.

UCTV: Parkinson’s disease research has made huge advances in recent years. What are some of the most interesting discoveries you have seen?

MJA: I have seen the disease move from being untreatable to one for which a variety of treatments are now available, at least for the movement disorder that is a major feature of the disease. Over my career, I have seen the advent of levodopa, drugs that act like it (dopamine agonists), the development of new surgical techniques such as deep brain stimulation, and now the beginnings of gene therapy. These have been truly exciting times.

UCTV: Where do you see Parkinson’s disease research going in the future?

MJA: I see an extension of gene therapies and eventually the development of stem cell therapies. I expect that therapies to slow or even reverse the disease will be developed (at present, treatments are purely symptomatic, i.e., help the symptoms without affecting the underlying disease process). It may eventually be possible to predict a patient’s response to therapy by their genetic make-up. There is much to look forward to.

UCTV: What do you want viewers of this program to learn about Parkinson’s disease?

MJA: That there is an increasing understanding about the nature and varying manifestations of Parkinson’s disease, and growing expertise in its management.

Michael J. Aminoff, MD, DSc, FRCP
Professor and Executive Vice Chair
Department of Neurology
Director of the Parkinson’s Disease and Movement Disorders Clinic
University of California, San Francisco

Dr. Aminoff was born and educated in England, graduating from University College London in 1962 and as a physician from University College Hospital Medical School in 1965. He subsequently trained in neurology and clinical neurophysiology at The National Hospital (Queen Square) in London, and also undertook basic research on spinal physiology at its affiliated Institute of Neurology, being awarded the MD degree (in England, an advanced medical degree based upon research) on completion of his thesis. In 1974, he moved to UCSF where he has been Professor of Neurology since 1982. He was Director of the Clinical Neurophysiology Laboratories at UCSF until 2004, when he became Executive Vice Chair of the department, and also directs the Parkinson’s Disease Clinic and Research Center. He is currently directing a gene therapy study of Parkinson’s disease, and is involved in other clinical trials and physiological studies of patients with movement disorders.

Dr. Aminoff is the author of over 200 published medical or scientific articles, as well as the author or editor of some 27 books and of numerous chapters on topics related to neurology. His published scientific contributions led to the award of a Doctorate in Science, an advanced doctorate in the Faculty of Science, by the University of London in 2000. He is one of the two editors-in-chief of the four-volume Encyclopedia of the Neurological Sciences (Academic Press, 2003), and one of the series editors of the multi-volume Handbook of Clinical Neurology (Elsevier). He was Editor-in Chief of the journal Muscle & Nerve from 1998 to 2007 and serves on numerous other editorial boards. His other interests include medical history and his new biography of Brown-Séquard was published by Oxford University Press in October 2010.

Dr. Aminoff is a Director of the American Board of Psychiatry & Neurology. He received the Lifetime Achievement Award, American Association of Neuromuscular & Electrodiagnostic Medicine in 2006 and the A.B. Baker Award of the American Academy of Neurology for life-time achievements and contributions to medical education in 2007.

Krystof Bankiewicz, MD, PhD
Professor and Kinetics Foundation Chair in Translational Research
Departments of Neurological Surgery and Neurology
University of California, San Francisco

Dr. Bankiewicz received his MD degree from Jagiellonian University in Crakow and his PhD degree from the Institute of Neurology and Psychiatry in Warsaw, Poland. After his residency and an appointment as Assistant Professor with the Post-graduate Medical Center in Warsaw, he received a Fogarty Fellowship and became a Visiting Fellow and then Visiting Associate Scientist with the Surgical Neurology Branch of the NINDS at the NIH in Bethesda, Maryland. There he became Chief of the Central Nervous System (CNS) Implantation Unit in 1991. Shortly afterward, he came to California to serve as Chief of Preclinical Studies with the Somatix Therapy Corporation in Alameda; the Director of the Division of CNS Implantation and Regeneration with The Parkinson’s Institute in Sunnyvale, and from 1994-1998, a visiting scientist with the Laboratory for Functional Imaging of the Lawrence Berkeley National Laboratory. From 1997-2001 he returned to the NIH as Acting Chief of the Molecular Therapeutics Section of NINDS. He has been Professor of Neurological Surgery and a Principal Investigator with the Movement Disorders Research Program and the Brain Tumor Research Center at the UCSF since 1998.

Dr. Bankiewicz is an inventor of 8 patents and has published more than 100 peer-reviewed research articles. He has considerable experience in supervising multi-investigator translational programs and is a Principal Investigator on several multi-center, multi-investigator grants. He has supervised a total of 25 post-doctoral fellows and manages a core research group of 20 individuals including technicians, post-doctoral fellows, and a senior scientist. He is currently Professor (In Residence) in the Neurosurgery and Neurology Departments at UCSF.

Throughout his career, he has maintained a strong focus on the development of practical approaches to gene and cell replacement therapies, and has displayed a remarkable ability to synthesize several individual technologies into powerful new approaches to the treatment of such serious diseases as brain cancer and neurodegenerative disorders of the brain, including Parkinson’s disease. Dr. Bankiewicz was instrumental at every stage of the Phase-1 clinical trial for AAV-hAADC gene therapy at UCSF.

Chad Christine, MD
Associate Professor
Department of Neurology
University of California, San Francisco

Dr. Chad Christine joined the UCSF Neurology faculty in 1999 and concentrates his practice and research on movement disorders. He attended medical school at Cornell University Medical College and completed his residency in neurology at UCSF in 1995. After completing residency, Dr. Christine studied synaptic transmission and plasticity in basic science laboratories at UCSF. He finds this experience extremely helpful, since all of the medications used for the treatment of movement disorders affect synaptic transmission and potentially synaptic plasticity.

Along with his colleagues, Dr. Christine sees patients in the UCSF Movement Disorders Clinic. Since confirmatory tests are not available for most movement disorders, Dr. Christine is working to develop methods to provide confirmation of a clinical diagnosis and is interested in understanding environmental risk factors for movement disorders.

Dr. Christine’s research on Parkinson’s disease (PD) treatment has included collaboration in randomized trials examining the relative benefits of globus pallidus versus subthalamic deep brain stimulation for the treatment of advanced PD. In addition, he and Dr. Michael Aminoff are participating in a long-term, NIH funded study to determine whether creatine slows the progression of PD. Finally, in collaboration with Drs. Aminoff, Starr and Larson, he has completed a phase 1 study of gene therapy study for advanced PD. The study utilizes the gene amino acid decarboxylase, the human gene which converts levodopa into dopamine. He received the William Koller Memorial Fund Award in 2006 in recognition of his work on this new treatment.

In addition to these roles in clinical neurology, Dr. Christine enjoys teaching medical students and residents in his clinic. He has developed a website-based resource for patients with PD and has recently developed a similar website as a resource for residents and other practitioners treating patients with PD.

Mariann Di Minno, RN, MA, CNS
Director of Outreach
Parkinson’s Disease Clinic and Clinical Research Center
Department of Neurology
University of California, San Francisco

Registered nurse Mariann Di Minno serves as the coordinator of the UCSF Parkinson’s Disease Clinic & Research Center and co-director of the UCSF Parkinson’s Disease Community Outreach, Diagnosis and Treatment Project. Di Minno is a clinical nurse specialist. She received her master’s degree in nursing from New York University and completed doctoral training in social and organizational psychology at the University of Chicago. She then went on to teach nursing at Bradley University in Peoria, Illinois; Radford College in Radford, Virginia; and Duke University in Durham, North Carolina. Currently, Di Minno is a clinical assistant professor in the UCSF School of Nursing. She has a special interest in the impact of cultural beliefs on the understanding of illness and its management, as well as the treatment and management of Parkinson’s disease.

Robert H. Edwards, MD
Professor
Departments of Neurology and Physiology
Co-Director, Cell Biology Graduate Program
University of California, San Francisco

Robert Edwards is a Professor with joint appointments in the Departments of Neurology and Physiology at UCSF. A native of New York City, he graduated from Yale College and Johns Hopkins Medical School. He did clinical training in neurology at UCSF, then joined the laboratory of William Rutter at UCSF for postdoctoral fellowship, where he worked on neurotrophic factors. He first obtained an independent faculty position at UCLA, in the Departments of Neurology and Biological Chemistry, where he began to work on neurotransmitter transporters and Parkinson’s disease. In addition, the Edwards lab has contributed to molecular cloning of the first opioid receptor, as well as the synaptic vesicle protein SV2. He moved back to UCSF in 1995 and has continued to make fundamental contributions to our understanding of both neurotransmitter release and neurodegenerative disease. His group has identified three distinct families of proteins that transport classical transmitters into synaptic vesicles, and explored their role in synaptic transmission using a combination of biochemistry, biophysical methods, optical imaging and genetic manipulation in mice. The group is also exploring both physiological and pathological roles of the Parkinson’s disease-associated protein alpha-synuclein. He is a member of the American Society of Clinical Investigation and has won a number of awards, including two Distinguished Investigator Awards from NARSAD. Dr. Edwards has served on scientific advisory boards of the Hereditary Disease Foundation and the Tourette’s Association and currently serves on the Scientific Advisory Board of the National Parkinson’s Foundation. He has also served on a study section reviewing grants for NIH, currently reviews papers for many scientific journals, and has served previously on the editorial boards of the Journal of Neuroscience and Neuron. He is currently Co-Director of the UCSF graduate program in Cell Biology.

Paul S. Larson, MD
Associate Professor
Department of Neurological Surgery
University of California, San Francisco
Chief, Neurosurgery Service
San Francisco Veterans Affairs Medical Center

Dr. Larson’s clinical interests are in stereotactic and functional neurosurgery, particularly with regard to movement disorders and psychiatric disorders. He has been involved in the development and evolution of novel surgical methods for deep brain stimulator implantation, including frameless techniques and the use of high-field, real-time intraoperative magnetic resonance imaging (MRI). He has extensive surgical experience in the use of intraoperative MRI for a number of neurosurgical applications. During his residency, Dr. Larson was extensively involved in the development of the Norton Hospital intraoperative MRI program, and spent a year in the Speed School of Engineering’s Computer Vision and Image Processing Lab studying the basic science of CT and MR image analysis and 3D modeling.

Dr. Larson’s research interests include neurostimulation, gene therapy, and other neurorestorative therapies for a variety of neurological diseases, including movement disorders and psychiatric disorders. He is also involved in studies using high-field MR brain imaging for clinical and basic science research. His basic science interests include MR research and the development of new technologies to perform functional neurosurgery using real-time MR imaging.

Caroline A. Racine, PhD
Assistant Adjunct Professor
Departments of Neurological Surgery and Radiation Oncology
University of California, San Francisco

Dr. Racine is a clinical neuropsychologist who specializes in the assessment of cognition and mood in patients with neurological disorders. She serves as part of the multidisciplinary team for three main patient groups: neurooncology, radiation oncology, and surgical movement disorders. Specifically, she provides neuropsychological assessment for patients prior to surgery or intervention (baseline evaluations) and also provides ongoing assessment in order to monitor cognitive function over time. The results of these evaluations are used to assist with treatment planning and return-to-work strategies.

Dr. Racine is interested in the effects of various types of surgical treatments on cognition and mood, with the overall goal being to minimize negative side effects and significantly improve quality of life. She received her PhD in clinical psychology from Washington University in 2005, with a specific focus in neuropsychology and aging. She subsequently completed an internship in neuropsychology at Duke University, followed by a two-year postdoctoral fellowship at the UCSF Memory & Aging Center focusing on aging and dementia, before joining the faculty.

National Resources:

UCSF Parkinson’s Disease Clinic and Research Center
Telephone: (415) 476-9276

National Parkinson Foundation, Inc.
Telephone: (305) 243-6666
Toll Free Line: 1-800-327-4545
NPF Helpline: 1-800-4PD-INFO (1-800-473-4636)
Email: contact@parkinson.org

Michael J. Fox Foundation
Toll Free Line: 1-800-708-7644
Email: info@michaeljfox.org

National Family Caregivers Association
Telephone: (301) 942-6430
Toll Free Line: 1-800-896-3650
Email: info@thefamilycaregiver.org

Family Caregiver Alliance
Telephone: 1-800-445-8106
Email: info@caregiver.org

San Francisco Bay Area Resources:

SF Parkinson’s Disease and Caregiver’s Support Group
Telephone: (415) 379-5530

PD Active (Yoga for PD, Dance for PD, PD Salon, Support group, and others)
Telephone: (510) 479-6119
Email: info@pdactive.org

PDSF Network (Dance Classes for PD)
Telephone: (415) 285-7377
Email: PDSFNetwork@gmail.com

Parkinson’s Association of Northern California
Toll Free Line: 1-866-979-7262
Email: parkanc@sbcglobal.net

San Francisco Bay Area Referral Services:

UCSF Physical Therapy Health and Wellness Center
Telephone: (415) 514-4816
Email: wellness@ptrehab.ucsf.edu

UCSF Institute on Health & Aging
Telephone: (415) 476-3047

St. Mary’s Outpatient Therapies
Telephone: (415) 750-5900

UCSF Voice and Swallowing Center
Telephone: (415) 885–7700

UCSF Osher Center for Integrative Medicine
Telephone: (415) 353-7700
Email: ocim@ocim.ucsf.edu

Don’t drink your calories. Liquid calories from soda, juices and fancy coffee drinks add up quickly and are a significant source of weight gain. Drink water, unsweetened coffee or tea (sweeten yourself if needed), and no or low calorie beverages. Eat whole fruit instead of juice- your body likes the fiber and portion control is much easier!

Visit your cardiologist on a regular basis! It is important that you have routine check-ups. Our health does not remain static – it is continually changing. Because of this, checking in with your cardiologist (or any physician for that matter) helps you keep ahead of the curve on possible health issues and helps to identify health issues and initiate treatment/management strategies. Either way, regular visits to the doctor are an important part of being a healthy diabetic!

For the complete air schedule and to view this program online, click here.

Dr. William H. Polonsky, PhD, CDE is the founder and president of the Behavioral Diabetes Institute as well as an Associate Clinical Professor in Psychiatry at the University of California, San Diego. He received his PhD in clinical psychology from Yale University and has served as Chairman of the National Certification Board for Diabetes Educators, Senior Psychologist at the Joslin Diabetes Center in Boston, and Instructor in Psychiatry at Harvard Medical School. He is an active researcher in behavioral diabetes, with his most recent projects focusing on the utility of home blood glucose monitoring in type 2 diabetes, the emotional and behavioral consequences of being diagnosed with diabetes, and the value of diabetes self-management support training for health care professionals.

Dr. Polonsky has served on the editorial boards of numerous professional and lay publications, including Diabetes Care, Diabetes Forecast, Clinical Diabetes, Diabetes Self-Management and Diabetes Health. A licensed clinical psychologist and certified diabetes educator, he has also authored Diabetes Burnout: What to Do When You Can’t Take it Anymore, a book for patients published by the American Diabetes Association.

Be aware of high calorie bread choices. Muffins, bagels, croissants and biscuits have significantly more calories than a slice or two of whole grain bread or toast. Add butter or margarine sparingly.

Monitor your blood glucose before and after exercise! WHY? So that you can understand how your body responds to certain amounts of physical activity. Also, monitoring blood glucose helps to reduce hypoglycemia and identifies when blood glucose may be significantly elevated. This knowledge helps you make better choices and increases behaviors that can help avoid the consequences of not knowing what your blood glucose level is.

For the complete air schedule and to view this program online, click here.

Dr. Irwin Goldstein has been involved with sexual dysfunction research since the late 1970′s. His interests include penile microvascular bypass surgery, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women. He has authored more than 325 publications in the field of sexual dysfunction, with 20 consecutive years of funding by the National Institutes of Health in this area. He is Editor-in-Chief of The Journal of Sexual Medicine, the official journal of the International Society for Sexual Medicine, its regional affiliate societies, and the International Society for the Study of Women’s Sexual Health. Dr. Goldstein has relocated to San Diego where he is Director of Sexual Medicine at Alvarado Hospital, Clinical Professor of Surgery at University of California at San Diego and Director of San Diego Sexual Medicine where he maintains his clinical practice.

Dr. Goldstein holds a bachelor’s degree in engineering from Brown University, with an honors thesis in biomedical engineering. In 1975, he graduated from McGill University Faculty of Medicine in his hometown of Montreal, Quebec, Canada. He was on the faculty of Boston University School of Medicine for 25 years where he was Professor of Urology and Gynecology and founding Director of the former Institute for Sexual Medicine at BUSM. Dr. Goldstein is currently President of The Institute for Sexual Medicine, Inc., a charitable corporation for education and research in the field. He is Secretary of the International Society for the Study of Women’s Sexual Health, a former President of the Sexual Medicine Society of North America, a board member of the International Society for Sexual Medicine and a member of the International Academy of Sex Research, the American Urological Association, the American Association of Sex Educators, Counselors and Therapists, and the International Society for the Study of Vulvovaginal Disease. Dr. Goldstein is a 2009 winner of the Gold Medal awarded by the World Association for Sexual Health in recognition of his lifetime contributions to the field.