2013: A Year for Welcomes, Tributes, Caring and Thanks
The physicians, researchers, managers and associates of the University of Cincinnati Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health, extend a heartfelt “thank you” to all of our friends who have supported our tripartite mission throughout 2013. With your help we have continued to build upon our efforts to provide the best available treatments and family-centered care, to aggressively pursue new therapies and potential cures for neurological disease, and to educate future physicians and the public. During the past year we have touched the lives of thousands of individuals. Our work has been steadfastly supported by donors, sponsors, private foundations, volunteers and the leaders of our Community Advisory Councils, who together have contributed millions of dollars and hundreds of hours in support of our research and patient education programs. We are grateful for the millions of research dollars we have received from tax-supported institutions that include the National Institutes of Health (NIH), the Department of Defense and the UC College of Medicine. And we are indebted, above all, to our study participants, whose selfless role in clinical trials fuels our research and makes future discoveries possible. From this memorable year, here are a few highlights: CLINICAL CARE We opened our Headache and Facial Pain Program, which promises a personalized treatment approach for the thousands of people in the Cincinnati region who suffer from migraines, cluster headaches and facial pain. We opened new clinics at the Mood Disorders Center for youth who are transitioning to adulthood and for patients with especially challenging cases. We welcomed Aram Zabeti, MD, our new Interim Medical Director of the Waddell Center for Multiple Sclerosis, MS physicians Patricia Colapietro, MD, and Reena Shah, MD, and neuromuscular specialist Hani Kushlaf, MD. We celebrated the one-year anniversary of the UC Health Telestroke Network, which enables UC Stroke Team physicians to “examine” stroke patients long-distance with the help of robots. The program now includes 10 partner hospitals. And we were certified by the Joint Commission as an Advanced Comprehensive Stroke Center, a new level of certification reserved for institutions with specific abilities to receive and treat the most complex stroke cases. We launched our Allies for Health and Healing mentoring program, which seeks to pair patients who have been newly diagnosed with a benign or malignant brain tumor with a mentor who also has had experience in fighting a brain tumor, either as a patient or a family member. In one of our most satisfying success stories, our multidisciplinary team treated Jim for a pituitary tumor that had the potential to become life-threatening. RESEARCH The UC Comprehensive Stroke Center was named the national stroke coordinating center for StrokeNET, a network of 25 regional stroke centers, highlighting its role as a leader in federally funded stroke research. The NIH designation, along with a new regional coordinating center designation, brings $8.4 million in federal grants to Cincinnati over the next three years. The UC Neurotrauma Center was chosen to take part in one of the largest international research collaborations ever coordinated by funding agencies. The five-year project, funded by an $18.8 million NIH award, will support research in concussion and traumatic brain injury at more than 55 sites worldwide. Private funding also comes from our partner One Mind for Research, which is mounting a global quest to cure brain disease and eradicate the stigma associated with mental illness and brain injury. Researchers at the UC Epilepsy Center received a $2.6 million grant from the FDA, the American Epilepsy Society and the Epilepsy Foundation to study generic equivalence for the drug lamotrigine (Lamictal). The UC Brain Tumor Center’s Molecular Therapeutics Program awarded $100,000 pilot grants to researchers to further their translational research into how to halt the growth of malignant brain tumors and brain metastasis of breast cancer. And the UC Neuroscience Institute awarded four $25,000 pilot grants that are intended to help imaginative researchers gain preliminary data that can be used in applications for larger grants from NIH. Our researchers continued to publish and present their findings. We led the global Interventional Management of Stroke III trial, the world’s largest trial to date of an endovascular intervention for acute ischemic stroke and published the results in the New England Journal of Medicine. We showed how the brain’s micro-environment fuels metastatic tumor growth and published our findings in the Nature Publishing Group journal Scientific Reports. And we showed that stroke patients with hemorrhages in their brain who randomly received minimally invasive surgery to deliver a drug designed to dissolve golf ball-sized clots went home from the hospital an average of 38 days sooner than those receiving supportive therapy, saving an estimated $44,000 per patient. Those findings were presented at the 2013 International Stroke Conference. HONORS Yash Patil, MD, an otolaryngologist with the UC Brain Tumor Center and UC Neurosensory Disorders Center, and John Hawkins, Deputy Chief of Research at the Lindner Center of HOPE, were winners at the Cincinnati Business Courier’s 2013 Health Care Heroes event, and Christopher McPherson, MD, of the UC Brain Tumor Center, was a finalist. UCNI Research Director Joseph Broderick, MD, was appointed Chair of the Stroke Council for the national American Heart and Stroke Association. Michael Privitera, MD, Medical Director of the UC Epilepsy Center, became the second vice president of the American Epilepsy Society. And Richard Curry, MD, became one of only 149 certified neuro-oncologists in America and one of only two in the Cincinnati region. EDUCATION The UC Neuroscience Institute continued its commitment to community education by hosting the Sunflower Revolution Parkinson’s Disease Symposium & Expo, the Midwest Regional Brain Tumor Conference and the Play It Safe Symposium & Expo. Experts from six countries joined Alberto Espay, MD, of the James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders for the first Unusual Movement Disorders Marathon Symposium. And with support from the Charles L. Shor Foundation, we held our annual symposium about stress and epilepsy, which attracts national leaders in the field.
Using Cognitive Behavioral Therapy To Curb Anxiety during the Holidays
From Thanksgiving to the New Year, a bustling stream of family gatherings, office parties and high expectations fill most hearts with joy. But for some people – and maybe more people than you think — the holidays bring untold levels of anxiety. An introverted personality, an inability to say no to relatives or colleagues, age-old family conflicts: all can heighten anxiety in normally healthy people while making life miserable for people with clinical anxiety disorders. “Holiday anxiety is similar to holiday depression,” says Cal Adler, MD, Professor of Psychiatry at the Mood Disorders Center at the University of Cincinnati Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health. “There’s an expectation that you’re going to have a great time and that you’re going to conform to these idealized holiday patterns. Like any stressful event, this brings out our frailties, our vulnerabilities, those spots in our personalities where we sometimes need to be shored up.” Adler and his colleague Scott Ries, LISW, Associate Professor of Clinical Psychiatry at the Mood Disorders Center, offer a variety of coping techniques for those whose anxiety shows up like an unwelcomed guest during the holiday season. All forms of anxiety, Ries explains, boil down to one emotion: fear. “Anxiety is a physiological response that is evolutionarily designed to keep us safe,” he says. “When the brain is like that, it’s doing you a favor. It’s trying to help you survive. The brain receives the same signal if a bear is after you or if you’re in a meeting with your boss.” Holiday anxiety can be triggered by a variety of circumstances: • Underlying social anxiety, which is a fear of being humiliated in public; • Introversion or shyness, which can go hand-in-hand with social anxiety; • Feelings of being overwhelmed by expectations to act a certain way; • Feelings of being overwhelmed by obligations and events; • A history of unhappy relationships with immediate or extended family members. Working toward an action-oriented solution Ries frequently discusses coping methods with his patients as the holidays approach, and he helps them draw on the tools of cognitive behavioral therapy, or CBT. The process involves identifying the individual’s dysfunctional thought process or behavior and working toward an action-oriented solution. Ries helps his patients think through a troublesome scenario to its potential conclusions and helps them recognize that 1) the worst feared outcome probably will not happen and 2) if it does happen, this is how it can be handled. “I don’t try to talk people out of the possibility that bad things will happen,” Ries says. “I sort of de-catastrophize them.” A typical scenario might involve telling family members that you won’t be joining them because of unhappy past experiences with another relative. “If you have really unpleasant memories you might want to create your own tradition,” Ries says. “Now, based on the assumption that your family will be mad at you, let’s assume that they do get upset with you. Then what? What will the outcome be? Do you fear that they’ll never speak to you again? In reality, that’s not likely to happen. It is unlikely that your family would cut you off. And if they did, you probably don’t have much of a relationship with them anyway.” The holiday party, through the introvert’s eyes In a second scenario involving the use of cognitive therapy, Ries helps an anxious, introverted person rehearse the potential outcomes of attending a company holiday party. The person fears, first, that he will walk in and no one will pay any attention to him. His second fear is that if he is invited into a conversation, he will say something stupid and be humiliated. Acting out the scenario, Ries asks: “Well, how would someone know that you’re feeling stupid? Do you have a sign that goes up that says ‘stupid?’ And what if you do say something stupid. Give me all the stupid things you can imagine saying. Let’s start a conversation and throw stupid at me. Now, let’s assume the worst: you not only say something stupid, but you also simultaneously spill something on yourself. Then what do you imagine happening? The belief is that everyone stops and stares and laughs at you. We’re replaying all those terrible classroom experiences. And I say, well, would you do that to someone else? Of course, you wouldn’t. And probably your co-workers wouldn’t either. Because in reality that’s not what happens at parties.” Ries encourages introverts to scan the crowd for other introverts, who make up half the world. That shy person hovering in the background, he notes, is a “soul mate.” He also reminds anxious patients that “you’ve already said lots of dumb things in your lifetime, and yet you have friends; you have a job.” And he notes that, “Because I’m an extrovert, I’ve said even more dumb things than most people. And yet people seem to think I’m competent.” So many decisions, so little time Decision-making, Adler says, also can contribute significantly to holiday anxiety. “A recent study about decision-making before and after lunch showed that people take routes of least resistance when they’re tired or making a lot of decisions,” Adler says. “You kind of run out of mental energy. And holidays are all about running out of mental energy. You’re deciding what to do, maybe deciding between competing demands and family members. You make a decision what to buy, what to spend, how much to spend. “And then other things pop up, like all the Giving Tuesday e-mails, requests for help from all sorts of spheres. And if you’re hosting or traveling, you have even more layers of obligation.” One of the ironies of holiday parties, Adler says, is that December is probably the worst time of year to have them because people have so many things to do. For that very reason, Adler adds, the Division of Bipolar Disorder Research moved its holiday party to February a few years ago.
Plas Lab Eyes a New Glioma Target with $100k Grant
Dr. David Plas at UC’s Vontz Center for Molecular Studies. Cindy Starr photo. David Plas, PhD, Associate Professor of Cancer Biology at the University of Cincinnati College of Medicine, brings a fresh viewpoint and the mindset of a leukemia researcher to the problem of glioma, a stubbornly aggressive form of brain cancer. He notes that while leukemias are treated more successfully than ever before, “gliomas could stand some major improvements.” Dr. Plas is among a cadre of researchers at the UC Cancer Institute whose expertise is being tapped by the UC Brain Tumor Center, which straddles both the Cancer Institute and the UC Neuroscience Institute. Together these talented researchers are homing in on the molecular profile of glioma, a cancer that develops from glial cells in the brain and whose most common form is glioblastoma multiforme. An estimated 13,000 Americans die of brain and other nervous system cancers each year. “In order to bring personalized therapy to brain cancers, it is necessary to develop new drugs that target the major pathways used by cancer genes,” Dr. Plas says. “Unfortunately, this approach has not yet been successful in brain cancer. We hope to bring some of the ideas from the world of leukemia research into brain cancer and see whether they can be successfully applied or modified.” Armed with a $100,000 pilot grant funded locally and awarded by the UC Brain Tumor Center’s Molecular Therapeutics Program, a translational research program that leads to Phase I clinical trials, Dr. Plas and his laboratory team are focused on a protein known as S6Kinase1, or S6K1. The protein is in a pathway downstream of another protein, PTEN, a major tumor suppressor that is frequently mutated in glioma. The deficiency of PTEN occurs in all four molecular subtypes of glioblastoma. Dr. Plas and his laboratory team have assembled a panel of five pre-clinical compounds through collaboration with chemists from the pharmaceutical industry as well as leading academic chemists. Using these compounds, they are performing the first comprehensive analysis of S6K1 as a target for brain cancer therapy. “This work will provide the critical first step for a new direction in the development of new drugs for personalized cancer therapy of brain cancer,” Dr. Plas says. Dr. Plas notes that S6K1 is a type of kinase – a protein that modifies other proteins – that has not yet been targeted. “We’ve only recently become able to target S6K1,” he says. “We are hoping to be on the front wave of targeting this pathway toward the development of S6K1 inhibitors.” Work in the Plas Lab fits into a larger picture of innovative laboratories at UC that are developing molecule-targeted therapies for glioblastoma. The laboratories of El Mustapha Bahassi, PhD, and James Driscoll, MD, PhD, for example, are focusing on mutations on the epidermal growth factor receptor (EGFR). In glioblastoma, EGFR can lead to faulty signaling or “overactivation,” which causes cells to multiply too rapidly and to result in cancer. At least 30 to 50 percent of glioblastoma cases involve a malfunction of the EGF receptor. Dr. Plas notes that, “EGFR actually controls many different pathways. One of those pathways leads to S6Kinase1. So you can say that our work is related because these pathways are often interconnected.” Dr. Plas says that one can visualize cancer from a genomic view (according to chromosomes or genes) or from a pathway view (according to molecular interactions). Metaphorically, one might imagine the chromosomes as busy airports and the pathways as the flights that go between them. Dr. Plas is clearly excited about the developments. “We have an opportunity to use targeted therapeutics that have not been successfully applied in glioma therapy,” he says. “What draws our interest is the importance of the problem.” — Cindy Starr
Waddell Center for Multiple Sclerosis Welcomes Dr. Aram Zabeti
Aram Zabeti, MD, in his office on the UC Academic Health Center campus. Photo by Cindy Starr. Aram Zabeti, MD, the new Medical Director of the Waddell Center for Multiple Sclerosis at the University of Cincinnati Neuroscience Institute, has a lot of people to meet. About 1,800 to be precise. Over the next several months he will be meeting the Waddell Center’s patients one on one, getting to know their personalities, their medical histories and the challenges they face every day. He brings a careful, disciplined approach to each new patient he sees. “My main focus right now is patient care,” Dr. Zabeti says. “Patients with MS need very close monitoring and follow-ups. I want to make sure all of my patients are safe and receiving the best care we can provide. Even if a patient has been to the Waddell Center before, I treat them as a new patient. I go over the diagnosis and how the diagnosis was made.” “We are delighted to have Dr. Zabeti, with his tremendous expertise and passion for MS care at the Waddell Center,” says Joseph Broderick, MD, Research Director at the UC Neuroscience Institute and Chairman of the Department of Neurology. Dr. Aram Zabeti – pronounced ah-RAHM Zah-BAY-tee – is a native of Tehran, Iran, and he comes to the Waddell Center from one of the strongest multiple sclerosis centers in the country: the Oregon Health and Science University’s Multiple Sclerosis Center. He replaces Maria Melanson, MD, who left for a position in industry earlier this year. Dr. Zabeti, whose father was an orthopedic surgeon and whose mother was a dentist, always knew that he would become a doctor. He found his calling in MS early, and by chance. “My cousin had MS,” he says. “For her to get medical care, she and her family moved to Tehran, the capital, and she stayed with us for a few months while I was in high school. It was for me the most important event. It impressed me, and it was my main motivation to specialize in MS. She was maybe 25 and in the last year of medical school. Unfortunately, she had a very progressive MS, and of course back then she was being given a late diagnosis with complications. “I was her host, and I provided whatever she needed: food, meals, those types of things. But I saw how much she suffered. Previously, when she was healthy, we had a lot of fun together. So it was hard for me to see her going through all these problems, just as her future was supposed to be in front of her.” Dr. Zabeti began Iran’s seven-year medical program after high school and became a general practitioner upon graduation. He established a private practice, worked as an emergency room physician and maintained a constant volunteer connection with the Multiple Sclerosis International Federation and the National MS Society of Iran. He held educational conferences for his patients and routinely translated published updates about MS into Farsi for their benefit. But pursuing a path in MS in Iran would prove difficult. “There were MS specialists in Iran, but none of them was fellowship trained, and there was no MS fellowship program,” Dr. Zabeti says. In order to follow his calling, Dr. Zabeti would need to leave his country and embark on a rigorous new academic path. At the end of 2005 he secured a research position at the University of Washington in Seattle, where he studied neurodegenerative diseases, including Parkinson’s, and began working toward the board examinations that would enable him to apply for a residency training program at a U.S. university. He was subsequently accepted at the West Virginia University School of Medicine, where he completed his residency in 2012. His goal now within his grasp, Dr. Zabeti began a fellowship at Oregon University’s acclaimed Multiple Sclerosis Center. “Their MS fellowship program is unique because they have seven full-time faculty working 100 percent on MS,” Dr. Zabeti says. “Dr. Dennis Bourdette, my mentor, is the Chairman of the Department of Neurology and is devoted to MS. For me it was important because MS is still a new disease whose diagnosis and management are frequently based on one’s clinical experience, and I was very fortunate to work with seven different faculty members with different experiences and slightly different approaches in diagnosis and treatment.” The fellowship-trained Dr. Zabeti was then persuaded to apply for the Waddell Center position by his senior physician from his residency program at West Virginia University, neurologist Laurie Gutmann, MD. “I saw Cincinnati as a very good match,” he says. “I felt there was a lot of demand here, a huge number of patients needing an MS specialist. The neurology department was strong and highly regarded, with great potential in my field. I found it a great opportunity for me and my future.” Dr. Zabeti is still getting traction at the Waddell Center. He has boxes that remain unpacked at his home, and he has had little time to enjoy his hobbies, which include squash and table tennis. (He is a former brown-belt in karate.) But he is immersed in patient appointments at the UC Health physicians’ offices at the UC Medical Center in Clifton (Tuesdays and Wednesdays) and at University Pointe (Mondays). Soon he will begin overseeing the Cincinnati portion of a 28-site, phase II clinical trial for Ibudilast, an anti-inflammatory drug that will be tested in study participants with the most challenging type of multiple sclerosis, known as progressive MS. Progressive MS has two sub-categories: primary and secondary. Patients with primary progressive MS experience steady progression of their disease from the onset. Patients with secondary progressive MS enter this progressive phase following an earlier phase called relapsing-remitting MS, a period marked by cycles of wellness, attacks and recovery. “Once they are progressive,” Dr. Zabeti says, “they keep getting worse, month by month or year by year.” At present, there are 10 FDA-approved medications for relapsing-remitting MS, but none approved for
UC Brain Tumor Center Celebrates a Stellar Weekend
Images from Walk Ahead for a Brain Tumor Cure: from left, the Purple People Bridge, emcee Kyla Woods of WLWT News 5, survivor Leslie Oliver and friend, and survivor Dr. Michael Wood. Photos by Cindy Starr / Mayfield Clinic. Thousands of individuals were touched by the glow of camaraderie, compassion and support last weekend during two of the UC Brain Tumor Center’s most significant events of the year. On Saturday more than 170 patients, caregivers and family members from six states participated in the Midwest Regional Brain Tumor Conference at the Miami University Voice of America Learning Center in West Chester, Ohio. And on Sunday, 2,350 people from 19 states walked or ran in the Walk Ahead for a Brain Tumor Cure at Sawyer Point in downtown Cincinnati. The fourth annual 5k walk/run, chaired by survivor Brian Wiles and his brother, Joe Wiles, has raised more than $213,000, with proceeds still coming in. But the number of participants and dollars raised were not as exciting to Brian Wiles as the number of teams – 191 – and “the individual stories of hope” they represented. “Walking through the event on Sunday, the sun was shining on each team as they smiled and shed a few tears for their loved ones,” Mr. Wiles reflected. The event’s new memory quilt, created from team T-shirts, “will provide the symbolic future of hope for the event,” he added. Proceeds benefit education and research at the Brain Tumor Center, one of nine centers of excellence within the UC Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health. Cumulative funds raised since 2010 have surpassed $700,000. These funds enable patients and families to attend the Brain Tumor Conference at no cost while also fueling basic research into the major pathways used by cancer genes and the specific proteins that play a role in the spread of cancer cells. Researchers at the UC Brain Tumor Center are also using Walk Ahead funds to study compounds that inhibit the ability of cancer cells to utilize energy, with the hope of converting such compounds into promising new medications. The Brain Tumor Conference, which was sold out, included 20 speakers, 16 volunteers, and exhibitors from 12 organizations. Registrants came from Ohio, Kentucky, Indiana, Michigan, Maryland and Arizona. Following presentations about wellness, patients and their families broke into 90-minute question and answer sessions related to specific brain tumor diagnoses (glioma, acoustic neuroma, meningioma and pituitary tumors). The conference was directed by Luke Pater, MD, Assistant Professor of Radiation Oncology at the UC Brain Tumor Center. The morning sessions, which focused on self-empowerment through wellness, were led by Stefanie Stevenson, MD, (above right) Adjunct Assistant Professor and Clinical Director of Integrative Medicine at UC Health, and Sian Cotton, PhD, (above left) Associate Professor and Director of Integrative Medicine at UC Health. Topics included the anti-inflammatory diet, stress reduction, the mind-body-connection and food as medicine. Dr. Stevenson encouraged the audience to: • Eat “a rainbow” of fruits and vegetables by choosing foods of different colors, such as red tomatoes, orange carrots, yellow squash, green broccoli and spinach, blueberries and purple grapes and cabbage. • Eat a minimum of 5 servings of fruits and vegetables a day and strive for 6 to 8 servings. • Choose healthy fats high in plant-based omega 3, including olive oil and canola oil, nuts, flaxseed, avocado, wild salmon and sardines. • Avoid or minimize consumption of foods that contain environmental toxins and excess calories, such as charred, pickled and salt-cured meats. Dr. Cotton demonstrated the mind-body connection during an interactive exercise. After asking audience members to close their eyes, she described – in a slow, deliberate, soothing voice – the act of holding, contemplating, and then slicing a lemon. After the audience was asked to raise the imaginary lemon slice to their lips, she asked how many actually salivated. Dozens of hands went up. The power of mind-body connection means that patients must take an active role in minimizing stress, Dr. Cotton said. “Stress is harmful when it is constant in patients who are fighting cancer,” she said. Meditation, yoga and deep breathing can help. She led audience members in a breathing exercise, in which they imagined slowly breathing in air up through three compartments: a lower compartment in the abdomen, a middle compartment in the lower chest, and an upper compartment in the upper chest. Air would be exhaled in reverse, starting with the top compartment and extending to the bottom. “The power of deep breathing cannot be overestimated,” Dr. Cotton said. At the conclusion of the conference, attendees headed over to the Precision Radiotherapy Center for a tour of the West Chester facility and a look at its three state-of-the-art radiotherapy technologies. There, attendees also were treated to a healthy and delicious lunch by Chef Suzy DeYoung of La Petite Pierre: a salad of quinoa, beans and squash coupled with wheat-flour wraps filled with chicken and kale. — Cindy Starr
Memories and Hope Stitched Together in Walk Ahead’s New Quilt
Terry Finnerty, owner of Walking Needle L.L.C., with the WalkAhead memory quilt. Photo by Cindy Starr / Mayfield Clinic. Friends of the UC Brain Tumor Center this weekend will unveil the newest addition to the annual Walk Ahead for a Brain Tumor Cure: a beautiful T-shirt quilt crafted and donated by Teresa Finnerty of Mason, Ohio. The quilt, approximately 6 feet long by 6 feet wide, is made of scraps of fabric and cutouts of T-shirts worn by Walk Ahead participants in previous years. Organizers of Walk Ahead, including members of the Brain Tumor Center’s Community Advisory Council, plan to make the T-shirt quilt an annual project. Participants in Sunday’s 5k walk/run, which takes place at Yeatman’s Cove in Sawyer Point Park, are invited to donate their T-shirts for the 2014 quilt following the event. “The hand-crafted work that Terry has translated from each team’s vision of hope is the building block to the future of our Walk Ahead event,” says Brian Wiles, event co-chair and Advisory Council member. “Thank you, Terry!” Runners and walkers who have not yet registered are welcome to sign up at Saturday’s Midwest Regional Brain Tumor Conference or at registration tables in the tunnels before Sunday’s event at Sawyer Point. Walk Ahead, which has raised more than $665,000 since its inception in 2010, supports education and research at the Brain Tumor Center at the University of Cincinnati Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health. Ms. Finnerty, a longtime friend of a Cincinnati brain tumor survivor, was a perfect choice to craft the Walk Ahead memory quilt. She lost her husband to pancreatic cancer when he was only 47, and Ms. Finnerty – who goes by Terry – is herself a cancer survivor. “It was my pleasure to make the quilt,” she says. “It was my honor to use my God-given gift of quilt-making to contribute in some way to a worthy cause!” It is indeed a God-given gift. Terry has had the desire to sew since she was a little girl. When she was in the second grade she told her mother that she wanted to make clothes for her Barbie doll. Her mother, thinking that she herself would end up making the clothes, brushed the request aside. Terry finally got her chance in an eighth-grade home economics course, and she has been sewing ever since. Three years ago, after concluding her career as a counselor at Princeton High School, Terry purchased a special retirement gift for herself: a professional long-arm sewing machine. Soon, she had a small but growing business. As the owner of Walking Needle L.L.C., she has about a dozen quilts in process at any given time and an enviable waiting list. Although she describes her primary work area as being “strewn with threads” and her T-shirt cutting area as “the danger zone,” it is in fact a place that is alive with color, creativity and the joy of preserved memories. Many of her quilts are commissioned, with T-shirts provided. Others are created with T-shirts found at thrift shops or eye-catching fabrics plucked from the novelty section of fabric stores. Terry produces her quilts in systematic fashion: cutting and interfacing shirts, laying out the quilt on a design wall, sewing the pieces together, and, finally, attaching a colorful binding and label. The Walk Ahead quilt, like all of Terry’s quilts, is one of a kind. Come take a look at Sunday’s Walk Ahead for a Brain Tumor Cure. – Cindy Starr
UC Researcher Embraces Role in Global Study To Improve Brain Injury Treatment
Jed Hartings, PhD, Associate Professor of Neurosurgery at the UC College of Medicine and an expert in spreading depolarizations. Photo by Cindy Starr / Mayfield Clinic. During the next seven years, 38 institutions from around the world hope to answer a basic but nagging question: how best to treat people who have suffered a brain injury caused by an accident, fall or violence. Jed Hartings, PhD, Associate Professor in the Department of Neurosurgery at the University of Cincinnati, will help find the answer. Dr. Hartings, who is part of the UC Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health, will design the data collection methods for a portion of the observational study of 5,000 patients at more than 60 European hospitals who have suffered mild, moderate or traumatic brain injury, or TBI. Dr. Hartings is also charged with assessing and scoring data. The 30-million-euro study, the Collaborative European NeuroTrauma Effectiveness Research, or CENTER-TBI, is funded by the European Union’s Seventh Framework Programme for Research and Development, part of a global collaboration established by the European Commission, the National Institutes of Health and the Canadian Institute of Health Research. Coordinating centers are the University Hospital Antwerp (Belgium) and the University of Cambridge (England). Only three U.S. institutions will participate: UC, the University of Florida and the University of California, San Francisco. A news conference announcing the study takes place in Antwerp today. “The overall objective of the grant is to document the variation in practice in treating injuries in order to determine which treatments are most effective,” Dr. Hartings says. “It is a comparative effectiveness study, as opposed to a randomized clinical trial of a specific treatment. These natural variants occur in practice in the area of TBI because we do not yet have adequate evidence that one method of treating a patient is more effective than another. More evidence-based guidelines need to be developed.” Each year one out of every 200 Europeans and Americans sustains some form of traumatic brain injury, according to the European Commission. The Centers for Disease Control reports that at least 1.7 million traumatic brain injuries occur in the United States each year and that TBI contributes to 30.5 percent of all injury-related deaths. Despite many advances in medical care, the outcome for a patient with TBI has not changed much over the past 20 years. “We can do much, but not enough,” says Dr. Andrew Maas, Professor and Chairman of Neurosurgery at University Hospital Antwerp. “This is difficult to accept for relatives of the often young patients.” The magnitude of the study has the global TBI community abuzz, Dr. Hartings says. “Historically, these large, observational databases have had the biggest impact on improving guidelines for care, in determining what’s effective and what’s not. They tend to have a large impact on the field. What’s exciting about CENTER-TBI is that it will incorporate study of the newest methods for patient monitoring and assessment. That includes imaging studies, biomarkers and the monitoring of spreading depolarizations.” Dr. Hartings was tapped for the CENTER-TBI study because he is at the forefront of research on spreading depolarizations and is a founding member of the international organization COSBID (Co-Operative Study on Brain Injury Depolarizations). Spreading depolarizations are a pathologic brain activity and complication of traumatic brain injury and stroke. These electrical disturbances spread through an injured brain like tsunamis, and Dr. Hartings has helped show that they lead to worse outcomes in patients. “Our role in COSBID, in collaboration with other groups in Europe, is to collect neuro-monitoring data that will enable us to assess the relative role of different secondary insults that occur in the intensive care unit – including hypotension, elevated intracranial pressure (ICP) and spreading depolarizations,” he says. “How can we use these factors, in combination, to assess a patient’s status, or outcome risk, or to guide treatment? “We want to come up with better classification systems to stratify patients in terms of risk for good or poor outcome. For decades we have used the Glasgow Coma Scale, an assessment of the level of consciousness, to determine whether patients have mild, moderate or severe head injury. “To improve on this limited classification system, we will collect blood samples to assess potential protein biomarkers that might provide us with a more intelligent way of stratifying patients. This would be useful, for instance, in the design of clinical trials that target sub-populations of patients who might benefit from one treatment or another.” The protein biomarkers being sought would include breakdown products from injured or dying brain cells. This approach will be combined with new approaches in neuroimaging and continuous patient monitoring. Although the role of Dr. Hartings and his team is modest in the scope of the entire effort, he says the honor of participating cannot be minimized. “It’s extremely important for results from our smaller research studies to be validated in the context of a massive international effort like CENTER-TBI,” Dr. Hartings says. “That’s the value of the study. It brings all the stake-holders in TBI research into the same arena.” – Cindy Starr
Rev Up Your Brain Cells for ‘Stroke of Genius’
An fMRI image shows a healthy control’s brain activity during a cognitive exercise that was part of a clinical trial at the UC Comprehensive Stroke Center. If you like video games and testing your smarts, you will not want to miss the Stroke of Genius Challenge. For a mere $10, which supports research and education at the Comprehensive Stroke Center at the University of Cincinnati Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health, you can enjoy 30 days of the brain-building game Lumosity and score points, which can be redeemed for prizes. The event is chaired by Emily Goodall, Senior Clinical Trials Coordinator and Community Liaison for the UC Stroke Team. A celebration, hosted by Bob Davis of Firehouse Grill, will take place Saturday, October 12. Lumosity – not to be confused with the recent LumenoCity light display in Cincinnati’s Washington Park — is a web-based platform that uses brain-training games to help you improve your memory and flexibility, speed, attention and problem-solving skills. Each day you train, your Personalized Training Program generates a new session tailored to help you make progress on your priorities. Lumosity is also helping researchers study cognition. Neuroscientists from around the world are using the platform in 38 research projects, including the study of Lumosity’s effects on emotional control, its potential as an effective cultivator of emotion regulation abilities, and its ability to curb anxiety. According to its website, Lumosity has “the world’s largest and fastest growing database on human cognition,” with more than 40 million research subjects and more than 780 million cognitive gameplays. For the greater good of the UC Comprehensive Stroke Center, I am giving Lumosity the old college try. It is a noble gesture in that I do not like tests or anything else that points to the weaknesses in my humble brain. I am also particularly wary of anything that addresses spatial skills, having incurred the permanent shame of scoring in the 14th percentile in spatial reasoning in ninth grade. Ask me where the dot will be if you rotate the cube counterclockwise, and I will turn my back and ignore you. So this is what I learned about Lumosity. The tests start out easy, making you feel rather competent, and then quickly accelerate into more difficult territory. A fast-paced exercise known as “Speed Match” exercised my brain’s ability to process information. It presented a quick series of shapes and required me to click on the right arrow if the shape was like the preceding shape, or the left arrow if it was different. Not too difficult, and I flourished in this one. The program then informed me that, “A majority of the population is deficient in omega-3 fatty acids, which are found in fish and flax seed oil and are important for the development and maintenance of brain function.” I made a mental note. On to test #2, which was a “Memory Matrix” that “exercises spatial recall: the ability to remember an item’s location.” This is something like remembering where you hid the Visa bill that you didn’t want your spouse to see and definitely not as bad as trying to figure out where the dot on the cube will be if you rotate the cube counterclockwise three times and turn it upside down. In this exercise, I was presented with a square grid with some of the squares filled in. The goal is to remember the filled-in squares when presented with a blank grid. Again, nice and easy at first and then a lot harder with lots of squares and two random patterns of squares filled in. I made lots of mistakes this time. “Lost in Migration” In my final exercise for the day, an attention-building game called “Eagle Eye,” the computer produced a picture of a bird somewhere on the screen and a number, from one to five. After the images disappeared, I was to mouse over where the bird and been and then click on the number that had fleetingly accompanied the bird. This is clearly a skill for a fighter pilot, whose eyes might need to track stimuli both left and right. As for me, I was so captivated by the bird that more than once I completely forgot to look at the number, which had disappeared by the time I decided to look for it. Still, I managed to get enough right that I acquired my own virtual “bird journal.” What’s not to love about that? So yes, I can see how this might be addicting. On Day 2 I started laughing hysterically during a problem solving exercise as little raindrops filled with simple arithmetic began falling faster than I could key in the answers. But I also learned an important lesson during a verbal fluency game when I rushed through a timed exercise, badly misspelling the word “shenanigans” and losing points, rather than taking my time and spelling it correctly. It was a reminder that even when time is of the essence, accuracy remains paramount. My experience with Lumosity had only one negative side-effect. The night after my first day of brain-building I dreamed that I was back in college. My parents had come to visit me, but at the last minute I realized I couldn’t join them because I had a past-due English paper for Mr. Jenkins, my toughest prof, that I had completely forgotten to write. – Cindy Starr
Hello Dr. Sanchez, and Her Surprising Alter Ego
Anya Sanchez, MD, MBA, Administrative Director of the UC Neuroscience Institute and Internal Consultant to UC Health’s Cancer Institute, Cardiovascular Institute, and Diabetes and Metabolic Disease Institute. Photo by Cindy Starr / Mayfield Clinic. In a recent profile of Anya Sanchez, MD, MBA, Administrative Director of the UC Neuroscience Institute, the Cincinnati Business Courier didn’t waste any time getting to the subject of Hello Kitty. In the fourth sentence, it announced to Cincinnati readers that the accomplished Dr. Sanchez considers Hello Kitty her favorite work of art. “I guess my love of Hello Kitty isn’t a secret anymore,” Dr. Sanchez says with a laugh. Dr. Sanchez, whom the Business Courier profiled as a member of its 2012 Forty under 40 class, has loved Hello Kitty since childhood. But her reason for liking the famous cartoon character as an adult might surprise you. “I like her because she’s always looking directly at you,” Dr. Sanchez says. “She’s very unapologetic, cards on the table, she is what she is. I like that about her. “Someone teased me once, because Hello Kitty has no mouth, whereas I’m always a talker,” Dr. Sanchez continues. “You know the phrase, ‘speak softly and carry a big stick.’ If Hello Kitty were a person, I think that would apply to her. I don’t think of her as cute and cuddly. She’s definitely cute, but she has strength, and that appeals to me.” Dr. Sanchez herself can’t afford to be shy and retiring as an administrative director who oversees the UC Neuroscience Institute and its nine neuroscience centers of excellence. She was also recently appointed to serve as an internal consultant to UC Health’s Cancer Institute, Cardiovascular Institute, and Diabetes and Metabolic Disease Institute. In this role she assists the CEO of UC Health and the Dean of the UC College of Medicine in the oversight and management of the institutes and centers, in partnership with the institute/center leadership teams. The Hello Kitty character, designed by Yuko Shimizu and first introduced by the Japanese company Sanrio in 1974, came to the United States in 1976. Dr. Sanchez vividly remembers receiving her first Hello Kitty gift at age 6. Fittingly, it was a first-aid kit with a few Band-Aids and a packet of tissues. She had Hello Kitty school supplies during her childhood and then, in college, kept her continuing adoration of Hello Kitty a secret. “I was shy about it because I was coming into my own as a professional,” she says. “But there was still something about Hello Kitty that appealed to me through my 20s and into my 30s. I finally stopped to psychoanalyze myself a few years ago, and that’s when I concluded that it’s because she’s always looking directly at you.” It is worth noting that Dr. Sanchez is only one of many adult Hello Kitty consumers. The cat’s gaze, whiskers and pink hair ribbon adorn dozens of products for grown-ups, including purses, laptop cases, clothing, and accessories for the kitchen, office and car. Part of the cat’s inter-generational appeal appears to extend from its lack of a mouth. According to Wikipedia, Sanrio spokespeople have said that Hello Kitty does not have a mouth because she “speaks from the heart,” and because they want people “to project their feelings onto the character” and “to be happy or sad together with Hello Kitty.” As Dr. Sanchez approaches her 40th birthday, she is able to finally share her affinity, publicly, for the iconic white cat. And that brings a big, unapologetic smile, cards on the table, looking right at you. – Cindy Starr
Forget-Me-Not Gala for Alzheimer’s Research Joins UCNI Calendar
Honorary event Co-Chairs Kathee Van Kirk, left, and Lisette Sehlhorst.Photos by Cindy Starr / Mayfield Clinic. Alzheimer’s is a disease of “abundant cruelty” that John Van Kirk, PhD, knows all too well. The Cincinnati businessman lost his wife of 56 years, Rosemary, to the disease in 2012. Eager to honor her memory by raising money for research, Dr. Van Kirk has founded a new event: the Forget-Me-Not Gala, which will support clinical research in Alzheimer’s at the Memory Disorders Center at the University of Cincinnati Neuroscience Institute, one of four institutes of the UC College of Medicine and UC Health. The upscale gala will be held Friday, Sept. 27, at the Phoenix in downtown Cincinnati. “I think about all that my wife gave me over 56 years, and what I gave her wasn’t enough,” Dr. Van Kirk reflects. “This is a give-back. You can’t go through five years of suffering without being touched by this disease.” The Forget-Me-Not Gala, a wine-pairing dinner and silent auction, will be presented by The Wine Merchant, in celebration of its 40th anniversary. The Oakley store, founded by Dr. Van Kirk, a retired Xavier University marketing professor, is owned by his daughter, Kathee Van Kirk, and Lisette Sehlhorst. Ms. Van Kirk and Ms. Sehlhorst are the event’s honorary co-chairs. The gala’s silent auction will feature thousands of dollars’ worth of fine wines, a Mendocino, Calif., vacation home, and other gifts. “The UC Memory Disorders Center is grateful to the Van Kirk family and The Wine Merchant for their commitment to Alzheimer’s disease research and their passion for making a difference in the lives of others,” says Joseph Broderick, MD, Research Director at UCNI and Chair of UC’s Department of Neurology and Rehabilitation Medicine. “We want to accelerate clinical and translational research in Alzheimer’s in Cincinnati, and this event will help us move toward that goal. All funds raised will remain in Cincinnati.” “Alzheimer’s disease and other forms of dementia brush elbows with numerous neurological diseases and disorders,” adds John M. Tew, Jr., MD, Clinical Director of UCNI and Professor of Neurosurgery. “The more we know about Alzheimer’s, the more we will know about the brain in general, and the greater our potential to pre-empt or interrupt a disease process that is devastating to individuals and their families.” The UC Memory Disorders Center employs the latest technologies and therapies to diagnose and treat hundreds of adult patients from across the Greater Cincinnati region each year. Its physicians are experts in the diagnosis and treatment of Alzheimer’s disease and non-Alzheimer’s dementia, including impairment resulting from cerebrovascular disease and hydrocephalus. The center’s physicians also have expertise in diagnosing and treating rare cognitive diseases, such as primary progressive aphasia, frontotemporal dementia and autoimmune encephalopathy. The UC Memory Disorders Center was officially launched in 2011 with generous support from Sandy and Bob Heimann, who in 2008 established the Sandy and Bob Heimann Chair in Research and Education of Alzheimer’s Disease. Forget-Me-Not table sponsorships begin at $1,500, single tickets at $100. To sponsor a table, donate an auction item, or sign up to volunteer, please contact [email protected] or call (513) 558-6769. The Forget-Me-Not Gala joins UCNI’s busy summer-fall event calendar, which also includes two upcoming fund-raisers for Parkinson’s disease research (the 22nd Annual Jerry Wuest-Pete Hershberger Dinner Gala & Golf Classic and the Sunflower Revolution Fitness Festival) and two fundraisers for brain tumor research (the 5th Annual Shemenski Foundation Strike Against Cancer Bowl-a-Thon and the 4th annual Walk Ahead for a Brain Tumor Cure). – Cindy Starr