example of the discipline’s increasing applications is the growing use of the King-Devick Test® as a diagnostic tool for acute concussion. The test, which involves reading a series of single-digit numbers, can accurately evaluate a player’s brain status on the sidelines in just two minutes. But Dr. Balcer’s observation applies to virtually any neurological condition, from multiple sclerosis (MS)—which can be studied in part by using an optical coherence tomography (OCT) scan to measure the thickness of the retinal layers at the back of the eye—to brain tumors and epilepsy surgery, where analysis of visual pathways can help determine which nerves are being affected. “Because we study an anatomical system, rather than a specific disease area, we do a tremendous amount of consulting with other neurologic disciplines,” notes Dr. Rucker, an expert in eye movement analysis. “Various conditions affect eye movement in different ways, almost like a fingerprint,” she explains. “There are subtle differences, for example, in the abnormal eye movements associated with Alzheimer’s disease compared to other cognitive disorders. We’re frequently called on to help diagnose uncommon conditions like atypical Parkinson’s disease or late-onset Tay-Sachs disease.” The program recently installed a sophisticated eye movement tracking device, and its new eye movement lab will be fully operational by early 2015. With the versatility of OCT, eye movement tracking, electroretinography, and other analytic tools, NYU Langone’s Neuro-Ophthalmology Program is also playing a central role in clinical research on a wide range of neurologic conditions. Drs. Galetta and Balcer (who have co-authored more than 350 original scientific publications between them) are principal investigators in an ongoing clinical trial of a remyelinating agent for the treatment of optic neuritis—a condition that is considered a model for MS lesions. “There was some skepticism at first about using vision as an outcome measure for this new drug, but we’re getting very solid results,” notes Dr. Balcer. “People are now realizing that visual analysis is the wave of the future in terms of testing these novel neurologic therapies.” Exploring a Window into the Central Nervous System 2014 Highlights — • Pioneered vision testing outcome measures in multiple sclerosis • Investigating King-Devick Test® as a sideline diagnostic tool NEURO-OPHTHALMOLOGY — “Various conditions affect eye movement in different ways, almost like a fingerprint.” — NYU LANGONE MEDICAL CENTER / NEUROLOGY AND NEUROSURGERY / 2014 PAGE 19 CLINICAL CARE Last April, neurosurgeon Werner K. Doyle, MD, associate professor of neurosurgery, performed the first nonexperimental implantation of the responsive neurostimulator system, a newly approved “smart pacemaker” that can detect incipient seizures before they start and shut them down through direct electrical stimulation to the brain. As a clinical trial site for the device, Comprehensive Epilepsy Center (CEC) clinicians know firsthand the impact of this important new treatment option for drug-resistant epilepsies. COMPREHENSIVE EPILEPSY CENTER New Approaches to Calming the Brain’s Trouble Spots This is just one way in which the center, which includes 30 neurologists, neurosurgeons, neuropsychologists, and neuroscientists that are now part of NYU Langone’s Faculty Group Practice, is pushing boundaries in epilepsy treatment and research. The CEC’s neurology staff includes Jacqueline A. French, MD, professor of neurology and a leader in the development of new anti-epileptic medications, as well as the center’s Director Orrin Devinsky, MD, and Co-Director Ruben Kuzniecky, MD, who are helping to spearhead the Epilepsy Phenome/Genome Project, a global consortium that is mapping the genetic mutations that have been linked to epilepsy. Last September, the consortium published its findings in the American Journal of Human Genetics, identifying mutations linked to synapse function as a causative factor in certain severe childhood epilepsies. FROM RESEARCH TO TREATMENT These genetic investigations and other pathophysiologic breakthroughs are yielding a growing array of novel therapeutic targets, many of which the center’s patients have access to. The CEC’s widely published research program is currently involved in numerous trials of new anti-seizure medications. These include cannabidiol—an oral agent containing the non-psychoactive ingredient of cannabis, which is being studied as a potential treatment for Dravet and Lennox-Gastaut syndromes—and everolimus, an immunosuppressant that appears to reduce seizure activity and improve cognition in tuberous sclerosis patients by inhibiting the mTOR protein, a key driver of the disease. Drs. Kuzniecky and French are also leading and coordinating the Epilepsy Phenome/Genome Project, a large multicenter consortium studying biomarkers in new-onset epilepsy with the aim of predicting seizure outcome. The CEC’s neurosurgeons, Dr. Doyle, and pediatric specialist Howard L. Weiner, MD, professor of neurosurgery and pediatrics, have a long history of advancing the field as well, with innovations that include the pioneering of multiple subpial transections and multi-stage procedures. Dr. Weiner, who serves on the Executive Council of the American