team, including a social worker and nurse, now visits them at home to conduct a full evaluation and regular follow-ups. The program, funded by the Edmond J. Safra Philanthropic Foundation, “is having an incredible impact on patients’ health,” says Dr. Di Rocco. In another major step forward, the center is teaming with the Edmond J. Safra Philanthropic Foundation, the National Parkinson® Foundation, and Jewish Community Center (JCC) Manhattan to launch the expansion of its noted Parkinson’s Wellness Program, bringing its fitness, support, education, and socialization opportunities to four additional U.S. cities over the next year. “The goal is to help build energetic, connected, and empowered local communities for individuals and families living with Parkinson’s nationwide,” said Amy C. Lemen, managing director of the Edmond J. Safra National Parkinson’s Wellness Initiative, and associate director of community services at the center. “We’re excited at the opportunity to expand a program that is redefining what it means to live well with Parkinson’s.” Pushing the Envelope in Parkinson’s Disease Research and Care 2014 Highlights — • Launched a program to disseminate its unique Parkinson’s Wellness Program nationally • Instituted one of the country’s first home-care treatment programs for patients with advanced Parkinson’s disease • Conducting clinical trials on the use of transcranial magnetic stimulation (TMS) to improve motor and non-motor function in Parkinson’s patients PARKINSON’S AND MOVEMENT DISORDERS CENTER National Parkinson® Foundation Center of Excellence PAGE 26 NYU LANGONE MEDICAL CENTER / NEUROLOGY AND NEUROSURGERY / 2014 1,500 patients receiving ongoing care CHARTING A NEUROLOGICAL PATH TO TREATMENT On the clinical research front, the center’s motor physiology lab is studying transcranial magnetic stimulation (TMS), which uses an external magnetic field to stimulate targeted brain neurons as a therapy for improving motor and non-motor function, and is teaming with Rusk Rehabilitation to investigate the use of TMS in recovery of motor function following stroke. Other research projects include trials of two promising medications, istradefylline, an adenosine A2 antagonist, and droxidopa. The center is also working with NYU Langone’s Neuroscience Institute on a translational research grant to investigate how faulty brain reorganization, or maladaptive plasticity, may contribute to Parkinson’s symptoms, and how exercise, external brain modulation, and other approaches may help the Parkinson’s-affected brain reorganize in more functional ways. “This is a radically new theoretical and practical approach,” notes Dr. Di Rocco. “We think it may lead to groundbreaking treatments for Parkinson’s.” — Exercise, external brain modulation and other approaches may help the Parkinson’saffected brain reorganize in more functional ways. NYU LANGONE MEDICAL CENTER / NEUROLOGY AND NEUROSURGERY / 2014 PAGE 27 CLINICAL CARE At NYU Langone’s Center for Neuromodulation, deep brain stimulation (DBS) is a therapy with unfolding potential. The center’s director, neurosurgeon Alon Mogilner, MD, PhD, and co-director, neurologist Michael Pourfar, MD, have been leaders in the use of DBS to alleviate physical symptoms of Parkinson’s, essential tremor, and dystonia in patients who aren’t responding to medication or are suffering from medication side effects such as excessive movements. Recently, they have pioneered the use of deep brain stimulation (DBS) for conditions including depression, obsessive-compulsive disorder (OCD), Tourette syndrome, cluster headaches, and neurological disorders such as Huntington’s disease. The center’s unique expertise resides in its finelytuned, interdisciplinary approach, including imaging and brain mapping of the DBS implantation sites to guide electrode placement, and extensive follow-up as needed to optimize electrode settings and other parameters. It has published widely on DBS clinical outcomes, and is currently conducting clinical trials of DBS for both OCD and Tourette’s that do not respond to medication (Tourette’s results to date “have been remarkable,” notes Dr. Mogilner). The center is also participating in a multi-institution trial of a novel DBS device that selectively stimulates targeted areas of the brain. In addition to its expertise in DBS, the center performs a large number of peripheral nerve stimulation (PNS) procedures for headache and facial pain conditions that don’t respond to other treatments, including migraines; cluster and post-traumatic headache and post-craniotomy pain; occipital, supraorbital, and infraorbital neuralgia; hemicrania continua; and trigeminal autonomic cephalalgia. The center has the most extensive experience in the nation in the use of PNS for headache associated with Chiari malformation, and has conducted clinical trials of this treatment method. Current PNS trials include participation in a multisite study of occipital nerve stimulation for migraine headache, and another multi-site trial of a selfregulating spine stimulating device for the treatment of intractable postsurgical back pain. The center’s physicians remain focused on finding new uses for this and other therapies. “Our goal is always to be one step ahead of the game,” says Dr. Mogilner. “If a new neuromodulation