Overview

Overview

Mellen Center for Multiple Sclerosis focuses on addressing physical, emotional, cognitive and rehabilitation needs of the MS patient and their family members through a team approach. Mellen Center for Multiple Sclerosis offers state-of-the-art resources to provide the most advanced specialized care, supported by an extensive program of research and education. The Mellen Center is one of the largest and most comprehensive programs for MS care and research worldwide, managing more than 20,000 patient visits every year. Basic and clinical research conducted at Cleveland Clinic sheds new light on MS every year.

Mellen Center physicians are national leaders in basic and clinical research related to MS pathogenesis and medical management and have made major contributions in the development of drugs to control MS disease activity and progression. The Mellen Center is the largest comprehensive program for MS care and research worldwide, managing more than 8,000 patients and more than 21,000 total visits every year. Basic and clinical research conducted at Cleveland Clinic sheds new light on MS every year, moving us ever closer to better treatments and hopefully, one day soon, a cure.

Program highlights for the Mellen Center include:

  • neurorehabilitation
  • neuropsychology
  • therapeutics
  • clinical research
  • Integration of neurorehabilitation with spasticity management through the use of baclofen pumps and Botox injections
  • Standard and investigational imaging provided through the 3 Tesla MR imaging facility, staffed by an expert team
  • Latest pharmaceutical therapies delivered in a comfortable 12-chair infusion center

Central to our philosophy is the importance of meeting your social and psychological needs, as well as your complex physical needs. At the Mellen Center, you will experience a supportive, welcoming atmosphere and receive assistance in managing the different aspects of MS so you will not feel overwhelmed.

If you have medical concerns beyond the immediate scope of the Mellen Center, you can benefit from the center's unique position as part of the world-renowned Cleveland Clinic, where a complete range of specialists and state-of-the-art treatments ensure that you will receive care that meets all your needs at each of our locations which include: Main Campus, Hillcrest Hospital and Fairview Hospital in Ohio.

News

What We Treat Physicians Scientists Clinicians

Clinicians

Malissa Ayers , PA-C
Physician Assistant
Charlene Fink , CNS
Clinical Nurse Specialist
Shauna Gales , PA-C
Physician Assistant
Claire Hara-Cleaver , CNP
Certified Nurse Practitioner
Jennifer Hartman , PA-C
Physician Assistant
Marie Namey , CNS
Clinical Nurse Specialist
Kathleen Schwetz , CNS
Clinical Nurse Specialist
Hilary Young , PA-C
Physician Assistant
Appointments

Appointments

Mellen Center appointment time.

Make an Appointment

To make an appointment with any of the Mellen Center staff in Ohio, please call 216.444.8600, Monday through Friday, between 8 a.m. and 5 p.m. or toll-free 800.223.2273 (CCF.CARE), ext. 48600. Physician referrals are not required.

To make an appointment with our physicians in Las Vegas, Nevada, please call 702.483.6000.

To make an appointment with our physicians in Florida, please call 1.877.463.2010.

When you call, an appointment secretary may ask several questions to help you better plan the visit. A package of information will be mailed before the first appointment date.

Evaluations and/or treatments are scheduled on an outpatient basis and may require the entire day to complete. Additional appointments may be necessary to complete the final evaluation. These appointments can be conveniently scheduled for additional days or subsequent visits.

Our appointment secretaries will make every effort to schedule your appointment when it is convenient for you. If the situation is urgent, please let us know when you call so that you can be seen at the earliest possible date.

For after-hours emergencies, please call 216.444.2200, and ask for the neurology resident on call.

Preparing for an appointment

Please refer to our PDF below, Care at the Mellen Center, to learn what to expect and how to prepare for an appointment for you or a loved one.

Virtual Visits

Select patients now can see our providers online from their home or office by using the Cleveland Clinic Express Care® Online tool. This service allows patients a fast, secure and easy way to receive care from their healthcare team in a live virtual visit using a smartphone (iPhone or Android), tablet or computer. The benefits of choosing a virtual visit include no travel or parking, less waiting, significant time savings, no facility fee and the convenience of seeing your physician from wherever you choose.

If you would like to use Express Care Online for your next visit, please call your provider’s office. If you are eligible, our team will schedule your virtual visit and provide details on the cost of your appointment and setup instructions.

MyChart

View portions of your medical record, see test results, renew prescriptions, request appointments and more.

Image Copy Request

When requesting a copy of radiology images, please allow a minimum of a 48-hour advance notice for all procedures conducted at any of our imaging centers.

The link below takes you to our secure website where you can request your images electronically.

All CDs will be sent to your home address via UPS.

Locations

Multiple Sclerosis Performance Test

The Multiple Sclerosis Performance Test (MSPT) is a new feature from Cleveland Clinic for patients to enhance their current care and better establish trends in the management of their Multiple Sclerosis. The MSPT is an iPad-based assessment of neurological function that includes health status questionnaires, a 25-foot walking speed test, 9-hole peg manual dexterity test, plus new assessments of processing/thinking speed and visual function.

The results of the tests are immediately available to your provider for use at the time of your visit, so it is important to complete the testing prior to the visit with your care provider.

Please note, your visit to the Mellen Center for Multiple Sclerosis will be structured as follows:

  • 20 minutes with a Medical Assistant including vital signs, review medication list, standard nursing intake questions
  • 30 minutes for MSPT
  • 45 minute appointment with your care provider

Please arrive at the time noted on your appointment reminder or in MyChart, but know that your visit will consist of more than just the 45 minutes that you spend with your provider.

In MyChart reminders – the details about the appointment time will not reflect this new structure, but the arrival time is accurate. Other appointment reminders will detail the breakdown of the various appointments that now comprise your total visit at the Center. Completing health status questionnaires in advance of your visit from home via MyChart will save approximately 10 minutes on the day of your appointment.

Research & Clinical Trials

Research & Clinical Trials

Mellen Center for Multiple Sclerosis offers state-of-the-art resources to provide the most advanced specialized care, supported by an extensive program of research and education. The Mellen Center is one of the largest and most comprehensive programs for MS care and research worldwide, managing more than 20,000 patient visits every year. Basic and clinical research conducted at Cleveland Clinic sheds new light on MS every year, moving us ever closer to better treatments and hopefully, one day soon, a cure.

The Mellen Center for MS Treatment and Research conducts clinical trials with the goal of advancing the development of new treatments and diagnostic tools for multiple sclerosis.

If you are interested in learning about research studies and clinical trials at the Mellen Center please contact a member of our research team at:

216.444.2330
MCResearchTeam@ccf.org

What is a clinical trial?

Clinical trials are the cornerstone of the drug and device development process. They are formal studies to determine if a new drug, device, or therapy is both SAFE and EFFECTIVE.

All new drugs and devices must go through several stages of testing before they are approved by the FDA to treat patients. There are four general types of clinical trials, corresponding to the different stages in the development of a new therapy:

  • Phase I- The initial trial of a drug or device in humans. Phase I trials provide preliminary evidence whether a drug or device is SAFE for use in humans. These trials may test a range of doses of a drug. These may involve healthy controls or individuals with a specific disease. Usually involve 20-80 individuals.
  • Phase 2- Phase 2 trials provide preliminary evidence whether a drug or device has a beneficial biological action for the treatment of a disease. They also provide additional information on the safety. Usually involve 100-300 individuals.
  • Phase 3- Phase 3 trials are much larger studies which give the FDA more solid information on both the SAFETY and BENEFITS of a drug or device. These studies collect information about side effects and sometimes compare the new drug or device to those already on the market. Usually involve 1000-3000 individuals.
  • Phase 4- Post-marketing studies performed after a drug or device is already FDA approved. These give additional information on safety and effectiveness in a much broader range and larger number of people. These studies help to determine if there are any problems associated with long-term use. Involve 1000+ individuals.

Why should I consider participation?

The success of finding new treatments and therapies relies on there being enough people willing to participate in clinical trials. Participants are followed very closely throughout their involvement in a trial. All assessments and interventions are performed according to the protocol for the specific trial. Many people participate to gain access to the newest experimental treatment options prior to FDA approval. Finally, some individuals participate to help other people who have their disease in the future.

How do I find out if I am eligible for participation in a clinical trial?

Clinical trials usually have very specific criteria for participation, and only individuals who meet those criteria may enroll. To determine if you are eligible, speak with your Mellen Center clinical team or the clinical trial research contact, listed for each actively enrolling clinical trial.

How do I find more information about clinical trials?

For additional information on clinical trials in general, see the U.S. National Institutes of Health site:

For a comprehensive list of clinical trials in the United States, please refer to clinicaltrials.gov:

Current Studies

Clinical Trials Currently Enrolling
Study Name Targeted Population Description Contact
OMB157/Ofatumumab (Asclepios) (Novartis) Relapsing Remitting MS & Secondary Progressive MS with relapses
Age: 18-55
Walking ability: Able to walk without a device
To determine is Ofatumumab is superior to teriflnomide (Aubogio®) in the treatment of relaspsing MS
Duration: 30 months
Susan Sharp sharps@ccf.org
Ocrelizumab (CHORDS) (Genentech Inc.) Relapsing remitting multiple sclerosis
Age: 18-55
Safety and effectiveness of the medication Ocrelizumab
Duration: 2 years
Jennifer Resto restoj@ccf.org
N-Momentum (MedImmune) Neuromyelitis Optica (NMO)
Age: Over 18 years old
Walking ability: Able to walk or wheelchair - dependent
Safety and effectiveness of the medication MEDI-551 in Neuromyelitis Optica
Duration: 6 months
Jennifer Resto restoj@ccf.org
Vitamin D (Johns Hopkins, NIH) Relapsing remitting multiple sclerosis
Age: 18-55
Walking ability: Independent
Efficacy of oral Vitamin D (low or standard dose) with Copaxone , No history of Copaxone use
Duration: 2 years
Susan Sharp sharps@ccf.org

Non-interventional Studies Currently Enrolling
Study Name Targeted Population Description Contact
Brain Tissue Donation (NIH) Any multiple sclerosis
Age: No age limits
Walking ability: N/A
Post-mortem tissue donation
Duration: N/A
Charlene Belsole belsolc@ccf.org
Monitoring exertion-induced changes in gait parameters Relapsing Remitting MS
Age: 18-65
Walking ability: Able to walk with or without a cane or walker
Assess if exertion-induced gait changes prove to be more sensitive than traditional clinical tests such as T25FW, and could be used as early markers of disability progression
Duration: Two 2-3 hour visits
Darlene Stough stoughd@ccf.org)
Cognition and Relapses Relapsing Remitting MS
Age: 18-50
Walking ability: Able to walk with or without a cane or walker
A study to assess whether MS relapses cause cognitive impairment(difficulty thinking)
Duration: 4 year study- total of 3 visits to the Mellen Center
Charlene Belsole belsolc@ccf.org
Brain Tissue Donation (NIH) Any multiple sclerosis
Age: No age limits
Walking ability: N/A
Post-mortem tissue donation
Duration: N/A
Charlene Belsole belsolc@ccf.org
Magnetic Resonance Fingerprinting of the Thalamus in Multiple Sclerosis Relapsing Remitting MS- Secondary Progressive MS- Healthy Controls
Age: 18-60
Walking ability: RRMS-independent, SPMS-able to walk with or without a device Healthy Controls- BMI< 30, if you have a diagnosis of high blood pressure of diabetes it must be controlled
Determine the  Magnetic Resonance Fingerprinting (MRF) parameters that best distinguish MS from healthy controls
Duration: 6 month study requiring 2 visits
Susan Sharp sharps@ccf.org
Pediatric Database Any MS
Age: Disease onset prior to age 18, Can be enrolled into study up to age 22
Walking ability: N/A
Develop a database for data collected during routine clinical care of pediatric patients with possible early onset of demyelinating disease. This information will help us better understand the cause, early detection and the best treatment for demyelinating disorders (like MS) in children
Duration: Collect information at clinical visits to CCF
Jennifer Resto restoj@ccf.org

What Type of Research is Being Conducted at the Mellen Center?

Non Interventional Studies at the Mellen Center

Non-interventional research involves the study of one or more characteristics of a disease without directly administering a treatment or intervention. Many non-interventional studies examine the natural process of disease. Others test the effectiveness of medications patients have already started. The Mellen Center conducts a large amount of non-interventional studies to understand MS better, develop new measurement tools for MS, gather ideas about possible new medications, and test the effectiveness of medications in clinical practice. A large portion of non-interventional studies includes the use of new technology or laboratory tests to improve our understanding of the disease.

Innovative Clinical Measures

Research at the Mellen Center is focused on developing sensitive tools to measure the loss of function which is sometimes associated with MS. In the past neurologist relied on semi-quantitative measures based on the physical examination; however these measures are not very sensitive and differ significantly from one rater to the other. The Mellen Center is studying novel technology based assessments of neurological function. These include dynamic gait analysis and testing of neurological function using measurements obtained from accelerometers in common devices such as I-Pads. Testing of memory, concentration and attention is also being studies using technologies that may, in the future, allow patients to be monitored from the comfort of their own home and conducting their regular activities. The Mellen Center is also investigating patient self-reported measures of function and quality of life, as these measures have received little attention in the past and may be sensitive to change when following MS over time.

Imaging Research

Magnetic resonance imaging (MRI) is a valuable tool for diagnosing and following MS patients. MRI can also be used to better understand the disease process and helps identify MS therapies in early stages of development. The Mellen Center has a dedicated Neuro Imaging Laboratory with MRI units housed in the Mellen Center building. A high field (7 Tesla) MRI machine was recently acquired, which is the first of its kind in Northeast Ohio and is among only a handful of such units across the entire country. The Mellen Center has a team of technicians, engineers and physicists who use advanced MRI to answer questions about the natural history of MS, how MS lesions develop, how MS medications work, and how to detect MS in early stages. MRI research may occur in the context of an interventional study (i.e. clinical trials). Techniques commonly used at the Mellen Center include diffusion tensor imaging or DTI, which analyzes the movement of water in brain tissue. Functional MRI (fMRI) combines anatomical images with measures of brain metabolism and function which allows investigators to understand how activation patterns in the brains of MS patients differ from normal individuals. Sensitive measures of atrophy have also been developed that allow researchers to measure how the thickness of the cortex changes over time and how this may relate to cognitive symptoms and disability.

Optical Coherence Tomography

Vision is commonly affected in MS and is most frequently caused by inflammation affecting the optic nerve. A novel technique called Optical Coherence Tomography (OCT) allows high resolution pictures to be taken of the retina of the eye. This allows for measurement of the nerve fiber layers in a rapid and highly reproducible manner. The Mellen Center has a spectral domain OCT until, which can capture data from patients in several minutes and may provide a window into disease processes in the brain. Research has focused on using the eye as a model system for testing of therapeutic agents in multiple sclerosis, and also as a sensitive biomarker of MS disease activity.

Biomarkers

The identification of a laboratory marker to help diagnose, prognosticate, or predict response to treatment in MS has been elusive to date. The Mellen Center is looking at several blood and cerebrospinal fluid markers that may prove useful in the clinical care of MS patients in the future. One such marker is Vitamin D, which has received significant attention as it appears to be low in MS patient and levels tend to correlate with disease activity. Studies that incorporate imaging, OCT and blood markers, such as Vitamin D, will be useful in determining the utility of these markers and possible interventions.

Basic Science Research

Research in the laboratory aims to understand the biological mechanism through which MS occurs and mechanisms which underlie the evolution of the disease over time. Basic science research commonly uses tissue from MS patients and other experimental models. Basic science research at the Mellen Center is conducted by scientists at the Lerner Research Institute who also see MS patients and understand the unmet needs of MS patients. Basic science is the most direct line for the discovery of new therapies for MS. Research at the Mellen Center has focused on the neurodegenerative aspects, including potential mitochondrial injury, and the inflammatory processes of the disease. The use of high resolution serial section 3D microscopy allows researchers to evaluate changes occurring at the ultra-structural level. Models simulating the blood brain barrier have also been developed which may aid in the identification of novel therapeutic molecules. The Mellen Center supports an active brain donation program which allows our scientists to directly examine the brain and the changes seen in MS.

Meet the Research and Clinical Trials Team

Jeffrey Cohen MD Jeffrey Cohen, MD
Dr. Robert Bermel

Robert Bermel, MD

Dr. Francois Bethoux

Francois Bethoux, MD

Dr. Devon Conway

Devon Conway, MD

Dr. Robert Fox

Robert Fox, MD

Dr. Deborah Miller

Deborah Miller, PhD

Dr. Daniel Ontaneda

Daniel Ontaneda, MD

Dr. Alexander Duart Rae-Grant

Alexander Duart Rae-Grant, MD

Dr. Mary Rensel

Mary Rensel, MD

Dr. Lael Stone

Lael Stone, MD

Dr. Mary Willis

Mary Willis, MD

Sarah Planchon Pope, PhD, CCRP

Sarah Planchon Pope, PhD, CCRP

Additional Clinical Trial Team Members:

  • Charlene Belsole, CCRP
  • Kalyani Gonuguntla BS
  • Dee Ivancic, CCRP
  • John Mays, CCRP
  • Sneha Natarajan, PhD, CCRP
  • Kaila Parker BS
  • Jennifer Sedlak, RN, BSN, MSCN
  • Tammy Skaramagas, BA, CCRP
  • Susan Sharp, BSN, RN, MSCN
  • Darlene Stough, RN, MSCN, CCRP
  • Lina Tarhuni BS
  • Malory Weber, MBA
  • Cassie Zimmerman, MPH, CCRP
For Medical Professionals

For Medical Professionals

With the development of the Cleveland Clinic Lerner College of medicine we have had the opportunity of interacting in teaching sessions in the neurosciences curriculum, as well as teaching students one-on-one in elective time at the Mellen Center.

There are educational training opportunities at the Mellen Center. We host a neuroimmunology fellowship, have elective rotations for neurology residents, and work with medical students. Additionally, there are physiatry opportunities for residents and fellows. To find out more about possible opportunities contact Dr. Alex Rae-Grant at 216.445.2751 or Janet Perryman at 216.444.8612.

Multiple Sclerosis: Virtual Grand Rounds

Mellen Center Approaches

To assist other medical professionals involved in treating patients with multiple sclerosis, the Mellen Center physicians have developed a series of professional Mellen Center Approaches fact sheets, which address a number of issues related to the diagnosis and treatment of MS.

Fellowships

Learn more about our Multiple Sclerosis Fellowships

At the Mellen Center we have a variety of educational opportunities at different training levels, as well as ongoing educational opportunities.

  • We run an annual regional update on Multiple Sclerosis in late spring, early summer. Watch for an announcement about this program in the spring of each year.
  • We have electives for physiatry trainees and neurology trainees at the Mellen Center.
  • We have medical students rotating through the Mellen Center as part of their outpatient neurology experience.
  • Every month we have a team conference on different topics in MS care which we call “Mellen Center Approaches”. These are posted on this website when they are finalized by the team.

Cleveland Clinic neurology residents are welcome to spend two weeks on an elective outpatient at the Mellen Center. We organize a variety of experiences including one on one bedside teaching with center staff, exposure to rehabilitation procedures such as botox injections for spasticity and intrathecal baclofen pump refills, neuroradiology, occupational therapy, social work, and physical therapy.

Contact Dr. Rae-Grant at 216.445.2751 for more information.

Resources