Parkinson's Disease: Center of Excellence and Deep Brain Stimulation Surgery

Overview

The Parkinson disease (PD) and Movement Disorders Program provides comprehensive medical and surgical (including deep brain stimulation [DBS]) care for all movement disorder patients. In the past decade and a half, the Center for Neurological Restoration has shown tremendous growth in the areas of clinical care, research, and education. It is among the first in the nation to introduce the comprehensive multidisciplinary team approach for the evaluation and surgical treatment of movement disorders. It is the State of Ohio’s only Parkinson Disease Center of Excellence, designated by the Parkinson’s Foundation, and Atypical Parkinsonism Center of Care, designated by the CURE PSP Foundation.

The Movement Disorders Program at Cleveland Clinic is one of the richest and most diverse sources of clinical materials in the world. Across all of its locations, the Center for Neurological Restoration examines and treats over 10,000 unique patients per year from all over the globe. Hundreds of DBS implantations have been performed in the Center for Neurological Restoration since its inception.

We are an international leader in DBS research with our primate lab in neurophysiology headed by Kenneth Baker, PhD. We performed the first human DBS implantation for stroke, and also the first human DBS implantation for chronic pain, headed by Andre Machado, MD, PhD. We perform clinical trials exploring directional leads in DBS. Recently, we obtained federal funding for several investigator-initiated projects, including examining cognitive and personality changes in DBS-treated patients.

Contact Information

Hubert Fernandez, MD
fernanh@ccf.org

Publications

Tardive Dyskinesia: Treatment Update. Arya D, Khan T, Margolius AJ, Fernandez HH. Curr Neurol Rep 2019 Aug 19; doi: 10.1007/s11910-019-0976.

Height and weight changes after deep brain stimulation in patients with Parkinson disease: role of clinical subtypes. Abboud H, Reyes D, Genc G, Ahemd A, Gostkowski M, Fernandez HH. Heliyon 2019 Jun 25; doi: 10.1016/j.heliyon.2019.e01862.

Factors associated with postoperative confusion and prolonged hospital stay following deep brain stimulation surgery in Parkinson disease. Abboud H, Genc C, Saad S, Thompson N, Oravivattanakul S, Alsallom F, Yu XX, Floden D, Gostkowski M, Ahmed A, Marouf HM, Manspour OY, Fernandez HH. Neurosurgery 2019 Aug 20; doi: 10.1093/neuros/nyz316.

Long-term safety and efficacy of deutetrabenazine for the treatment of tardive dyskinesia. Fernandez HH, Stamler D, Davis MD, Factor SA, Hauser RA, Jimenez-Shahed J, Ondo W, Jarslog LF, Woods SW, Bega D, LeDoux MS, Shprecter DR, Anderson KE. J Neurol Neurosurg Psychiatry 2019 Jul 10; doi: 10.1136/jnnp-2018-319918.

Safety and efficacy of CVT-301 (levodopa inhalation poder) on motor function during off periods in patients with Parkinson’s disease: a randomized, double-blind, placebo-controlled phase 3 trial. LeWitt PA, Hauser RA, Pahwa R, Isaacson SH, Fernandez HH, Lew M, Sait-Hilaire M, Pourcer E, Lopez-Manzanares L, Waters C, Rudzinska M, Sedkov A, Batcky R, Oh C, SPAN=PD Study Investigators. Lancet Neurol Feb 2019; 18 (2): 145-154.

The next chapter in symptomatic Parkinson disease treatments. Hengartner D, Fernandez HH. Parkinsonism Relat Disord Feb 2019; 59: 39-49.

Predicting early cognitive decline in newly-diagnosed Parkinson patients: A practical model. Hoque O, Fernandez HH, Floden DP. Parkinsonism Relat Disord 2018 June; doi: 10.1016/j.parkreldis.2018.06.031.

Dopamine agonist withdrawal syndrome (DAWS) in a tertiary Parkinson disease treatment center.J Neurol Sci 2017 Aug; 379:308-311.Patel S, Garcia X, Mohammad ME, Yu XX, Vlastaris K, O’Donnell K, Sutton K, Fernandez HH.

Rasagiline for the symptomatic treatment of fatigue in Parkinson disease. Mov Disord 2015 Nov; 30 (13): 1825-30. Lim TT, Kluger BM, Rodriguez RL, Malaty IA, Palacio R, Ojo OO, Patel S, Gurati Y, Nutter B, Swartz C, Hennesy C, Fernandez HH.

Impact of mild cognitive impairment on outcome following deep brain stimulation surgery for Parkinson’s disease. Parkinsonism Relat Disord 2014 Dec; PMID: 25578289; doi: 10.1016/j.parkreldis.2014.12.018. Abboud H, Floden D, Thompson NR, Genc G, Oravivanttanakul S, Alsallom F, Swa N, Kubu C, Pandya M, Gostkowski M, Cooper S, Machado A, Fernandez HH. 

Comprehensive, Multidisciplinary Deep Brain Stimulation Screening for Parkinson Patients: No Room for “Short Cuts”. Movement Disorders Clinical Practice 2014; doi: 10.1002/mdc3.12090. Abboud H, Mehanna R, Machado A, Ahmed A, Gostkowski M, Cooper S, Itin I, Kubu C, Floden D, Ford PJ, Fernandez HH. 

Randomized controlled trial of deutetrabenazine for tardine dyskinesia: The ARM-TD Study. Neurology 2017 May; 88 (21): 2003-2010. Fernandez HH, Factor SA, Hauser RA, Jimenez-Shahed J, Ondo WG, Jarskog LF, Meltzer HY, Woods SW, Bega D, LeDoux MS, Sphrecter DR, Davis C, Davis MD, Stamler D, Anderson KE. 

Deutetrabenazine for treatment of involuntary movements in patients with tardive dyskinesia (AIM-TD). Lancet Psychiatry 2017 Aug; 4(8) 595-604. Andreson KE, Stamler D, Davis MD, Factor SA, Hauser RA, Jarskog LF, Jimenez-Shahed J, McEvoy J, Ondo WG, Fernandez HH.

Levodopa-carbidopa intestinal gel in advanced Parkinaon’s disease: Final 12-month open-label results. Mov Disord 2015 Apr; 30 (4): 500-9. doi: 10.1002/mds.26123. Fernandez HH, Standaert DG, Hauser RA, Lang AE, Fung VS, Klostermann F, Lew MF, Odin P, Benesh JA, Espay AJ.

Chronic deep cerebellar stimulation promotes long-term potentiation, microstructural plasticity, and reorganization of perilesional cortical representation in a rodent model.J Neurosci. 2014 Jul 2;34(27):9040-50. PMID: 24990924; PMCID: PMC4078081. Cooperrider J, Furmaga H, Plow E, Park HJ, Chen Z, Kidd G, Baker KB, Gale JT, Machado AG.

Barriers to investigator-initiated deep brain stimulation and device research. Neurology. 2014 Apr 22;82(16):1465-73. PMID: 24670888; PMCID: PMC4001198. Kelly ML, Malone D, Okun MS, Booth J, Machado AG.

Predicting quality of life outcomes after subthalamic nucleus deep brain stimulation. Neurology. 2014 Oct 28;83(18):1627-33. PMID: 25274851; PubMed Central PMCID: PMC4223084. �. Floden D, Cooper SE, Griffith SD, Machado AG.

Correlation Among Anatomic Landmarks, Location of Subthalamic Deep Brain Stimulation Electrodes, Stimulation Parameters, and Side Effects During Programming Monopolar Review.Neurosurgery, 2015:Suppl 2, 99-108. PubMed PMID: 25599207. Matias CM, Mehanna R, Cooper SE, Amit A, Lempka SF, Silva D, Carlotti CG Jr, Butler RS, Machado AG.

Cortical and motor responses to acute forced exercise in Parkinson's disease. Parkinsonism Related Disorders. 2016 24:56-62. Alberts JL, Phillips M, Lowe MJ, Frankemolle A, Thota A, Beall EB, Feldman M, Ahmed A, Ridgel AL

Exercise Therapy for Parkinson's Disease: Pedaling Rate Is Related to Changes in Motor Connectivity. Brain Connectivity. (2016) 6:25-36. Shah C, Beall EB, Frankemolle AM, Penko A, Phillips MD, Lowe MJ, Alberts JL.

Members & Collaborations

Neurology

• Benjamin Walter, MD
• Hubert H. Fernandez, MD
• Michal Gostkowski, MD
• Ilia Itin, MD
• Joseph Rudolph, MD
• Zoltan Mari, MD
• Xin Xin Yu, MD
• Kristin Appleby, MD
• James Liao, MD
• Adam Margolius, MD
• Amanda Mook, DO
• Umar Shuaib, MD
• Junaid Siddiqui, MD

Neurosurgery

• Andre Machado, MD
• Sean Nagel, MD
• Richard Rammo, MD

Psychiatry

• Donald Malone, MD
• Kasia Rothenberg, MD

Neuropsychology/Bioethics

• Darlene Floden, MD
• Cynthia Kubu, MD
• Paul Ford, MD
• Scott Sperling, PsyD

Biomedical Engineering/Translational Scientists/Collaborators

• Jay Alberts, MD
• Kenneth Baker, MD
• Ela B. Plow, MD
• Ignacio Mata, MD
• James Levenerenz, MD
• Jagan Pillai, MD