Posted on Fri, Aug 06, 2010 @ 03:44 PM
Dr. Todd Feaster's platform presentation from this Summer's Consortium of Multiple Sclerosis Centers meeting can now be viewed online. The study aims to understand the cognitive difficulties of MS patients and the extent that low Vitamin D levels contribute to the problem.
Dr. Feaster is a neuropsychologist at MidAmerica Neuroscience Institute's Multiple Sclerosis Center in Lenexa, KS.
The study can be found here:
VITAMIN D DEFICIENCY CORRELATES WITH LEARNING TASKS
Posted on Fri, Jul 02, 2010 @ 10:41 AM
MidAmerica Neuroscience Institute in Lenexa, KS was highlighted in an investigational news piece about Alzheimer's clinical drug research. The story featured neurologist Dana Winegarner, DO discussing the Institute's involvement and his initial impressions of the investigational drug Bapineuzumab.
The 5- minute long video captures the hopes and fears of a 77 year old Kansas City man with Alzheimer's disease, and his wife, as one of the thousands of participants across multiple sites that involved in this clinical trial.
MidAmerica Neuroscience Institute is a comprehensive clinical
neurology practice that also engages in basic science research and clincal research trials of Multiple Sclerosis, Dementia, Headaches and Sleep Disorders.
The practice has three Kansas City area locations with headquarters located at:
8550 Marshall Dr, Suite 100
Lenexa, KS 66214
913-894-1500
Posted on Thu, Jul 01, 2010 @ 10:22 AM
Be sure to watch or set your DVR for KCTV5 tonight (July 1st, 2010) at 10 PM.
The investigational report will feature MidAmerica Neuroscience Institute's Dr. Dana Winegarner and a particpant in a clinical research trial.
If you aren't in the Kansas City news market and can't receive the Channel 5 broadcast, be sure check back here soon for a link to the story.
Dr. Winegarner is the Director of the Memory Loss Center at MidAmerica Neuroscience Institue and heads many of the Alzheimer's research studies at the Institute.
Posted on Tue, Jun 29, 2010 @ 11:23 AM
Dr. Rowe and the MidAmerica Neuroscience Sleep Center were featured on Kansas City's NBC Action News. Sleep Technologist, Sheila Miller demonstrated the process of wiring a sleep patient for a sleep study on reporter, Sloane Heller.
Posted on Fri, Jun 18, 2010 @ 02:29 PM
Association of Restless Legs Syndrome - Like Movements and Periodic Limb Movement Disorder with Lumbar Radiculopathy
New Research from MidAmerica Neuroscience Institute
(click to open PDF below)
Study: Restless Legs Syndrome
Posted on Thu, Jun 10, 2010 @ 09:48 AM
The following article appeared in Medscape Today from WebMD
Vitamin D Linked to Poor Learning Performance in Patients With MS
June 9, 2010 (San Antonio, Texas) - A new study shows that serum vitamin D deficiency is associated with poor learning performance among patients with multiple sclerosis (MS). The research was presented here at the Consortium of Multiple Sclerosis Centers 24th Annual Conference and the Third Joint Meeting of Americas Committee for Treatment and Research in Multiple Sclerosis.
There is some evidence that vitamin D suppresses proinflammatory cytokines, and that low levels of these cytokines could contribute to MS. Other evidence suggests that vitamin D plays a role in cognitive function in older adults. Cognitive impairment is very common in MS, but few studies have examined the relationship between serum vitamin D and cognitive deficits in this population.
The researchers enrolled 23 patients with relapsing-remitting MS and secondary progressive MS. After laboratory work to determine serum vitamin D levels, patients underwent a comprehensive neuropsychological evaluation to assess emotional functioning, memory, executive functioning, processing speed, attention, and visuospatial abilities.
Low vitamin D levels and poor performance were correlated on a verbal learning test (r = .49; P < .05). The effect was stronger in single-trial learning (r = .65; P < .001). No correlation was observed during later learning trials.
"These findings suggest the importance of determining vitamin D levels in order to maximize cognitive potential among MS patients. Future randomized trials should examine whether vitamin D supplementation may improve learning in MS," the researchers wrote in the abstract.
The work was prompted by several recent studies that showed a relationship between cognitive function and vitamin D levels in the elderly, Todd Feaster, PsyD, a neuropsychologist at the MidAmerica Neuroscience Institute in Lenexa, Kansas, told Medscape Neurology. Dr. Feaster also works with patients with Alzheimer's disease, so those findings struck a chord in him, he said.
The study suggests that cognitive impairment might not be caused
by MS alone but could be caused or exacerbated by vitamin D deficiency, and supplementation might improve symptoms.
"When you have a winter like we've had in the Midwest, you're stuck inside all day. So is vitamin D deficiency exacerbating cognitive issues? And if we get those levels up, will we get improvement?" Dr. Feaster posited.
The study was relatively small, cautioned Helen Tremlett, PhD, assistant professor of neurology at the University of British Columbia in Vancouver, Canada. "It does need to be reproduced," she told Medscape Neurology.
"He didn't factor in seasonality, which could be [important]. But if the findings are true, we might be able to supplement vitamin D and bring up cognitive levels" in these patients, Dr. Tremlett suggested.
However, the study isn't robust enough to change clinical practice just yet. "We can't do an intervention based on what he's presented, but it gives us real food for thought. A longitudinal study would be nice to see," she remarked.
The study did not receive commercial support. Dr. Feaster and Dr. Tremlett have disclosed no relevant financial relationships.
Consortium of Multiple Sclerosis Centers (CMSC) 24th Annual Conference and the Third Joint Meeting of Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS): Abstract P03. Presented June 4, 2010.
Posted on Thu, May 27, 2010 @ 09:23 AM
Bob DeMarco of the Alzheimer's Reading Room recently wrote an article where Alzheimer's caregivers shared their experiences that first alerted them that their loved one was having memory issues that they could no long attribute to "old age". We regularly evaluate patients at our Memory Loss Center and lament that we did not get the opportunity to see this patient earlier.
Many of the clues that these people shared were centered on common themes:
- Driving problems
- Checkbook and finances
- Mood changes like unexplained irritability or paranoia
- Hygiene and clothing attire
- Eating issues - usually not remembering to
Key takeaways from this article: 
1. Don't rely upon your personal care physician to pick up on these things before you do.
2. When you begin to suspect a problem, get tested by a memory loss specialist.
3. Don't wait!
The entire article can be read here.
Currently there are therapies for Alzheimer's dementia but there is no cure. We felt that these personal experiences will help educate the public on the importance of getting a diagnosis early. At our Memory Loss Center we participate in clinical trials of investigational drugs for Alzheimer's disease. Keeping patients sharper, longer with currently available therapies is the key - should one of the new drugs in trial now become a future cure.
Posted on Mon, May 24, 2010 @ 09:29 AM
With healthcare reform dominating the news recently, MRI and other imaging tests have become the (misguided) targets of many critics. Although MRI makes up only one-half of one percent of total healthcare expenditures it is easy to demonize since the average healthcare consumer can understand imaging much easier than DRG's, hospital facility fees or insurance contracts.
It is unfortunately true that some physicians order expensive imaging tests in C.Y.A. mode but I felt it would be important to share the proper decision making criteria our clinicians utilize when making decisions about ordering these tests.
There are a variety of tools available to help make decisions about imaging a patient. These include the Appropriateness Criteria by the American College of Radiology, the Milliman Care Guidelines - Ambulatory Care Section, and Medicare LCDs and eventually the Medicare Appropriateness Criteria Demonstration Project. Some rely on diagnostic criteria, some on symptoms combined with evidenced based research such as the Cochrane Reports and input from various medical societies and associations.
Clinical Judgment is Irreplaceable
But nothing can substitute for the clinical judgment of an
experienced physician who understands the significance of treating the patient at the highest level of competency and is evaluating with eyes, ears and hands the patient in front of them. The Guidelines can be used on a case-by-case basis by qualified, healthcare professionals as a tool in making medical necessity decisions, but by definition they are nothing more than "guidelines" and therefore should not be used for denying evaluation and possible treatment to patients. Additionally, if one simply utilized guidelines like a recipe for mixing a cake, a physician would be dissuaded from determining that imaging is not required when their experience tells them it is likely unnecessary. They must always be used in the context of a qualified and experienced healthcare professional's clinical judgment.
Imaging Decisions Should Come After, and as a Result of the Clinical Examination
Once a decision to image the patient has been made based on the outcome of a history and physical examination of the patient, there are four important elements we consider when ordering and performing the neuroimaging.
1) The careful selection of which body part to image and the selection of the particular MRI or MRA protocol and sequences needed to evaluate the patient's symptoms.
2) The use of highly trained and experienced certified technicians. Even the best equipment does not insure that the image quality will be achieved without the experience of qualified technicians.
3) The use of an accredited (ACR or ICAMRL) Neuroimaging Center. This assures that the equipment and procedures used meet a high level of competency and that procedures are in place to constantly evaluate and improve quality.
4) Fellowship trained or Board Certified Neuroimaging/Neuroradiologist interpreting the images. A general radiologist who is minimally trained in MRI and in particular central nervous system MRI will not give us the quality we expect or patients deserve.
Further, each test in a diagnostic testing program plays its own separate role in the evaluation of a patient. No test is simply a substitute for another, since each test gives critical and unique information necessary for patient diagnosis and treatment.
In the end, the treating physician must be able to trust the results from each test and must correlate all test results with the patient being examined, in order to design an optimal treatment plan for each patient. Delayed evaluation for any reason squanders the most valuable assets in patients' lives, namely, their time and their health. The subsequent effects on their lives and the lives of the organizations they serve, is incalculable. - by Vernon Rowe, MD
Posted on Fri, Apr 23, 2010 @ 02:30 PM
After my first exacerbation at age 29, but unaware of the M.S.
I had my second child at age 30
I became a preschool director, a position I held for nearly 8 years that necessitated a 45-55 hour work week
I took numerous family trips to Branson, MO (where I had my first horseback ride); Galveston, TX; Littleton, CO (where I white water rafted 3 times in the southern part of the state); Minneapolis, MN; Oklahoma City, OK; and many other locations with family attractions such as white water rafting (3x), and multiple amusement parks (where we rode every scary ride possible!)
Our family had season passes for many years to Worlds of Fun
I took frequent walks, often 2 miles or more
I was stewardship chairman for our church
I was part of a 100% club for successful directorship of my preschool academy resulting in trips to NY, CA, FL, HI (2x), England, France and Holland.
I became a member of our church council and was on the personnel committee as well
13 years after my first exacerbation, I was promoted to a company directorship, leading the customer service department for the second largest educational and proprietary childcare in the nation
I went parasailing, the same month as my initial diagnosis
After diagnosis (2 months prior to my 46th birthday):
2 years after diagnosis, I initiated the first licensed daycare for jr high age children during the summer
I became an M.S. advocate with Shared Solutions, bringing hope to others with this disease
We took many family vacations including to Redondo Beach, CA and Tijuana, Mexico
Five years after diagnosis, I was the first recipient from the corporate office to win the customer loyalty award and another trip to HI
I attended a company leadership in the mountains of CO, engaging in physical challenges that served as exercises to promote values and teamwork
The following year, I attended another leadership workshop to the same area in CO, but required an overnight camping trip in February
I wrote the company's Good Customer Service Guide
I developed a program for my company of utilizing parent boards and traveled extensively throughout the U.S. presenting it to parents and the field. At one point, there were 6 straight weeks of travel that managed to be different time zones from each previous trip
We bought a kayak to use on a nearby lake
I drove my son's Jeep with extra big tires
Six years after diagnosis, my husband and I celebrated our 30th anniversary 3 months early by going to Cancun where we snorkeled, shopped, and enjoyed our tourist
Eight years after diagnosis, I accepted a position that did not require commuting in a government call center and was promoted to a supervisor position within 3 months.
Nine years after diagnosis, I became an Operations Rep, supervising the supervisors and implementing many new programs that I created or helped to create
I wrote a children's book yet to be published, but nevertheless accomplished
Ten years after diagnosis, our entire family went to HI where we visited volcanoes, dolphins in the ocean, and enjoyed the incredible ambiance of the islands
Later I retired due to secondary progressive M.S. and to spend time with my husband who was fighting cancer. I booked all of our numerous travels to Houston, Chicago and Texas. I became his caregiver on many occasions.
Eleven years after diagnosis: I continue to fly (even alone to CA) My eldest son and I spent time between the holidays in Orlando, FL, visiting Kennedy Space Center, Universal Studios, and riding on a swamp boat to view "gators." I have an upcoming advocate reunion in July to San Diego, and my sons and I are taking our first cruise in August where we will visit the Grand Cayman Island and Playa del Carmen, Mexico.
I am on the Vision Team at our church that creates small groups within the congregation. I am the coordinator for one of the groups which I created, and a member of another which I developed.
SUMMARY
You can maintain who you are. I now use a mobility scooter to substitute for walking of any distance but I do have a lift in my car to accommodate my scooter. This enables me to go many places by myself. I do navigate the stairs in my two story home, and I fully intend to do what I want and can do for as long as possible.
- This story was submitted by a patient at MidAmerica Neuroscience Institute who understands that a diagnosis of MS is a defining moment in life but that MS does not have to define your life. The clinicians and staff at our Multiple Sclerosis Center were so impressed with the spirit of this woman that we asked to share her MS story with our readers.