Title: University of Florida Movement Disorders Center
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00090035/00001
 Material Information
Title: University of Florida Movement Disorders Center medicine, surgery and research for Parkinson's disease, tremor and dystonia
Physical Description: Book
Language: English
Creator: Shands Neurological Center, University of Florida
Publisher: Shands Neurological Center, University of Florida
Place of Publication: Gainesville, Fla.
 Record Information
Bibliographic ID: UF00090035
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.


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University of Florida
Movement Disorders Center
Medicine, Surgery and Research for Parkinson's Disease, Tremor and Dystonia


Michael S. Okun, MD, Co-Director
Michael S. Okun, MD, University of Florida neurologist and movement disorders
expert, completed two fellowships, one in movement disorders, and a second in
microelectrode recording and surgical treatments of movement disorders. As an
experienced researcher and bedside movement disorders physician, his goal is
to provide the best care for patients while at the same time ensuring that the
University of Florida is on the cutting edge of research and new therapies.
Recruited from Emory University, one of the world's foremost centers in surgical
therapy for movement disorders, Dr. Okun brings to the University of Florida a real
strength in the surgical treatment of Parkinson's disease, dystonia, tremor and
other movement disorders.

Kelly D. Foote, MD, Co-Director
Kelly D. Foote, MD, University of Florida neurosurgeon and movement disorders
expert, has been fellowship trained in stereotactic and functional neurosurgery.
In addition to a one-year fellowship in stereotactic neurosurgery and radiosurgery
under William A. Friedman, MD, at the University of Florida, Dr. Foote trained in
movement disorder surgery at the Universite' de Grenoble in Grenoble, France, as
well as at Emory University, two of the pioneering institutions for movement
disorders surgery. By combining his expertise in image-guided surgery with Dr.
Okun's expertise in microelectrode recording and brain mapping, they have
created one of the most technologically advanced operating rooms in the country.


At the Center, patients are treated medically and/or surgically for all forms of
movement disorder. Research is conducted for:
Parkinson's disease
Atypical Parkinsonism (PSP, Lewy body disease, corticobasal degeneration, MSA, trauma, other)
Tremor (essential, outflow, trauma, other)
Dystonia (primary, secondary, tardive)
Chorea (Huntington's disease, other)
Other neurodegenerative disorders with basal ganglia involvement
Tic (Tourette's syndrome, other)

The Growing Need for Advanced Studies and Care
Diseases like Parkinson's that occur more commonly with age will present a continuing and
increasing challenge for movement disorders experts

P r e v a e n c e o e D i s o r d e r s
Disorder per 100,000 USA (281,421,906) Florida (15,982,378)
Essential tremor 306 415 861,000 1,168,000 49,000 66,000
Parkinson's disease 18 187 51,000 526,000 3,000 30,000
Tourette's syndrome 30 160 84,000 450,000 5,000 26,000
Focal dystonia 30 84,000 5,000
Generalized dystonia 3.4 10,000 544
Huntington's disease 5- 10 14,000 28,000 800- 1,600
Wilson's disease 3 8,000 480
Progressive supranuclear palsy 1.4 4,000 224

Since 1990, % change in USA population >65 years old: 12.4% Since 1990, % change in Florida population >65 years old: 17.6%
These numbers are an underestimate in Florida, where the population is much older than the national average.

Clinical Services Offered at the Center
Optimization of medication treatments
Deep brain stimulation
Ablative therapy (pallidotomy, thalamotomy, subthalamotomy)
Botulinum toxin treatments
Speech and language disorder evaluation and treatment
Gait training, physical therapy
Treatment of associated anxiety, depression and mood disorders

Current Research
Deep Brain Stimulation Microelectrode Recording
The Movement Disorders Center offers state-of-the-art deep brain stimulation and ablative therapy for Parkinson's
disease, dystonia, tremor and other movement disorders. The combination of a locally developed image guidance
system, multiple pass microelectrode recording and advanced brain mapping techniques sets UF apart from
many other institutions performing these procedures. In addition, the program has assembled a complete multi
disciplinary movement disorders team to ensure the highest quality of care.

GDNF, Viral Vectors and Genetics
Ronald Mandel, PhD, and his team are actively investigating both direct intrastriatal transmitter replacement
(L-dopa delivery) and neurotrophic support strategies (GDNF delivery) in the unilateral 6-OHDA-lesion model
of Parkinson's disease using recombinant adeno-associated viral vectors (rAAV). The laboratory plans to begin
analogous studies in primates to obtain the data necessary to support a Phase I clinical trial using rAAV in
Parkinson's disease. The laboratory also has studies underway to develop regulated vectors to express GDNF

Other major interests in the laboratory are using rAAV to study the etiology of Parkinson's disease, using rAAV
to transfer ribozymes to the striatum of transgenic mice expressing a mutant form of Huntington's disease to
determine if knocking down gene expression will block Huntington's disease-like pathology and other potential
projects involving gene transfer in Huntington's disease models concerning the trophic factors, brain derived
neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF).

Stem Cell Research
The major research goal of Dennis Steindler, PhD, and his team is to see the use of stem cell therapy become a
major treatment for debilitating neurological diseases. There is widespread interest in the use of stem cells for
cell replacement therapies in human neurological disease. However, we have only begun to appreciate the cell
and molecular biology of these cells, which hold great promise for transplantation or other therapeutics relying
on the potential use of our own persistent stem/progenitor cell population in autologous transplant paradigms
for diseases such as Parkinson's. This laboratory is currently developing stem cells for the potential treatment
of Parkinson's.

* Brain Bank

The Human Brain Tissue Bank at Evelyn F & William L. McKnight Brain Institute of the University of Florida aides studies of

traumatic brain and spinal cord injury, as well as Parkinson's and other neurodegenerative diseases and movement disor-

ders. This collaborative effort, which is led by Thomas Eskin, MD, will provide human blood and tissue for research at the

cellular and molecular levels, as well as collaborative genetic research. Such studies should help explain the destructive

processes in a variety of human brain diseases.

Other Active Research Initiatives

Improvements in MRI and imaging
Improvements in surgical techniques
Lesion surgery
Surgical and medical clinical trials
Gait and kinematics
Speech, swallowing, language disorders
Cognitive and mood disorders
Clinical trials new therapies

To ensure our success in both clinical and research endeavors, we have

assembled a top-notch team of experienced professionals in the fields of

Parkinson's disease and movement disorders.

Michael Okun, MD
Edward Valenstein, MD
Robert Watson, MD
Kenneth Heilman, MD
Steve Eisenschenk, MD
Janet Romrell, PA
Sarah Munson, BS

Kelly Foote, MD
William Friedman, MD
Frank Bova, PhD
Pam Martin, RN

Ron Mandel, PhD
Dennis Steindler, PhD
William Luttge, PhD
Douglas Anderson, PhD

Greg Crucian, PhD
Dylan Wint, PhD
Wayne Goodman, MD
Tanya Murphy, MD

Gait and Rehabilitation
Pam Duncan, PhD
Leslie Gonzalez-Rothi, PhD
Bruce Crosson, PhD

Speech, Voice and Language
John Rosenbek, PhD
Christina Sapienza, PhD

Steven Robicsek, MD, PhD
Michael E. Mahla, MD

Web Page
Sue Legg
Lynn Romrell, MD
Richard Rathe, MD

Bio-information Systems
Su-Shing Chen, PhD

Brain/Blood Bank
Thomas Eskin, MD
Anthony Yachnis, MD

Jacksonville Partnership
Alan Berger, MD
Zigao Huang, MD

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