Movement DisordersThe Movement Disorders Center at Duke University is a comprehensive clinical program offering evaluation and treatment of movement disorders, including Parkinson's disease, generalized and focal dystonia, tremor, tardive dyskinesia, tic disorders, restless leg syndrome, chorea, and myoclonus. Patients with these conditions may be seen in the Duke Movement Disorders Clinic at 932 Morreene Road, or in the Movement Disorders Clinic at the Durham VA Hospital.
Duke Movement Disorders physicians conduct clinical trials in the areas of Parkinson's disease, dystonia, and tremor disorders. In the past five years Duke Neurologists have participated in clinical trials for new drugs, surgical interventions, and diagnostic imaging compounds in Parkinson's disease. These include: altropane, AMG-474, apomorphine subcutaneous injection, CEP-1347, ß-CIT, Neurturin (NTN), creatine, entacapone, glial-derived neurotrophic factor (GDNF), GPI-1046, istradefylline, levodopa dispersible, melperone, minocycline, olanzapine, pramipexole, rasagiline, ropinirole, rotigotine transdermal patch, sarizotan, TCH-346, tolcapone, estrogen and zydis-selegiline. Clinical trials in dystonia have focused on the use of botulinum toxins in treating focal dystonia; these agents include three type A botulinum toxins (Botox®, Dysport® and Xeomin®) and one type B toxin (Myobloc™). In addition, the Duke University Movement Disorders Physicians are one of the three active programs in the country allowed to provide Tetrabenazine to patients with hyperkinetic movement disorders such as Tardive Dyskinesia, Huntington's Disease, Dystonia and Tic Disorders. This dopamine depleting drug has been most recently studied in patients with choreiform disorders, and Duke Physicians are collaborating with outside industry to bring this agent to approvable status by the Food and Drug Administration (FDA).
Current clinical research efforts are highly focused on Parkinson's disease and involve the study motor symptoms, such as wearing off and dyskinesias, and non-motor symptoms, including Impulse Control Disorders, such as pathological gambling, and psychosis and cognitive disorders. Neurological imaging studies looking for biological markers for disease, using Single Photon Emission Computed Tomography (SPECT) scanning is also an area continued research interest at the center. The Movement Disorders Program manages a large number of patients with Parkinson's Disease or Tremor, Dystonia and other Movement Disorders who have been treated by surgical placement of Deep Brain Stimulators (DBS), in a multi-specialty setting with Neurologists, Neurosurgeons, Neuro-psychologists, Bio-Engineers, and other Duke researchers. Clinical research in Dystonia includes the evaluation of novel botulinum toxins and the study of non-motor symptoms associated with this disorder associated with abnormal postures.
Educational activities in the Movement Disorders Center include a wide variety of opportunities for Neurology residents, residents in other Duke Programs, and practicing Neurologists. In addition, one and two year Movement Disorders Fellowships are available to board eligible Neurologists. Neurology residents may rotate through both the Duke and VA Movement Disorders Clinics, may participate in educational conferences and Grand Rounds as a part of residency training, and in monthly clinical conferences concentrating on the Deep Brain Stimulation program, Botulinum Toxin Program, and Movement Disorders Journal Club. In addition an annual Continuing Medical Education (CME) Botulinum Toxin Course is offered at Duke is available for both residents and other interested health care providers. Lastly, clinical externships or rotations are available to practicing Neurologists or residents from other programs are available on a limited basis. Board eligible Neurologists interested in a Movement Disorders Fellowship at Duke are encouraged to contact the Movement Disorders Program for additional information.
In addition to the collaborative DBS program, physicians in the Movement Disorders Center also work closely with researchers in other Duke Centers of Excellence. Because of the long-time effort of the Duke Center for Human Genetics, Duke is a major center for studies of the genetics of Movement Disorders with Dr. Marcy Speer. The faculty also collaborate with one of the eleven Morris K. Udall Parkinson's Disease Research Center of Excellence, directed by Dr. Jeffery Vance and funded by the National Institute of Neurological Diseases and Stroke (NINDS). The Movement Disorders Program is participating in the study of the genetics of neurodegenerative diseases supported by funding from the Deane Laboratory for Parkinson's Disease Research and GlaxoSmithKline. Basic research into the pathophysiology of trinucleotide repeat diseases such as Huntington's disease is ongoing in the Neurology Division, led by Dr. James R. Burke and Dr. Warren Strittmatter.
The North Carolina Chapter of the Huntington's Disease Society of America is headquartered at Duke and coordinates collaborations with UNC Medical Center in Chapel Hill and Wake Forest University Medical Center in Winston-Salem.
Movement Disorders Center faculty:
Nicole Calakos, M.D., Ph.D.
Assistant Professor
Division of Neurology
Box 2900, DUMC
Durham, NC 27710
calak001(at)mc.duke.edu
Calakos Laboratory:
http://www.neuro.duke.edu/CTN/faculty/calakos
Burton L. Scott, M.D., Ph.D.
Associate Clinical Professor
Division of Neurology
Box 3333, DUMC
Durham, NC 27710
scott007(at)mc.duke.edu
Mark A. Stacy, M.D.
Associate Professor and Director, Movement Disorders Center
Division of Neurology
Box 3333, DUMC
Durham, NC 27710
stacy002(at)mc.duke.edu
Biography
For more information:
The Movement Disorders Center at Duke University
The Morris K. Udall Parkinson's Disease Research Center
The Deane Laboratories at Duke University Medical Center
Selected Manuscripts by Duke Movement Disorders Faculty (2000-2006):
Shill H, Stacy M. Malignant catatonia secondary to sporadic encephalitis lethargica. J Neurol Neurosur Psychiatry 2000;69:402-3.
Stacy M. Idiopathic cervical dystonia: An overview. Neurology 2000;55(Suppl 5):S52-8.
Mahant P, Stacy M. Normal aging and movement disorders. Neurologic Clinics of North America 2000;19:553-63.
Stacy M. Pharmacotherapy for advanced Parkinson's disease. Pharmacotherapy 2000;20:S8-16.
Stacy M. Progressive Supranuclear Palsy. In: Parkinson's Disease and Movement Disorders. Adler CH, Ahlskog JE, eds. Humana Press, Totowa, NJ 2000 pp. 229-34.
Stacy, M. Sleep disorders in Parkinson's disease: Epidemiology and management. Drugs & Aging 2002;19:733-9.
Shill HA, Stacy M. Respiratory complications of Parkinson's disease. Semin Respir Crit Care Med 2002;23:261-6.
Stacy M. Apomorphine North American clinical experience. Neurology 2004:62 (suppl): S18-21.
Koller WC, Stacy M. Other formulations for apomorphine and future considerations for subcutaneous injection therapy. Neurology 2004:62(suppl):S22-6.
Driver-Dunckley E, Samanta J, Stacy M. Pathological gambling associated with dopamine agonist therapy in Parkinson's disease. Neurology 2003;61:422-3.
Nutt JG, Burchiel KJ, Comella CL, Jankovic J, Lang AE, Laws ER Jr., Lozano AM, Penn RD, Simpson RK Jr, Stacy M, Wooten GF; ICV GDNF Study Group. Implanted intracerebroventricular. Glial cell line-derived neurotrophic factor. Randomized, double-blind trial of glial cell line-derived neurotrophic factor. Neurology 2003;60:69-73.
Scott WK, Zhang F, Stajich JM, Scott BL, Stacy M, Vance JM: Family-based case-control study of cigarette smoking and Parkinson disease. Neurology 2005;64:442-7.
Stacy M, Bowron A, Guttman M, Hauser R, Hughes K, Larsen JP, Lewitt P, Oertel W, Quinn N, Sethi K, Stocchi F. Identification of motor and non-motor wearing-off in Parkinson's disease: Comparison of a patient questionnaire versus a clinician assessment. Mov Disord 2005;20:726-33.
Kolls BJ, Stacy M. Apomorphine: An Overview of Clinical Use. Aging Health 2005:1;193-202.
Stacy M. Dopamine Agonists. In: Handbook of Parkinson's Disease, 3rd Edition. Pahwa R, Lyons K, Koller W, eds. Marcel Dekker, Inc. New York. 2003 pp 407-24.
Sathornsumetee S, Stacy M. Post-traumatic Movement disorders. Neurobase 2005, 2006. Jurkowski A, Stacy M. Taxonomy and Clinical Features of Movement Disorders. In: Animal Models in Movement Disorders, LeDoux M, ed. Elsevier, San Diego 2005 pp 1-12.
16. The Dystonia Study Group. Rating Scales for Dystonia: Assessment of Reliability of 3 scales. Dystonia 4. Raven Press, 2005 pp 329-36.
Stacy M. Generalized Dystonia and Limb Dystonia. Jankovic J, ed. Seminars in Neurology. Demos Medical Publishing, New York 2005, pp. 23-30.
Sathornsumetee S, Stacy M. Movement Disorders. In: Adult Neurology, 2nd edition. Corey-Bloom J, ed. Mosby, St. Louis, 2005 pp 256-274.
Stacy M. Catatonia. Neurobase 2005. Stacy M, Tsui J. Limb Dystonia. Neurobase 2006. Lang, AE, Gill S, Patel NK, Lozano A, Nutt JG, Penn R, Brooks DJ, Hotton G, Moro E, Heywood P, Brodsky MA, Burchiel K, Hutchinson M, Kelly P, Dalvi A, Scott B, Stacy M, Turner D, Wooten VGF, Elias WJ, Laws ER, Dhawan V, Stoessl AJ, Matcham J, Coffey RJ, Traub M. A multicenter, randomized, double-blind, placebo controlled trial of liatermin (r-metHuGDNF) administered by bilateral Intraputaminal infusion to patients with idiopathic Parkinson's disease. Ann Neurol 2006;59:459-66.
Ondo WG, Jankovic J, Connor GS, Pahwa R, Elble R, Stacy M, Koller WC, Schwarzman L, Wu S-C, Ph.D., Hulihan JF on behalf of the Topiramate Essential Tremor Study Investigators. Topiramate in essential tremor: A double-blind, placebo-controlled trial. Neurology 2006;66:672-7.
Hancock DB, Martin ER, Fujiwara K, Stacy MA, Scott BL, Stajich JM, Jewett R, Li Y-L, Hauser MA, Vance JM, Scott WK. NOS2A and the modulating effect of cigarette smoking in Parkinson disease. Ann Neurol 2006 Jul 5: [Epub]
Stacy M, Hauser R, and the Wearing Off Study Group. Development of a Wearing-Off Patient Questionnaire to facilitate recognition of the motor and non-motor symptoms of wearing-off in Parkinson's disease. J Neural Transm 2006 Aug 10; [Epub]
Stacy M, Hauser R, Oertel W, Schapira A, Sethi K, Stocchi F, Tolosa E. End of Dose Wearing-Off in Parkinson's Disease: a 9-question survey assessment. Clin Neuropharm (in press)
Kolls B, Stacy M. Apomorphine: A rapid rescue agent for motor and non-motor fluctuations in advanced Parkinson's disease. Clinical Neuropharmacol 2006:(in press)
Jankovic J, Hunter C, Dolimbek BZ, Dolimbek GS, Adler C, Brashear A, Comella CL, Gordon M, Riley D, Sethi K, Singer C, Stacy M, Tarsy D, Zouhair Atassi M. Clinico-immunologic aspects of Botulinum Toxin Type B Treatment of Cervical Dystonia. Neurology (in press)
Pahwa R, Stacy MA, Factor SA, Lyons KE, Stocchi F, Hersh BP, Elmer LW, Truong DD, Earl NL on behalf of the EASE-PD Adjunct Study Investigators.. A randomized, double-blind, placebo-controlled, parallel-group study of ropinirole 24-hour prolonged release as adjunctive therapy in patients with Parkinson's disease not optimally controlled on L-dopa (EASE-PD Adjunct study). Neurology (in press)
Stacy M. Clinical Use of the Botulinum Toxins. In Handbook of Dystonia, Stacy M, ed. Taylor & Francis, Philadelphia. 2007 (in press)
Menon RN, Stacy M. Adenosine A2A Receptor Antagonists in the Treatment of Parkinson's Disease. In Parkinson's Disease: Diagnosis and Clinical Management, Factor SA and Weiner WJ, eds. Butterworth 2007 (in press)
Books: 1. Stacy M. Handbook of Dystonia, Stacy M, ed. Taylor & Francis, Philadelphia. 2007 (in press) |
