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Center for Movement Disorders and Neurorestoration

MD-big-group-front-trimmed-680x484The UF CMDNR is founded on the philosophy that integrated, interdisciplinary care is the most effective approach for patients with movement disorders and disorders involving a group of circuits in the brain called the basal ganglia. The Center delivers motor, cognitive and behavioral diagnoses as well as various treatments, all in one centralized location. Care is coordinated and provided by leading specialists from many advanced medical and surgical services. The center lives on a single floor (4th floor of the Orthopedic and Sports Medicine Institute on 34th street across the street from the UF Hilton) and has over 15,000 square feet of dedicated interdisciplinary space. All specialists live together in an avant-garde side by side arrangement– with clinical services, an automatic gait and balance machine, rehabilitation services, a MRI, a swallow suite, laboratory space, a database, a telemedicine room, and dedicated clinical trials space. The space and architecture plan are unique, and everything about the center is patient-centric all the way down to the art on the walls–all contributed by actual UF patients. Patients can stay the night at the hotel, walk across the street, see multiple specialists in a single day, and check out all the clinical trials. Though UF has had a PD center since 2002, the ribbon cutting for the new patient-centered experience occurred on April 18, 2011, and the first patient and caregiver seen in the center were former Attorney General Janet Reno and her sister Maggy Hurchalla.

 

Built on the expertise of the UF faculty and researchers from 17 different specialty and subspecialty areas, the CMDNR has earned a reputation for excellence and it has become an international destination for patient care, research and teaching in PD, movement disorders and neurorestoration. At UF, patients have access to the latest clinical/translational research studies, as well as the opportunity to contribute to future research. Since its creation less than a decade ago, the Center has treated more than 9,000 patients, the majority of whom continue to be followed in one of the largest databases of movement disorders in the world (UF-INFORM).

 

The international prominence of the CMDNR is reflected by the multiple Centers of Excellence. These include a National Parkinson Foundation Center of Excellence, Tyler’s Hope Center for a Dystonia Cure, a Huntington’s Disease Society of America Center, a Bachmann-Strauss Dystonia Parkinson Center of Excellence, a Tourette Syndrome Association Center of Excellence, and the NIH designated headquarters of the nationwide Clinical Research Consortium for Spinocerebellar Ataxias.

 

The UF CMDNR includes clinicians and researchers from the fields of neurology, neurosurgery, neuroscience, neuropsychology, speech and communication disorders, physical therapy/rehabilitation, psychiatry, neuropathology, bioengineering, radiology, social work, nursing, and computer science.

 

In recent years, neurosurgical procedures for the treatment of PD, essential tremor, dystonia, OCD, Tourette and other movement/neuropsychiatric disorders have become important and exciting areas for both patient care and research. UF has been a pioneer in these operations and a leader in DBS for many disorders including OCD, Tourette, and multiple sclerosis tremor. Appropriately selected patients may benefit from intervention with deep brain stimulation therapy (DBS), or ablative procedures such as pallidotomy, subthalamotomy, or thalamotomy. The CMDNR has a particular expertise in the surgical treatment of movement disorders offering all currently available procedures. An interdisciplinary staff performs care and research directed at improving the delivery and efficacy of these novel surgical treatments. The operating room at the UF is equipped with the finest instruments available including microelectrode recording, physiology, and imaging capabilities. Many of the instruments used at UF have been invented or refined by the UF team.

 

The team at UF is a large interdisciplinary DBS team offering careful selection, improved targeting, refined microelectrode mapping, and a full-time dedicated DBS programming nurse and staff. Over the last decade UF has led or has been a participating center in over half a dozen major NIH DBS trials, and UF has implanted over 1400 leads. The center is the home to a DBS troubleshooting clinic where over 50 patients a year travel to UF from around the US and world to be evaluated for a “DBS failure.”

 

In addition to the world class surgical services, UF has a Clinical Trials Center offering patients the latest in all new drug, botulinum toxin, behavioral therapies, and device therapies. The clinical trials program offers over 50 trials in collaboration with the National Institutes of Health, industry, and with foundations.

 

The space for PD and movement disorders includes 21 dedicated patient exam rooms, as well as tailored space for clinical trials, research, telemedicine, and for the movement disorders databases. The space is equipped with a full physical therapy, occupational therapy, neuropsychology, psychiatry, and speech therapy area, and convenient in building access to a MRI and swallow suite. The center staff is specifically trained to arrange patient specific and coordinated rehabilitation programs either within the building, or alternatively in another UF-Shands location in the city or within the state.

 

The CMDNR provides both the finest possible coordinated interdisciplinary care for patients, but also by providing each patient with an opportunity to become part of the Institutional Review Board approved research protocol titled quantitative measures in movement disorders. Patients have the option to sign an informed consent and to allow data from all visits to be collected, stored, de-identified, and made available for researchers in the field. This database has over 9000 patients and is one of the largest prospective PD and movement disorders databases in the world. The data for recruitment and also for study related purposes is fully available for our investigators. The center is also home to a NIH T32 pre-doctoral (PhD) training program in Movement Disorders.