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Department of Neurology

Multiple Sclerosis Program

History

The Multiple Sclerosis Program at the University of Pennsylvania was established in 1980 to provide specialty services for individuals who were burdened with what was, at that time, an untreatable disease.  Since then, Penn's MS Program has trained many of the leading MS clinicians and researchers throughout the country and the Program’s current faculty have been involved in producing some of the most important findings in the MS field during the past two decades.  For example:

  • Penn clinicians and radiologists first demonstrated that the use of Gadolinium contrast agents could differentiate active demyelinating lesions from chronic ones, establishing MRI as a modern methodology used to measure disease activity;
  • Clinicians in the MS Program have provided important contributions to the development of immunomodulatory therapies for MS by participating in landmark treatment trials;
  • Researchers at Penn are leading international efforts to validate measures of visual function to be used in MS clinical trials, and have established the visual profile of MS as including sub-clinical dysfunction not detectable by conventional visual acuity testing.

Current Research

  • Validation of visual outcome measures for MS trials using new techniques that assess retinal nerve fiber layer thickness as a marker for axonal loss;
  • Assessment of multimodal MRI, diffusion-tensor imaging, and other modalities as measures of MS disease location and activity within the brain and spinal cord;
  • Participation in international, multi-center clinical trials to determine the efficacy of current and novel immunomodulatory therapies for patients with first demyelinating events (such as optic neuritis) as well as relapsing-remitting and primary progressive MS.

Program and Faculty

As a leading center for MS research, Penn is an active site of enrollment for ten international treatment trials, and supports numerous basic and clinical research projects sponsored by the National Institutes of Health and the National MS Society.  Following are profiles of our faculty and their current research interests and projects.

Steven L. Galetta, M.D.
Van Meter Professor

Dr. Galetta is Chief of the Neuro-Ophthalmology Division, and is the local Principal Investigator for several landmark clinical trials that have examined strategies and potential roles for early therapy in MS.  These studies have most recently included the Controlled High-Risk Avonex Multiple Sclerosis Prevention Study (CHAMPS), and its extension study, CHAMPIONS.  In this trial, patients with first demyelinating events were randomized to receive interferon beta-1a (Avonex) or a placebo, following a course of intravenous corticosteroids.  This trial provided important evidence in favor of early treatment at time of first demyelinating events, and also showed that early therapy slowed progression of silent disease activity on MRI.  The CombiRx-Phase III Trial is an NIH-supported multicenter that will examine the potential role for combination therapy (two or more medications) in MS patients. 

Clyde E. Markowitz, M.D.
Assistant Professor

Dr. Markowitz and Dr. Galetta (above) have led the effort to develop Penn’s Program as an internationally recognized center for MS clinical trials.  He is Chair of the Clinical Advisory Board of the Delaware Valley Chapter of the National MS Society.  In addition to his recognized clinical expertise in the diagnosis and management of MS, Dr. Markowitz is the local Principal Investigator for several national and international clinical trials of new and combination MS therapies.

In addition to clinical trials, Dr. Markowitz provides outstanding mentorship to residents and clinical fellows.  He is an important collaborator with Dr. Balcer on clinical research studies on visual function and quality of life, and has ongoing collaborations with the Penn Neuroradiology and Medical Imaging groups to examine multimodal MRI techniques for analysis of MS lesions.  Recognizing the importance of advanced technologies for the care and investigation of MS patients, Dr. Markowitz has led the effort to develop a computerized patient care and research database. 

Dina A. Jacobs, M.D.
Assistant Professor

Dr. Jacobs joined the Penn's MS Division as a faculty member in 2002.  Dr. Jacobs has distinguished herself within PENN Medicine, and throughout the Delaware Valley region as an expert, thoughtful, and compassionate clinician for MS patient care.  As local Principal Investigator for clinical trials, she is currently enrolling patients in a study to investigate the potential roles for periodic intravenous corticosteroids and methotrexate as adjuncts to interferon beta-1a (Avonex) in patients with breakthrough disease (recurrent relapses). 

Women’s health and the potential effects of MS on family planning represent another important research and clinical interest.  Dr. Jacobs recently served as a mentor for a Penn medical student for a project, entitled Experiences and Concerns Regarding Pregnancy and Family-Building in Patients with MS.  Results of this ongoing survey will be particularly important for assessing patient expectations with regard to MS therapy and disease. 

Amy A. Pruitt, M.D.
Associate Professor

As the Director of Medical Student Education and Academic Coordinator for the Department of Neurology, Dr. Pruitt is an educational leader within the MS Program.  She single-handedly runs and coordinates medical student education within the Department, using her expertise in clinical MS to focus on aspects of neuroimaging, diagnosis, and treatment.  She also serves as Ombudsman for the School of Medicine. 

Dr. Pruitt is the local Principal Investigator for a follow-up study to the original clinical trial that examined glatiramer acetate therapy (Copaxone) for relapsing-remitting MS. 

Donald H. Silberberg, M.D.
Professor

Dr. Silberberg served as Chair of Neurology at PENN Medicine from 1982-1994, and was Senior Associate Dean for International Programs from 1994-2004.
As an advisor to the National Institutes of Health, the World Health Organization, The World Bank, The National Security Council (The White House), the International Clinical Epidemiology Network, and the National Multiple Sclerosis Societies of the US (NMSS), Canada, and the United Kingdom, Dr. Silberberg’s expertise has extended to the global community.  He is the Editor-in-Chief of the journal Multiple Sclerosis.

 

Dennis L. Kolson, M.D., Ph.D.
Associate Professor           

Dr. Kolson has been a member of the MS Division at PENN Medicine since 1992, and has worked in the areas of MS clinical trials and the application of neuroimaging modalities to study the natural history of MS.  With colleagues within the Division of Neuroradiology at PENN Medicine he has co-authored more than 25 publications investigating the natural history of the progression of MS brain plaques and how this correlates with neurological functioning in patients.  PENN Medicine radiologists (Dr. Robert Grossman) pioneered the development and application of advanced techniques in MRI, magnetization transfer imaging (MTI – a measure of abnormality of brain tissue that appears normal by conventional MRI), and magnetic resonance spectroscopy (MRS – a technique that provides quantitative data on neuronal loss). 

Dr. Kolson has basic research interests in how HIV infection of the brain leads to degeneration of neurons (nerve cells), and how strategies to protect the brain against such virus infection might also lead to new way to protect the brain in patients with MS.

Francisco González-Scarano, M.D.
Professor and Chair

Dr. González-Scarano, formerly head of the MS Division, is Chair of the Department of Neurology.  Together with Dr. Robert Grossman, former head of the Neuroradiology Division, Dr. González-Scarano first described the use of Gadolinium-enhanced MRI to identify active plaques in MS.  Their studies defined many of the important imaging modalities for MS currently in use.

As the Principal Investigator for the Copaxone (glatiramer acetate) trial in relapsing-remitting MS, Dr. González-Scarano has made important contributions to pivotal early MS trials.  More recently, his recent work has studied the role of HHV-6 in the pathogenesis of MS.

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