Bruce McGrath Impact Report 2021

With Gratitude to Bruce McGrath

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I M PA C T

R E P O R T

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Mr. McGrath, On behalf of the CU Department of Neurology and the Movement Disorders and Neurology Supportive and Palliative Care Divisions, thank you for your many years of investments in a shared vision for improving the lives of those living with Parkinson’s disease (PD) and other movement disorders.

Your incredible generosity, starting with your initial gift in 2016, has helped us build the CU Movement Disorders and the Neurology Supportive and Palliative Care Programs into the leading enterprises that they are today. Philanthropy is key to ensuring these programs attract the highest caliber of physicians and fellows in the country, and provides them the resources to improve patient care and identify preventions and new treatments.

We are grateful for your generous investments in the Movement Disorders Program. Thank you!

Sincerely,

Kenneth L. Tyler, MD Chair, CU Department of Neurology Louise Baum Endowed Professor and Chair 2

L to R: Benzi Kluger, MD, MS, FAAN, Christina Vaughan, MD, Julie Berk, PA

Your Support of the Neurology Supportive and Palliative Care Program

OUR PROUD HISTORY In 2013, Benzi Kluger, MD, MS, FAAN, founded the specialized neurology clinic

With your generous support of our fellowship program, we are training physicians and growing this new and expanding field of neurology supportive and palliative care. We are proud to share some accomplishments with you. Our training program is recognized globally as the first of its kind, and nationally as our country’s flagship neurology supportive and palliative care fellowship. We now have our first-ever child-focused neurologist and three palliative fellowshiptrained neurologists as faculty. Other fellowship recipients who care for adults and children are completing their training, creating synergies within the Neurology Supportive and Palliative Care Program to address care across the lifespan. Your investments in fellowships have contributed greatly to growing the program. We invite you to learn about the fellows you have supported on the following pages.

in the CU Department of Neurology.

Three years later in 2016, the Neurology Supportive and Palliative Care section was formed within the Department. Julie Berk, PA, was hired to support patients, and Christina Vaughan, MD, was added in 2017 as care provider for the section.

Dr. Vaughan also holds an appointment at the U.S. Department of Veterans Affairs and cares for patients at the Veterans Affairs Hospital. Our supportive staff now includes nurses, social workers, and a chaplain. We have a clinical location at the CU Anschutz Medical Campus and our physicians spend one day a week devoted to a site in Boulder. The CU Department of Neurology has a strong clinical and basic science research component, consistently ranking in the top 30 Departments nationally in NIH research support.

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When I think about how I might do the

PROFILE

greatest good within medicine, I always

Summer Scultz, MD

come back to thinking about how I can help people reflect on and enrich their

Neurology Supportive and Palliative Care Fellow

story. This year, I lost a mentor and guiding force in my life, a man who had practiced pediatric infectious diseases for 50 years. He was known for taking on cases that others might shy away from due to their emotional heaviness and chronicity of suffering. He encouraged me to see both the grief and gratitude in everything. He also expressed his belief that the greatest source of suffering for an individual was often rooted in their thinking. I am grateful that there are fields within medicine where the person’s story is the priority, and there is space and time to address the many ways that a person might be suffering. Through training in hospice and palliative medicine, I hope to walk with my patients on their journey with, as my mentor would say, ‘a handful of grief and a handful of gratitude.’

— Summer Scultz, MD

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Dr. Scultz has a varied professional background including dance, counseling, and physical medicine and rehabilitation.

As a Neurology Supportive and Palliative Care Fellow, she helps position patients to write their next chapter, focusing on what is most important and meaningful in their lives. Dr. Scultz appreciates the opportunity to discover patients’ stories and understand the ways in which their roles and sense of purpose have changed due to their illness. She is particularly interested in providing palliative care to young adults with chronic life-limiting neurologic diseases who are in the process of transitioning to adult neurology. Shifting from pediatric to adult care can be very challenging for these patients. As a new member of the team, Dr. Scultz is excited to learn and grow as a clinician.

PROFILE

I am extremely grateful for the support

Lauren Treat, MD

that you have shown in helping to build

Assistant Professor of Pediatrics, CU Department of Pediatrics

neuropalliative care as an essential part of modern neurology practice.

Your ongoing commitment enables us to train physicians to meaningfully

Your generous support enabled Dr. Treat to pursue and complete her Neurology Supportive and Palliative Care Fellowship. This training provided her with important clinical experience, granted her eligibility to sit for palliative medicine boards, and connected her with a network of incredible palliative care physicians and neurologists. Your investments funded these valuable opportunities, which are the foundation upon which Dr. Treat’s current work is built.

speak with patients who suffer from neurological diseases about the human element of their experience, and to provide support where possible.

— Lauren Treat, MD

Dr. Treat is now a junior faculty member at Children’s Hospital Colorado (CHC). She opened the first pediatric neuropalliative care clinic at CHC in January 2020. Despite the challenges of the COVID-19 pandemic, this new offering has demonstrated tremendous growth. For Dr. Treat, her proudest accomplishments over the last year have been the initiation of the clinic and the support that it has provided to families. In her clinic, Dr. Treat sees children and young adults with a range of neurological conditions. She speaks with their families about how to consider quality of life in the context of serious medical illness. In addition, she has been an invited speaker to several venues including the Neurocritical Care Society Meeting, a visiting professorship at Johns Hopkins School of Medicine and several family foundations’ events.

She was also able to attain her board certification this year in hospice and palliative medicine.

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Your Support of the CU Movement Disorders Center Our campus hosts the largest and most comprehensive movement disorders center in the Rocky Mountain Region. Our team of specialized physicians and clinicians offer the highest quality, multi-disciplinary care, which gives patients with Parkinson’s disease (PD) the ability to live their best life. Our team is also pushing the boundaries of science and technology to create better diagnostic tools, improve quality of life, and develop therapies that may halt or slow disease progression, or prevent it altogether.

In 2019, the CU Movement Disorders Center was named a Parkinson’s Foundation Center of Excellence. This means we are a medical center with a specialized team of neurologists, movement disorder specialists, rehab professionals, mental health professionals and others with deep expertise in the latest PD medications, therapies and research. The Parkinson’s Foundation Center of Excellence network is now comprised of 48 leading medical centers around the world, with 34 based in the U.S. Your support helps us build on our success and lay the foundation to transform more lives. Through research innovations and educational programs, we will continue to set the standards for the highest-level care for those living with movement disorders now and in the future. Specifically, your investments in pilot grants, fellows, and research by our core movement disorders center faculty is already showing impressive dividends.

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Your Investments in Research at the CU Movement Disorders Center At the CU Movement Disorders Center, our core faculty members are our senior clinicians and researchers with years of experience in research and clinical care. These faculty consistently advance complex research projects that have developed through these leaders’ long-standing expertise. Your support for our core faculty members’ research augments grant funding for their projects, allowing further research and innovation. These resources can also provide bridge funding to move early research along, enabling researchers to apply for additional grant funding. Your investments ultimately help us develop new and better diagnostics and therapies and elevate the CU Movement Disorders Program’s level of excellence and national influence. Thanks to your support, Drs. Berman, Buard and Holden are making great strides in bringing their research closer to application in the clinic.

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Application of Transcranial Alternating Current Stimulation for Modulation of Sleep and Cognitive Performance in Patients with Parkinson’s Disease Principal Investigator BRIAN BERMAN, MD, MS

Co-Investigator SAMANTHA HOLDEN, MD

Co-Investigator BRICE MCCONNELL, MD

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Thank you for your support for Brian Berman, MD, MS, whose research into novel treatments for PD has continued under the leadership of Samantha Holden, MD. We are proud to see this research in her hands and are confident that she will carry forward the work in collaboration with Dr. Berman.

The goal of Dr. Berman’s research was to begin to explore the relationships between the quality of slow wave sleep, inflammation, and cognition in people with PD. Previous studies in people with Alzheimer’s disease shows that shorter duration and less organization of slow wave sleep is associated with poor cognition. However, the direction of the relationship between poor sleep and cognition is unclear. For example, people may not sleep well because they are already experiencing brain changes related to Alzheimer’s disease, or poor sleep could be contributing to the brain changes.

Sleep problems are very common in people with PD, as are cognitive changes. Dr. Holden and her team plan to enroll 15-20 individuals with PD that are experiencing these concerns in an overnight sleep study. They will undergo cognitive testing, blood work and MRI. The pilot data generated will help Dr. Holden develop a hypothesis regarding the connections between sleep, inflammation, and cognition in PD. The work that is being conducted will lead to the second aim of this research, which will be to perform a study to assess whether enhancement of slow wave activity with overnight transcranial alternating current stimulation can improve memory consolidation in PD patients. It will also lead to future grant applications to advance this research, partnering with Dr. Berman’s group at Virginia Commonwealth University.

Prior to clinical research shutting down on campus late last year, one patient completed all study procedures. The inpatient Clinical and Translational Research Centers unit, where the sleep studies are performed, has been closed because the space has been needed for overflow patients during the COVID-19 surge. An additional three participants were scheduled prior to this shutdown and will be rescheduled once the unit is reopened. We are co-recruiting from another one of Dr. Holden’s studies, following people with PD to evaluate how and when functional abilities relate to cognition change.

AN UPDATE FROM BRIAN BERMAN, MD, MS Your support enabled the creation of the study protocol and attainment of Institutional Review Board (IRB) approval.

The funds also helped to purchase the necessary equipment and establish procedures to carry out the research.

In addition, I received a clinical research award from the Parkinson’s Foundation to conduct a complementary study at Virginia Commonwealth University. This means we will have the ability to increase the study’s overall participation numbers and impact by combining data obtained at two sites.

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Exploring the potential of Neurologic Music Therapy (NMT) to Improve Fine Motor Skills in Parkinson’s Disease Patients

ISABELLE BUARD, PHD Assistant Research Professor Research Director, Transcranial Magnetic Stimulation Lab Director, CU Movement Disorders Center Research Program CU Department of Neurology

I am incredibly thankful for the resources you have provided me through salary support. The funding made it possible to bring my line of research up to speed, as well as apply for and obtain competitive grants. I am motivated by your support and the great potential my research holds for new treatments for PD and other movement disorders.

— Isabelle Buard, PhD

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Your support has been instrumental in developing Dr. Buard’s research and driving her career trajectory, as well as resulting in a major return on your investment. Dr. Buard began her work on the potential of Neurologic Music Therapy (NMT) for those living with Parkinson’s through a CU Movement Disorders pilot grant. Shortly after, you provided follow-on funding to push the research even further. Your support allowed Dr. Buard to gather preliminary data, which led to her work receiving an NIH award to conduct a randomized controlled trial comparing Neurologic Music Therapy (NMT) and Music Supported Therapy for enhancing fine motor skills in PD. Thereafter she obtained a Michael J. Fox Foundation grant to help support the work, and then a prestigious K Award from NIH, reserved for promising research by rising young scientists. Your additional investment is ensuring Dr. Buard’s results are as powerful as possible, by adding a comparison of occupational therapy to neurologic music therapy to her K Award grant.

Overall, your investments have helped to develop a thorough and impactful clinical research program as well as fostered related ones. Your funding has propelled Dr. Buard and her research to be recognized among a large variety of people, including movement disorders clinicians, therapists and researchers. This notoriety helps to strengthen the CU Movement Disorder Center’s reputation for pursuing patient and caregiver-centered research. With your support, you have also helped Dr. Buard collect neuroimaging data related to standard of care interventions in the PD population, and to raise awareness and offer alternative options related to weaknesses in current clinical interventions for patients with PD.

The following key initiatives have also been made possible because of your support:

NMT training at the Fulginiti Pavilion in February 2020

• Dr. Buard hosted a NMT training on campus, which led us to expand her team, as well as to promote awareness of the use and benefits of music-related therapies for neurologic disorders.

• Her team trained on virtual NMT intervention protocols to keep enrolling and working with patients while being confined at home during the pandemic.

• Her team is developing a new NMT research project for PD-related cognitive decline and have sought additional funding for this project. Their application received excellent feedback but was not selected for funding.

A cohort of NMT trainees

• Her team created and implemented a standardized OT protocol for their clinical comparator group for the PD clinical trial. They now have three locations throughout Colorado that are working with them.

• Her team has enrolled almost 30 participants in the PD randomized controlled trial in the past couple years and are now on track for completion within their expected time frame.

Your appreciation plaque 11

Your Support for the CU Movement Disorders Center Pilot Grant Program An important goal of the CU Movement Disorders Center’s Pilot Grant Program is to attract early-career researchers with innovative ideas to movement disorders research, and to help them lay the groundwork for life-long careers dedicated to improving the lives of movement disorders patients. Pilot grants of around $10,000 are essential to initial idea testing, where NIH and large foundation grants are scarce. The pilot grants allow researchers to gather enough foundational data to more successfully compete for major private foundation and National Institutes of Health (NIH) Grants. For clinician-researchers who are in training, the program offers them experience with managing clinical, academic and research careers.

The CU Movement Disorders Center pilot program has grown immensely over the past five years, thanks to your support. Throughout the life of the program, we have awarded over $110,000 in seed funding to ten scientists. The pool of applicants has also become more competitive, has increased considerably, and comes from a wide range of disciplines that overlap with movement disorders. In this report, we would like to share some of our most notable pilot projects, led by Tara Carlisle, MD, PhD, and Alex Baumgartner, MD. Your investments are launching the careers of exceptional young scientists by allowing them to explore new ideas and directions in research. Their discoveries will inform tomorrow’s treatments for those living with PD and other movement disorders.

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Development and Validation of a Clinical Predictor Tool for Cognitive Decline in Parkinson’s Disease The goal of Dr. Carlisle’s study is to develop a predictive tool: PD Risk Estimator for Decline In Cognition Tool (PREDICT). This technology is based on clinical history and assessment focusing on modifiable risk factors specifically for PD-associated cognitive decline. Cognitive changes are exceedingly common in patients with PD. These cognitive changes are present early with 10-20% of patients with newly diagnosed PD presenting with cognitive impairment, and nearly 80% of patients with PD developing dementia when followed longitudinally.

Principal Investigator TARA CARLISLE, MD, PHD Neurobehavioral Fellow

There is an enormous personal and financial burden of cognitive decline for patients, their families, and communities. Given this, there is an urgent need to identify those at risk early to maximize the potential for modification and prevention. The worldwide prevalence of PD is increasing, which underscores the importance of being able to identify patients reliably with PD at risk of developing cognitive decline.

Currently. Dr. Carlisle is organizing preliminary data from the international Parkinson’s Progression Markers Initiative (PPMI) longitudinal study and collaborating with a professional statistician on the tool design. She is also drafting study protocols to seek approvals for formal launch of the project.

The predictive tool proposed for Dr. Carlisle’s study has the potential to significantly improve PD care. Using PREDICT, physicians could provide individual patients a more accurate prognosis regarding cognitive decline rather than offering a range of risk developed from population studies. Individualized care could be determined based on personal risk and the presence of modifiable risk factors.

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Sleep Assessed by Actigraphy and Direct Recordings of the Subthalamic Nucleus in Parkinson’s Disease

ALEXANDER BAUMGARTNER, MD Movement Disorders Fellow

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Dr. Baumgartner’s study aims to obtain a more robust understanding of sleep in patients with PD who have undergone placement of a deep brain stimulator (DBS). His team knows that sleep disturbances are very common in these patients, but how these relate to DBS is unclear. The team will use one of the most advanced technologies in DBS, the Medtronic Percept device, which records electrical activity from the brain region where the device is located. By combining this with data from other wearable monitors, Dr. Baumgartner’s team hopes to gain new insights into the nature of sleep and sleep disturbances in patients with PD. With these insights, they may be able to develop therapies to improve those disturbances.

Movement Disorders Center Fellowship Program

2003

Training began

2008

MDC fellowship program established

The Movement Disorders Center Fellowship Program at CU Anschutz aims to develop highly trained specialists to become the next generation of leaders in Parkinson’s research and clinical care. Across the US, there is a significant lack of general neurologists, and specialized neurologists, like those specializing in movement disorders, are even fewer. With fellowships, we can draw physicians to this specialty and provide them excellent training. Therefore, patients will have access to the care they need, and that improves their experience living with and managing their condition. By graduation, the MDC fellows are experts in managing Parkinson’s disease, Huntington’s disease, dystonia, ataxia, and all other movement disorders across the stages of illness. MDC Fellows also serve as an important bridge between scientific advances in the lab and positive patient outcomes in the care setting, where they can improve lives.

The MDC has graduated:

Your philanthropic support allows us to fully fund the fellowship program, and to attract some of the best neurology residency graduates to train with us. Your support also help to further our fellows’ education by funding their travel to important conferences or by providing additional educational materials. By investing in the Movement Disorders Fellowship Program at CU Anschutz, you help increase the number of future neurologists dedicated to practicing in Colorado and the Rocky Mountain region, as our history shows that if we can attract the brightest minds, they most often stay. In the following profiles, you’ll see the caliber of fellows we have attracted, both of whom we have retained as faculty following their fellowships.

2021

17 FELLOWS 9 ACADEMIC CAREERS PRACTICE WITH 3 PRIVATE ACTIVE RESEARCH PRACTICE IN 5 PRIVATE UNDERSERVED AREAS

The MDC is currently training:

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FELLOWS FIRST-YEAR FELLOWS SECOND-YEAR FELLOW

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PROFILES Now that I am a faculty member, I have

Trevor Hawkins, MD

continued to see the perpetual benefits

Assistant Professor Neurology, CU Movement Disorders Center

provided by our generous benefactors in launching the careers of many excellent movement disorders neurologists. I am thankful of the support, as without it I would not be the neurologist I am today.

- Trevor Hawkins, MD

My years in fellowship were transformative

Dr. Hawkins completed his training at the University of Colorado and welcomed the opportunity to continue his career with the excellent faculty here at the CU Movement Disorders Center. He believes fellowship support is not only important but necessary to help train the next generation of movement disorder experts. Dr. Hawkins’ fellowship personally allowed him to obtain pilot grants that were instrumental to launching his academic career. He is proud to be affiliated with such a comprehensive movement disorders program that reflects the breadth and depth of the campus’s expertise in providing care to the PD community.

as a clinician and a person. I had the opportunity to learn how to properly exam and diagnose patients and provide superior treatment. I learned about the importance of clinical trials and the determination required to produce investigator-initiated research. I am incredibly thankful to have had this opportunity and am compelled to pass on my expertise to future fellows and optimize their experiences in this program.

- Jeanne S. Feuerstein, MD

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Jeanne S. Feuerstein, MD Assistant Professor of Neurology, CU Movement Disorders Center During her fellowship, Dr. Feuerstein enjoyed learning how to take care of a variety of movement disorders from a group of unique clinicians. She appreciated having the opportunity to incorporate their practices into hers, as each clinician examines, describes, and treats patients differently. With varying subspecialties focused on research, teaching, education and clinical practice, these clinicians enabled Dr. Feuerstein’s own decision-making regarding the trajectory of her career. She is grateful for benefactors like you, whose investments allow fellows the time and support to learn how to care for patients, ask key questions and engage in meaningful research. The tools that fellows like Dr. Feuerstein learn in their fellowships give them support in their future career.

A Message from the Movement Disorders Center Director Dear Bruce, Thank you for your generous support of the CU Movement Disorders Program. Your philanthropic investments have contributed greatly to our core faculty research projects, pilot grant program and fellowship program. Philanthropic support for these areas is critical to the success of the CU Movement Disorders Center and our ability to deliver on our vision. With your help, we can provide the most cutting-edge care today while transforming care of tomorrow through research and education.

Your investments have supported us with the resources needed to help keep our program’s competitive edge. Notably, your investment helped us attain a Parkinson Foundation Center of Excellence designation. I want to extend my gratitude for having confidence in my work as the director of the MDC and the fellowship program. Your support allows me to run and grow the kind of center I envision, which will change the future of care for those with Parkinson’s disease and other movement disorders.

I cannot say thank you enough for your support.

Sincerely,

Lauren Seeberger, MD Professor, Department of Neurology Director, CU Movement Disorders Center Director, CU Movement Disorders Center Fellowship program

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Mr. McGrath, On behalf of the CU School of Medicine, thank you for your generous philanthropic investments in the CU Department of Neurology and the Movement Disorders and Neurology Supportive and Palliative Care Programs. Your support is helping us redefine the future of care for Parkinson’s disease and other movement disorders while developing and training the workforce to deliver it.

We sincerely appreciate your contributions to this vital work. Your investment helps keep our skilled physician-scientists and fellows at the leading edge of innovation and bolsters our mission of developing improved knowledge and delivering high-quality patient care.

With your support, we continue to deepen our understanding of Parkinson’s disease and other movement disorders. I am honored by your generosity and humbled that countless dedicated faculty and patients will benefit from our partnership.

Thank you for the work you make possible here every day. We look forward to all that we will accomplish together.

Thank you,

John J. Reilly, Jr., MD Dean, CU School of Medicine Vice Chancellor for Health Affairs Richard D. Krugman Endowed Chair

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