Department of Neurology
Neurology concerns itself with the diseases of the brain, spinal cord, peripheral nerves and muscles. An introduction to the anatomy and physiology of the nervous system is presented in the first-year neuroscience course by faculty from the Department of Neuroscience, with participation of faculty from the Department of Neurology. A first-year selective titled Clinical Correlations in Neurosciences (FYSelect 5017) is available, which is an opportunity for interested students to shadow physicians in neuro-related fields and to attend basic science or clinical conferences. During the second year, the Department of Neurology presents the course Diseases of the Nervous System (Neurol 632) in conjunction with the departments of Pathology & Immunology, Neurosurgery and Ophthalmology & Visual Sciences. The course emphasizes the pathophysiology, pathology, clinical manifestations and treatment of the major neurological and neurosurgical diseases. The department also participates in the Practice of Medicine course, providing lectures, demonstrations and teaching exercises with patients in neurological physical diagnosis.
For more information about the Department of Neurology and its 13 divisions, please visit the department website.
Neurology Research Electives
During the fourth year, opportunities exist for many varieties of advanced clinical or research experiences.
Beau Ances, MD
Taylor Avenue Building Extension, 2nd Floor
Neuroimaging of neurodegenerative disorders. Students can work in a neuroimaging laboratory that is focused on the translational discovery of neuroimaging biomarkers for neurodegenerative diseases. The laboratory focuses on the pathogenesis of Alzheimer's disease and HIV-associated neurocognitive disorders. We are investigating the effects of neurodegenerative diseases on the brain network level using functional (blood oxygen level dependent imaging, arterial spin labeling), structural (volumetrics, diffusion tensor imaging), and metabolic (PET amyloid and tau) methods. Multiple projects that involve bioengineering, neuroimaging and infectious disease are available, depending on the interest of the student.
Randall Bateman, MD
Biotechnology Center, Room 304
Central nervous system protein metabolism in aging and dementia. This research elective will expose the student to translational research in the study of Alzheimer's disease and other neurodegenerative diseases. The student will participate in multiple areas of the research, including participant recruitment, consent, enrollment and admission to a research hospital unit. Lumbar puncture for cerebrospinal fluid sample collection, blood collection and intravenous labeling methods will be demonstrated and taught. The student will participate in sample analysis, including processing for mass spectrometry quantitation, enzyme-linked immunosorbent assay and Western gel methods. Quantitation, analysis and modeling of the data will be taught in the context of data interpretation and study design.
Anne H. Cross, MD, and Laura Piccio, MD, PhD
McMillan, 3rd Floor
Phone: 314-747-4591 or 314-747-0405
Understanding interactions of the immune system with the central nervous system as it relates to multiple sclerosis and other neuroimmunological disorders. Our goal is to understand how immune cells cross the blood-brain barrier and initiate the cascade of events that leads to the lesions of multiple sclerosis. We are also funded to study the effects of diet and adipokines on neuroinflammation. Depending on the time commitment of the student and their individual interests and goals, they will either assist with ongoing projects or be given a laboratory project on which to work. Projects may involve animal models of multiple sclerosis, cell culture or studies of human samples (cerebrospinal fluid, blood or autopsied specimens). Interested students should contact Dr. Cross or Dr. Piccio several weeks in advance before signing up for this research to allow for sufficient planning.
Robert T. Naismith, MD
McMillan, Room 310B
Clinical imaging research in multiple sclerosis. The student will learn about neuroimaging, imaging analyses, data collection, data management and clinical study endpoints in multiple sclerosis. They will observe patient participants undergoing a detailed evaluation of disability measures, such as ambulation, symptom scales, cognition, vision, upper extremity function, and so on. They will witness the entire process of image acquisition, processing, analysis and data extraction. They will have the opportunity to interact with many people who are vital to the research, including research coordinators, imaging technologists, imaging physicists/chemists and specialized research clinicians (i.e., neurocognitive and physical therapy research specialists).
The student will assist with hands-on clinical investigative research. They will gain an excellent appreciation of multiple sclerosis, from its pathophysiology within the central nervous system to how it affects the neurological function of individuals. Through detailed and quantitative imaging analysis, the student will become very adept at analyzing brain MRI scans. They will mark and track lesions to determine their effects on clinical function and learn to identify normal-appearing white matter, cortex and gray-matter structures. They will become familiar with Amira Imaging Analysis Software, SPSS Statistical Analysis Software, SIENA Volume Analysis Software and Matlab Imaging Analysis Software.
Steven E. Petersen, PhD
East Building, Room 2108
This lab is interested in brain organization and function, particularly for language, attention and memory. Our main approach to these issues is through functional MRI and large-scale network analysis.
Joel S. Perlmutter, MD
East Building, 2nd Floor
Pathophysiology of movement disorders. The lab is primarily interested in the etiology, pathophysiology and treatment of basal ganglia disorders. We have several studies of Parkinson disease (PD). We investigate mechanisms of action of deep brain stimulation, which is a dramatic new treatment. These studies combine PET, cognitive testing and quantified measures of movement. We also test new drugs that might rescue injured nigrostriatal neurons (a model of PD). For these, we use PET to measure dopamine pathways and also to quantify motor behavior. We also have an active program developing and validating neuroimaging biomarkers for PD and for determining the integrity of the nigrostriatal pathway that includes studies in human and animal models of PD. We have an active program that combines a variety of approaches to developing biomarkers and investigating the pathophysiology of dementia associated with PD. We use PET to measure radioligand binding and sensorimotor processing in dystonia. We developed a new animal model of dystonia to investigate pharmacologic and physiologic changes. We use PET to investigate drug-mediated pathways in the brain and to parse out the effects of selective dopaminergic agonists. We are also working to develop MR-based methods including diffusion tensor imaging and resting-state functional connectivity to investigate the brain mechanisms underlying PD and dystonia.
Brad A. Racette, MD
McMillan, 9th Floor
Our lab is primarily interested in environmental risk factors associated with Parkinson's disease. We use a variety of techniques to study these risk factors, including traditional field epidemiology, in which we evaluate workers exposed to metals in the United States and residents living near a smelter in South Africa; neuroimaging, in which we study the pathophysiology of toxin-mediated parkinsonism; geographic information systems research, in which we associate environmental toxin exposures with the incidence and prevalence of Parkinson's disease in the United States and Finland; and neuropathologic studies, in which we evaluate manganese-exposed workers from South Africa. There are numerous opportunities available for students to be involved with any of these projects. Students will receive some clinical exposure as well to familiarize them with pertinent clinical syndromes.
Marcus E. Raichle, MD
East Building, 2nd Floor
This lab investigates in vivo brain hemodynamic, metabolic and functional studies of human cognition and emotion using cyclotron-produced isotopes and PET as well as fMRI in humans. Refer also to the listing on this page for Steven E. Petersen, PhD.
Gregory Wu, MD, PhD
McMillan, 3rd Floor
Understanding how immune responses are generated that target the central nervous system. Specifically, this lab studies antigen-presenting cell contributions to autoimmune animal models of multiple sclerosis. Our goal is to understand what cellular interactions are critical to the development of immune-mediated demyelination.
Visit online course listings to view offerings for M35 Neurol.
M35 Neurol 632 Diseases of the Nervous System
The goal of this course is to provide an introduction to the diseases of the central and peripheral nervous systems, including their clinical manifestations, pathology, pathophysiology and pharmacotherapy. The course includes reading assignments, lectures, laboratories, team activities, and clinical presentations.
Credit 53 units.
M35 Neurol 720 Neurology Clerkship
During the four week Neurology clerkship, students will gain proficiency in understanding diseases of the nervous system, the neurologic work-up, localization and differential diagnosis generation, and devising a treatment plan. A variety of settings are available, which could include adults or pediatric services, with both inpatient and outpatient experiences. Students will provide care for patients with neurologic problems under the supervision of residents, fellows, and attendings.
Credit 154 units.
M35 Neurol 730 Physical Medicine and Rehabilitation Clerkship
Clerkship in PM & R for 3-rd year medical students provides an opportunity to gain basic knowledge and clinical skills in evaluation and management of wide range of neurological and musculoskeletal diseases and conditions that require specialized rehabilitative medical and therapeutic care. Students spend time on Spinal Cord Injury Unit (SCI) and time on Brain Injury (BI) & Stroke Unit at The Rehabilitation Institute of St. Louis. Students are expected to be a part of the rehabilitation team, follow 2 to 3 patients, participate in daily morning rounds, participate in performing consults, attend team meetings and family conferences. Students are required to attend several outpatient clinics such as SCI, BI, Amputee and Stroke. During the entire rotation, students work together with PM&R residents and fellows, and under direct guidance of the NeuroRehabilitation faculty. The usual duty hours are 7-7:30AM to 5PM during weekdays, and 8AM -12NN on Saturdays. There is no night call. Students are required to attend all PM&R curriculum lectures and conferences. On the first day of rotation, students meet with the PM&R program director to go over goals, objectives and schedules. Upon completion of the rotation students are required to fill out the evaluation form to provide feedback regarding rotation experience.
Credit 77 units.
M35 Neurol 827 Neurology Subinternship for WUSM Students
This four-week elective will be customized to include inpatient and outpatient experiences desired by WUSM students who have completed the WUSM Neurology Clerkship. Students may choose this elective to further improve their neurology knowledge and skills. Students considering neurology as a career may also desire additional exposure to supplement their prior clerkship experience. The elective is split into two two-week rotations, which may include the following: (1) Adult Inpatient General Service (with one clinic/week); (2) Adult Inpatient Stroke Service (with one clinic/week); (3) Adult Inpatient Consult Service (with one clinic/week); (4) Pediatric Neurology Consult Service (with one clinic/week); (5) Adult Neurology ICU (with one clinic/week); and (6) Outpatient Clinics (with eight to 10 clinics/week).
M35 Neurol 827A Special Elective in Adult Inpatient Clinical Neurology
Special Elective in Adult Inpatient Clinical Neurology
M35 Neurol 828 Neurology Subinternship for Visiting Medical Students
This four-week elective for fourth-year visiting students from a US medical school provides the option (space permitting) of four weeks of Adult Inpatient Service (Stroke for 2 weeks, General Neurology for 2 weeks), or two weeks on an Adult Inpatient Service and two weeks on the Adult Consult Service. Students on the inpatient service will function as a subintern under the supervision of their junior resident, chief resident, and attending physician. The student will also attend weekly clinical conferences and a weekly outpatient clinic experience. This elective is suitable for visiting fourth-year students interested in Neurology, who wish to improve their Neurology knowledge and skills.
M35 Neurol 830 Neuro-Oncology
This elective provides an outpatient-oriented pediatric and adult neuro-oncology experience for fourth-year medical students. Students will: - attend multidisciplinary adult and pediatric neuro-oncology clinics and case conferences (tumor boards), - attend adult and pediatric radiation oncology clinics, - attend neuropathology brain tumor review, - participate in subspecialty brain tumor clinics, and - attend monthly brain tumor research conferences.
M35 Neurol 851 Clinical Aspects of Aging and Dementia
This elective provides the opportunity to learn about clinical research and clinical care in healthy brain aging and dementia. Students are encouraged to contact the Course Directors (Dr. B. Joy Snider and/or Dr. John Morris) before the elective begins to discuss their interests, as this elective is customized based on student interests. This can be a two-week or four-week elective. Students can gain proficiency in interviewing techniques and in the neurologic examination of the geriatric patient, and are introduced to neuropsychology, neuropathology, biomarkers, neuroimaging, genetics, and other biomedical procedures important in the diagnostic evaluation of older adults. The Knight ADRC is an interdisciplinary group, so students have the opportunity to interact with physicians, nurse clinicians, psychologists, and social workers, and to explore the neuropsychology, neuropathology, biomarkers, neuroimaging, genetics, and other biomedical procedures used in the diagnosis of dementing disorders such as Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementias, cerebrovascular disorders, and affective disorders.
M35 Neurol 859 Neonatal Neurology
The Neonatal Neurology elective will consist of a combination of inpatient and outpatient experiences designed to provide medical students with comprehensive exposure to the field. Through the rotation, students will actively participate in all aspects of patient care, acquiring the knowledge and skill necessary to effectively evaluate infants with neurological disorders, including encephalopathy, stroke, seizures, hypotonia, intraventricular hemorrhage, and periventricular leukomalacia, among others. Clinical activities will be tailored to fit the interests and goals of the individual student and include a combination of inpatient and outpatient exposures. Inpatient activities will occur in the St. Louis Children's Hospital Neonatal Intensive Unit as part of the Neonatal Neurology Consultation service. Outpatient activities will occur in the St. Louis Children's Hospital Outpatient Clinics. Students will also attend educational conferences specific to the field during the rotation, including Neonatal Neurology Clinical Conference and Neonatal Neuroradiology Conference.
M35 Neurol 860 Pediatric Neurology
The senior elective experience in child neurology is designed to adapt to the individual goals and objectives of students. The elective takes place in one or two 2-week blocks that occur among five possible venues as chosen by the student: 1. Outpatient clinics, 2. Inpatient ward service, 3. Inpatient general consult service, 4. NICU consult service, and 5. Video EEG (VEEG) monitoring service. The combination of services and experiences will be arranged directly between the student and the Course Director prior to beginning the rotation. In the outpatient clinics, students will rotate between a variety of subspecialty clinics and work with a variety of attendings in order to experience the breadth of outpatient pediatric neurology. Students rotating on the inpatient ward service will have a different role than the third-year student on pediatrics. The fourth-year student will focus solely on neurology patients and work closely with the pediatric neurology resident to develop neurology-specific care plans. No call or weekend duties will be expected on this rotation. On the general consult services, students will work with the consult attending and pediatric neurology residents on that team to see consults in the PICU, CICU, ER, and other hospital floors. The NICU consult team focuses on infants in the NICU. Student rotating on the VEEG monitoring service will focus on learning the indications and uses of VEEG and basic EEG reading skills
M35 Neurol 861 Neurointensive Care Unit
The student will be integrated into the Critical Care Team that provides care in the Neurology/Neurosurgery ICU. Diseases frequently encountered include intracerebral hemorrhage, head trauma, subarachnoid hemorrhage, stroke, spinal cord disease, and neuromuscular disease.. The student will follow patients, participate in rounds and pay participate in some procedures under supervision. Didactic sessions will be provided as conferences or lectures from the ICU attending and fellow.
M35 Neurol 865 Adult and Pediatric Epilepsy
Students will learn how epileptologists diagnose and manage epilepsy in adults and children. They will learn how to use the history and physical exam and laboratory studies such as EEG, MRI, PET, and SPECT to diagnose and manage patients with new onset epilepsy, established epilepsy, and medically intractable epilepsy. They will become familiar with the medical management of epilepsy as well as the treatment options for medically intractable epilepsy including surgery, the vagus nerve stimulator, and the ketogenic diet. They will also learn how to manage the co-morbid conditions that accompany epilepsy such as depression, behavioral problems, cognitive impairment, sleep disturbance, and non-epileptic events. Students will accomplish these goals by attending epilepsy clinics and rounding on the inpatient epilepsy service with the epilepsy team at Barnes-Jewish Hospital and St. Louis Children's Hospital. They will attend the Adult Epilepsy Conference, the Pediatric Epilepsy Conference, and Neurology Grand Rounds. Students will also have the opportunity to observe epilepsy surgery if they wish. They will have the option to present one 15-30 minute talk on a topic relevant to epilepsy.
M35 Neurol 872 MS Center/Outpatient - Missouri Baptist
Students will develop their skills in taking histories and performing neurological examinations on patients with multiple sclerosis under direct supervision of multiple sclerosis specialists. Localization of neurological findings and symptoms to the neuro-axis will be emphasized. A major goal for the students will to increase the understanding of comprehensive patient management including disease treatment, symptom management, adjunctive therapy services, and psychosocial issues. The outpatient rotation will be four weeks at The MS Center for Innovations in Care at Missouri Baptist Medical Center with Dr. Barry Singer and Dr. Mark Tullman. An additional goal for students will be to understand process of clinical research and translation into approved therapies. The center has been a leader in clinical trial development of therapeutics that have been or will soon be FDA-approved as new medications for multiple sclerosis.
M35 Neurol 900 Research Elective - Neurology
Research opportunities may be available. If interested, please contact the Department of Neurology.