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Amyotrophic Lateral Sclerosis and Neuromuscular Disease Care at the Forbes Norris MDA/ALS Research and Treatment Center

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The Forbes Norris Research and Treatment Center has developed a comprehensive program for the diagnosis, medical treatment, and management of patients with all types of nerve and muscle disorders. Physicians Robert Miller, M.D. and Jonathan Katz, M.D. treat adult and pediatric neuromuscular diseases. Their expertise range from EMG studies, myasthenia gravis to neuropathy, myopathy, and other types of motor neuron disorders.

Norris Center Clinical Trials

The Norris Center is best known for amyotrophic lateral sclerosis (ALS) care. The Center was recently recognized by the International Alliance of ALS/MND Associations as one of the five leading U.S. centers for ALS clinical research. With this award, we are developing a national consortium to optimize the screening of promising drugs in ALS. The consortium will bring trial costs down and facilitate the evaluation of many exciting new therapies.

Our goal of creating novel trial designs is also reflected in the ongoing phase II clinical trial of lithium in ALS. After a preliminary Italian study report suggested a large benefit from lithium, our group devised and was funded to lead a national effort to test the Italian result. Our trial, using placebo controls, fully enrolled more than 100 patients at 10 sites in fewer than five months, and will be complete in early 2010.

Other exciting ALS clinical trials in the Center include: Ceftriaxone, which clears excess glutamate; the first gene therapy trial in ALS using a zinc finger protein that increases the expression of vascular endothelial growth factor (VEGF) by promoting the transcription of this specific protein; Talampanel, an inhibitor of the AMPA receptor; and an enantiomer of pramipexole, a dopamine agonist with neuroprotective properties.

Other studies searching for a biomarker in ALS include brain MRI using a 4T magnet, an analysis of longitudinal cognitive and behavioral changes in ALS, and studies of genetic and inflammatory markers of disease progression. Dr. Miller led a task force sponsored by the American Academy of Neurology updating the evidence-based practice parameters for managing ALS, results are expected to be published later this year.

The Norris Center is actively involved in peripheral neuropathy treatment and research. Involvement includes participation in an international group seeking answers to chronic immune demyelinating polyneuropathy (CIDP) diagnosis concerns and CIDP IVIg therapy placebo controlled trial. Additionally, Dr. Katz is engaged in projects to define neuropathy clinical and electrodiagnostic patterns that predict responses to therapy.

The Norris Center also administers the largest multidisciplinary clinic in the San Francisco Bay Area for the treatment of all types of muscle and nerve diseases. These include inflammatory and genetic myopathies, all types of neuropathy, myasthenia gravis, and other motor neuron disorders. Our clinic offers diagnostic services, including sophisticated EMG/NCS, nerve and muscle biopsies, DNA analysis, and genetic counseling. Patients benefit from a distinctive diagnostic and rehabilitation approach that incorporates the full range of treatments available while providing support for psychosocial issues related to these conditions.

Bob Osborn, R.N. with patient
Bob Osborn, R.N. providing respiratory treatment.
Dallas A. Forshew, R.N., BSN and ALS Team member with patient
ALS team works with a patient in the ALS Clinic.
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