Divisions

Divisions

Cognitive/Geriatric Neurology Division

Friedland, Robert P.


Dr Friedland is a clinical and research neurologist interested in behavior and aging who is frustrated by the lack of highly effective therapies for Alzheimer’s disease. His work is focused on clinical and biological issues in the disease using a diversity of approaches. The first reports of abnormal patterns of brain structure, metabolism and cerebral blood flow in Alzheimer’s disease using positron emission and magnetic resonance computed tomography came from his group at the University of California, Berkeley. While at the National Institutes of Health Dr Friedland’s group contributed early studies of driving performance in patients with Alzheimer’s disease. More recently, Dr. Friedland has worked on patterns of disease occurrence and risk and protective factors, involving Kikuyu in Kenya, Jews and Arabs in Israel and Caucasian and African-American subjects in the USA. His group has documented important determinants of the disease, including physical and mental inactivity, smoking and diet. This work is focused on interactions of genetic and environmental lifestyle factors and uncovering new disease genes. As much as 50% of the inherited risk of getting the disease is currently unknown, and new genes may provide ways to develop treatments. Dr. Friedland’s group contributed to a report of a novel Alzheimer gene which has been found to be linked to the disease in Arab subjects studied in Israel, as well as in people from 3 other populations worldwide. His work has led to a Health Literacy Program to enhancing public awareness of the disease and how lifestyle modifications influence risk. Dr Friedland and colleagues are also using animal models to define the biology of the disease better and develop new treatments. Work is underway on the role of immune factors in the disease and development of new vaccination and antibody treatments.


Dr. Friedland has authored or coauthored over 200 scientific publications and has current research funding from the National Institutes of Health (National Institute on Aging), as well as several foundations, institutes, corporations and families.

 

Research Interests

Dr. Friedland’s work has focused on clinical and biological issues in Alzheimer’s disease and related disorders. He was the first to document patterns of abnormal brain metabolism and cerebral blood flow in the disease using positron emission and single photon emission computed tomography. He also contributed the initial studies of magnetic resonance imaging in dementia. The first studies of driving behavior in patients with Alzheimer’s disease came from his group at the NIH. Dr. Friedland has also worked on the patterns of disease occurrence and risk and protective factors, with studies of the Kikuyu in Kenya, Jews and Arabs in Israel, Caucasian and African-American subjects in Ohio and Mexican and European American subjects in Texas. He has documented a series of important determinants of the disease, including physical and mental inactivity, smoking, obesity, and diet. This work has focused on interactions of genetic and environmental lifestyle elements. These studies have led to a National Health Literacy Program working to enhance public awareness about the disease and how lifestyle modifications may influence risk. His group also participated in the discovery of the important Alzheimer’s disease risk factor gene, SORL1. Animal models have been used by Dr Frieldand and his collaborators to better define the biological mechanisms of Alzheimer’s disease in order to develop new treatments. The first demonstration of catalytic antibodies targeting the Alzheimer amyloid Beta protein in the blood was published by his group in 2007. In 2008 Dr Friedland and colleagues reported the first demonstration of a possible interaction involving molecular mimicry between protective anti-amyloid antibodies and exposure to a plant virus. Current studies are devoted to developing immunological approaches to the treatment of both Alzheimer and Parkinson’s diseases.

 

Academic and Community Education Activities

1. On Sep 17, 2011 at the Crowne Plaza we hosted a meeting for the community called “The Journey: Alzheimer’s Disease and Caregiving”. The session was attended by about 120 persons, many of whom were family caregivers. The talks were well received by the audience and there were many questions asked during the Q&A session as well as during the lunch break. The links below are video recordings of the talks. We plan to continue to host such educational meetings regarding Alzheimer disease and other dementias for the community each year.

Alzheimer Meeting Sep 17th 2011 Agenda Download PDF (453KB)

  1. Opening Remarks (Suhas Kulkarni and Helen Lang): http://louisville.edu/television/Med/Alzheimers/OpeningRemarks1.asx
  2. Dr Obisesan: http://louisville.edu/television/Med/Alzheimers/Obiesesan1.asx
  3. Dr Robert Friedland: http://louisville.edu/television/Med/Alzheimers/Friedland1.asx
  4. Dr. Karen Robinson: http://louisville.edu/television/Med/Alzheimers/Robinson1.asx
  5. Dr Dee Antimisiaris: http://louisville.edu/television/Med/Alzheimers/Antimisiaris1.asx
  6. Dr David Casey: http://louisville.edu/television/Med/Alzheimers/Casey1.asx
  7. Johanna Weiss (Alzheimer Association, Louisville): http://louisville.edu/television/Med/Alzheimers/Weiss1.asx
  8. Q&A http://louisville.edu/television/Med/Alzheimers/QandA1.asx
  9. Panel Discussion: http://louisville.edu/television/Med/Alzheimers/Panel1.asx

2. Louisville Free Pubic Library series: Boom Time Series Jan 18, 2012

Dr. Robert Friedland. “Your brain: How to reduce your risk”

http://louisville.edu/television/Med/Alzheimers/Friedland.asx

3. Neurology Grand Rounds Mar 16, 2012

Dr. Robert Friedland. The Framing of the Concept of Dementia:

From Emil Kraepelin to National Institute of Aging

http://louisville.edu/television/Med/GrandRounds/NGR031612.asx

4. Rotary Club of Louisville, KY, USA Jan 31 2013

Dr. Robert Friedland "Alzheimer's, Dementia and Aging"

http://www.youtube.com/watch?v=jFD2K4Ns-0Y

Collaborators

University of Louisville

A. Roberts, Ph.D. Physiology

R. Vaishnav Ph.D. Physiology

Ruolan Liu, Ph.D, Neuroscience

CWRU

Xiongwei Zhu, Ph.D., Pathology

M. Zagorski, Ph.D. Chemistry

Tel Aviv Univ.

R. Inzelberg, MD Neurology

University of Cambridge, United Kingdom

Ruma Raha-Chowdhury, Ph.D (University of Cambridge, United Kingdom)

University of Michigan, Ann Arbor

Matthew Chapman, Ph.D, Microbiology

Headache

Patient Care

The University of Louisville Comprehensive Headache Program promotes excellence in patient care to individuals with headache and facial pain throughout the Kentuckiana region. This mission is accomplished through patient care, teaching and research. This includes the use of an in-office IV infusion suite which delivers patient care through a number of standardized headache relief medication protocols.

Clinical Research

Excellence in clinical research is accomplished in the headache program through clinical drug trials, retrospective chart review and scholarly dissemination of that information at National Headache meetings.

Education

University of Louisville Medical students and residents are educated in the Headache program through direct patient care at UL Physicians Neurology, the faculty practice of the University of Louisville Department of Neurology. In addition to regular course offerings, specific elective rotations in Headache are offered to medical students and residents.

Program Members

Michael K. Sowell, MD is Director of the University of Louisville Comprehensive Headache Program.

Patient & Public Information

A number of patient-centered headache education websites can be found by links from this website.

Consultation/Referral

For consultation or referral, please contact:

For Adults
UL Physicians Neurology
Health Care Outpatient Center
401 E. Chestnut St., Suite 510

Louisville, KY 40202

For Children
UL Physicians Child Neurology
601 South Floyd St, Suite 500
Louisville, KY 40202

Appointments & Referrals: (502) 852-8033

Fax: (502) 589-8233

Neuroimmunology

The Department of Neurology at the University of Louisville has great interest in neuroimmunology. Focus on neuroimmunology takes place in both clinical services and research.

Clinical

The Department provides consulting services for multiple sclerosis in the Louisville area. Autoimmune diseases of the peripheral nervous system including autoimmune neuropathies, myasthenia gravis and other neuromuscular junction disorders, and inflammatory myopathies form a majority of the clinical practice in the neuromuscular division.

Research

Several clinical and basic science projects are being conducted by the Department.

Multiple Sclerosis Care Center Program

DESCRIPTION

Multiple Sclerosis – often referred to as MS - is a chronic, sometimes progressive disease of the Central Nervous System (including the brain and spinal cord) that affects more than 400,000 people in the United States. MS is typically diagnosed when the patient is between 20 and 40 years old, with more women than men affected. Scientists are still working to determine the causes of MS. Some believe that MS is the result of an autoimmune response in the body that causes damage to healthy tissues. Others believe that a virus is involved in causing the disease. Research is ongoing to determine the causes of MS and target treatments toward the underlying mechanisms of the disease. Symptoms of MS are unpredictable and vary from person to person, depending on the area of the nervous system that is affected. Symptoms may include:

  • Loss of coordination
  • Weakness
  • Vision disturbances
  • Sensory disturbances
  • Fatigue
  • Memory loss
  • Cognitive problems
  • Muscle spasms
  • Loss of bladder and bowel control
  • Depression
  • Speech problems

No two individuals with MS are exactly alike. That’s why medical care should be individualized and involve the patient in the decision-making.

OUR APPROACH

University of Louisville's MS Care Center Program provides comprehensive, multidisciplinary care for each patient - with access to the full range of medical expertise, without the inconvenience of multiple appointments and referrals.

The MS Care Center Program provides a broad spectrum of services including:

  • Diagnostic evaluation and testing, including MRI, neurological examinations and laboratory testing.
  • Rehabilitative assessment and services such as physical therapy and occupational therapy to help patients regain mobility and independence and speech therapy to overcome speech or swallowing problems.
  • Evaluation and treatment of cognitive (thinking) problems and emotional problems by a specially trained neuropsychologist.
  • Medication to improve symptoms and reduce the occurrence and severity of attacks, including newer drugs that have been shown to reduce progression or long-term disability in MS patients.
  • Opportunity to participate in clinical studies examining new treatments for MS.
  • Educational programs such as the Newly Diagnosed and Healthy Steps programs.

This patient-centered approach to MS primary care is designated to address each individual’s unique needs.

Our MS specialists are an interdisciplinary group of highly skilled and trained team members serving approximately 1000 MS patients with access to state-of-the-art technology, and up-to-the-minute research and drug therapies based on the MS Care Center Program’s participation in clinical trials.

ASSESSMENT AND TREATMENT

The assessment, evaluation and treatment of MS patients begin with a highly-skilled team:

  • MS Neurologists - lead the patient care team in creating and following an individualized plan of action.

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  • MS certified Nurse Practitioners – Provide evaluation, education and treatment

Michele Melton, NP

  • Certified Clinical Research Coordinator/ MS Certified Nurse – works with patients and physicians involved in research studies and provides education and addresses concerns specific to MS patients and their families.

Angela Siegwald, RN, CCRC, MSCN, Research Manager has over 12 years of experience in the field of Multiple Sclerosis. She is a Multiple Sclerosis Certified Nurse as well as a Certified Clinical Research Coordinator. She coordinates and assists with the conduction of several MS clinical trials. Angela also helps provide counseling and education to MS patients and their families at the Baptist Hospital East Multiple Sclerosis Center.

In 2007, she was instrumental in initiating a monthly Newly Diagnosed MS program at the center.

  • Infusion Nurse - provides the specialized expertise to assist patients with infusions used to manage MS and treat acute attacks (exacerbations).

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  • Neuropsychologist - helps address issues of cognitive (thinking) function and depression that maybe part of MS.

N/A

  • Physical and Occupational Therapists - provide individualized rehabilitation treatment.

N/A

  • Medical Assistants – coordinate care and medication support.

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  • Social Workers - offer support and referrals to appropriate community resources.
  • Durable Medical Equipment - referrals can be made to obtain devices or equipment for home treatment.
  • Specialist Referrals - referrals to specialists, such urologists to evaluate and manage MS-related problems or neuro-ophthalmologists to provide specialized assessment of MS-related vision and eye problems.

YOU CAN COUNT ON US

MS treatment should be as individual as you are. The MS Care Center Program sees patients at the following location:

UL Physicians Neurology
UL HealthCare MS Center
401 East Chestnut Street Suite 510
Louisville, KY 40202
(502) 589-0802

Neuromuscular

The University of Louisville Neuromuscular Unit provides a full complement of services ranging from clinical assessment, laboratory testing and electrodiagnosis to biopsy and histology of nerve and muscle. Currently, several clinical trials are in place for investigation of new and novel therapies of nerve, muscle and neuromuscular junction disorders.

List of services

  • Clinical assessment of disorders of nerve, muscle and neuromuscular junction.
  • Electrodiagnosis of neuromuscular disorders including electromyography, nerve conduction studies (NCV), single fiber EMG, autonomic testing.
  • On-site biopsy of nerve and muscle.
  • Preparation and pathological evaluation of nerve and muscle specimens.

Neurodiagnostics

The Clinical Neurophysiology Laboratories provide expert electrodiagnostic evaluations of the central and peripheral nervous system. Using state of the art equipment, certified electrodiagnostic technologists and expert interpretation by board certified neurologists, we offer timely, precise diagnostic information to the patient and referring physician.

List of Services

  • Complete in-patient and outpatient digital EEG and epilepsy monitoring
  • Somatosensory, brainstem, auditory and visual evoked potentials
  • Intraoperative monitoring
  • Comprehensive nerve conduction studies and EMG (Adults and Pediatrics)
  • Transcranial Magnetic Stimulation
  • Intracarotid amobarbital testing for epilepsy surgery
  • Carotid duplex/Transcranial doppler for cerebrovascular evaluation
  • Lumbar Puncture

Personnel

Order Form

Sleep Disorders

Patient Care

University Sleep Center was established to help individuals return to a normal productive lifestyle through diagnosis and treatment of sleep disorders. Our dedicated center, which is fully accredited by the American Academy of Sleep Medicine, has a team of experienced, knowledgeable professionals who work with patients to evaluate each individual situation. Our state of the art facility, located in the beautiful new Residence Inn – Marriott at 333 East Market Street, is also on the leading edge of sleep research and serves as a teaching and training center for physicians.
Each patient suite at the Residence Inn - Marriott is a private one-bedroom suite with full kitchen and separate living room area; the suite is very conducive to a great nights sleep for our patients. University Sleep Center is the only center in Kentucky located in a hotel environment.

Approximately 40 million Americans suffer from chronic sleep disorders. They experience fatigue, irritability, depression, lack of concentration and memory, lost productivity and car or workplace accidents, all due to sleep deprivation and sleeping disorders. If left untreated some sleep disorders may increase the risk of high blood pressure, heart attack or stroke. The University Sleep Center is ready to restore restful sleep to your nights and improve the quality of your days.

Clinical Research

University Sleep Center has participated in numerous beneficial research studies involving Phase I and II trials for Modafinil and Zyrem for Narcolepsy/Cataplexy, research involving Sleep Apnea and Pulmonary hypertension in apnea and other non-funded research studies.

Education

University Sleep Center is aligned with University of Louisville Healthcare and the University of Louisville School of Medicne. The Center serves as a teaching site for physicians who are interested in sleep and sleeping disorders. The Center has both Neurologists and Pulmonologists on site to consult with our patient population as well as train interested physicians in sleep and sleeping disorders.

The Sleep Center is involved in community education for both patients and care-givers. We educate our patients through our support groups and provide community education at numerous events during the year.

Our Affiliations

University of Louisville Healthcare

Patient & Public Information

American Academy of Sleep Medicine
American Medical Society
Kentucky Sleep Society
American Academy of Neurology
National Sleep Foundation
Sleep Net.com

Consultation/Referral: Please contact University Sleep Center directly at 502-562-3792 for detailed information or to schedule a consultation with our physicians.