Letter from the department chair
Welcome to the Department of Neurology.
The Department of Neurology at the University of Louisville School Of Medicine is a vibrant clinical department devoted to providing the adults and children of Kentucky and Southern Indiana with comprehensive neurological care. The department is also dedicated to teaching the neurologists of the future and committed to participating in innovative clinical and translational research.
The clinical subspecialties include general neurology, stroke, epilepsy, movement disorders, neurodegenerative diseases, multiple sclerosis, neuromuscular disease, clinical neurophysiology, headache, sleep disorders, and child neurology. All programs function as multidisciplinary teams with neurology faculty members at the helm. We serve three hospitals, two rehabilitation centers, and provide outpatient neurology services at several clinical facilities.
Education of medical students, neurology residents, residents from other specialties, and clinical fellows is our priority. The residency training program provides house officers with a rich exposure to a large and diverse patient population of individuals with acute, subacute, and chronic neurological diseases under the close supervision of expert faculty in neurology. State of the art clinical care coupled with extensive clinical mentoring by faculty make our training program unsurpassed.
Our clinical research in stroke and multiple sclerosis are among the fastest growing programs in the country, enrolling patients in important clinical trials with potentially life saving innovative treatments. Our research in movement disorders, particularly in progressive supranuclear palsy and Parkinson’s disease is internationally recognized as the leading work in this subspecialty of neurology. Our research programs in these and other areas involve a worldwide interdisciplinary network of collaboration aimed at developing preventive and corrective treatments for neurological disorders.
Please review our website and contact any of our faculty or staff with questions. We are proud of our growing department and the many accomplishments of our faculty.
Please also see the discussion below of "Why Basketball is Neurology". We are convinced that our speciality is key to understanding the critical features of human abilities which are essential to a life full of joy and meaning.
Robert P. Friedland, M.D.
Professor and Mason C. and Mary D. Rudd Chair of Neurology
University of Louisville
Ten Reasons Why Basketball is Neurology
- The force needed to throw the ball depends on our calculation of the weight of the ball and the motor resources available. The brain evaluates the ball’s weight and through the activities of the pyramidal and extrapyramidal motor systems calculates the coordinated action of the legs, trunk, arms and hands necessary to send the ball in the desired direction.
- The force of gravity acts consistently on the ball throughout its path. The brain calculates this unconsciously to determine how high to throw the ball in order for it to end up in the basket. This process involves procedural memory… the memory for action and not events.
- The player calculates the likelihood of the shot being blocked and must adjust the height of the shot and also the force applied to the ball in regard to the height of the opponent and the expected height of his or her outstretched arms at the point the shot is released. This is a complex perceptual, attentional and judgemental task.
- The position of the player on the court is constantly monitored by the player using all the signals available (not only the position of the basket.) The basket may not be visible to the player who has the ball as he or she may be dribbling with their back to the basket, but the markings on the court (including the three-point line, sidelines and half court line) are all permanent and never changing in regard to the position of the basket….so an experienced player can calculate the position of the basket in regard to these lines through unconscious processes involving simple geometry [most likely completed by the right parietal lobe with assistance of the cerebellum] so the player who turns and shoots does not need to actually see the basket before the ball is released.
- The player needs to focus attention on the task at hand. Thus a player who devotes his attention entirely to the task of dribbling is likely to have the ball stolen. He or she must have divided attention; paying attention to the balance of body weight, the position of partners as well as opponents and the flow of a game. Also, focusing attention requires the ability to not pay attention to other factors which may be distracting. A player shooting a free throw concentrates on the weight of the ball, the feeling of the ball in his or her hands, the elasticity and strength present in his or her legs and is hopefully able to ignore the distraction provided by fans screaming in the stands and standing up behind the basket attempting to divert attention from the shot itself. The process of division of attention has been attributed in large part to the frontal lobes. Focusing of attention is supported by brainstem projection systems and the entire cerebral cortex (e.g., visual cortex for seeing and auditory cortex for hearing).
- The player must remember what is happening, and what the coach’s plan for the game is for that moment. This may involved knowing that a certain defender does not defend well when challenged from the left as well as when they are challenged from the right. They may also remember that an opponent is likely to foul in certain situations and must recall that they have accumulated so many fouls and that an additional foul would make them to leave the game. Memory is a vital function of the medial temporal lobes.
- Emotion is an integral feature of basketball and a player can be severely disturbed by having a foul called again him or her when such a foul, in their opinion, was actually not committed. In order to hold back their anger and expression of emotion (which could result in expulsion or technical foul), the player must be able to inhibit emotional expression. This is an interaction of the frontal lobes and the amygdala, an important nucleus in the anterior medial temporal lobe.
- Basketball players are constantly falling… every time they jump they fall to the floor, hopefully landing on their feet. They do not often crash to the floor because of the ability of the semicircular canals and otolith organs in the inner ear to calculate precisely the position of the body in regard to the center of the earth and make appropriate adjustments.
- When we move our head our eye position is adjusted with feedback from the inner ears to allow the brain to interpret the visual word without being confounded by the motion of the head. This problem is apparent when we see a movie shot from a camera perched on someone’s shoulders…. the image appears to be jumping and is often impossible to watch without getting sick. Our heads are also attached to our shoulders, of course, but our inner ears instruct the eye muscles, with the help of complex brainstem interactions, how to move in a way that produces a stable image of the world. Without these systems basketball would be impossible!
- Joy: the reason people play basketball is because it is fun. The capacity for fun is shared by many mammals that enjoy play (including, of course, dogs, cats and primates.) The capacity for joy and for play cannot be localized in the brain but is undoubtedly an interaction between the frontoparietal, temporal and occipital lobes and memory, emotion and the basic reward systems of nervous functioning which are many millions of years old.