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David Charles | |
|---|---|
| Born | Decatur, Alabama, U.S. |
| Alma mater | Vanderbilt University School of Medicine |
| Years active | 1995 - Present |
| Known for | Parkinson's Disease research |
| Medical career | |
| Profession | Physician |
| Institutions | Vanderbilt University Medical Center |
| Sub-specialties | Neurology |
| Research | Movement disorders |
David Charles is an American neurologist, professor and vice-chair of neurology, [1] and the medical director of Telehealth at Vanderbilt University Medical Center. [2]
David Charles attended Vanderbilt University School of Medicine, graduating in 1990. After completing his neurology residency at Vanderbilt University Medical Center, he joined the faculty of the Department of Neurology at Vanderbilt University in 1994. In 1995, he obtained his fellowship in Movement Disorders and Clinical Neurophysiology. In 1996, he completed the Health Care Management Program from the Owen Graduate School of Management. In January and May 1997, he completed Harvard Macy Institute's Program for Physician Educators, and in 1998, he studied deep brain stimulation, and its use as a treatment of Parkinson's disease as a Fulbright Senior Scholar at the Universitaire de Grenoble in Grenoble, France. [3]
Charles is president of the Clinical Neurological Society of America, [4] co-chair of the North American Neuromodulation Society Neurology Committee, past chairman of the Public Policy Committee of the American Neurological Association, [5] a Fellow of the American Academy of Neurology and the American Neurological Association, and past board member of the United Council of Neurologic Subspecialties. [6] He is a past-president of The Tennessee Academy of Neurology. [7] From 1997 to 1998, he was a Health Policy Fellow on the staff of the Labor Subcommittee for Public Health and Safety, United States Senate. [3]
At Vanderbilt he serves as vice-chair of neurology, and previously served as the assistant dean of admissions for the medical school and the Neurology Residency Program Director. [8]
He is also the chair of the Alliance for Patient Access, which, according to The Wall Street Journal "represents physicians and is largely funded by the pharmaceutical industry. The contributors mostly include brand-name drug makers and biotechs, but some – such as Pfizer and Amgen – are also developing biosimilars." [9]
In 2013 he published an article on specialty drugs in which he agreed with the findings of the Congressional Budget Office that spending on prescription medications "saves costs in other areas of healthcare spending." [10] He observed that specialty drugs are so high priced that many patients do not fill prescriptions resulting in more serious health problems increasing. His article referred to specialty drugs such as "new cancer drugs specially formulated for patients with specific genetic markers." [10] He explained the high cost of these "individualized medications based on diagnostic testing; and "biologics," or medicines created through biologic processes, rather than chemically synthesized like most pharmaceuticals." [10] He argued that there should be a slight increase in co-pays for the more commonly using lower-tier medications to allow a lower co-pay for those who "require high-cost specialty tier medications." [10]
Charles' research is primarily focused on movement disorders including Parkinson's disease, cervical dystonia, tremor, spasticity, and neurotoxin injections. [11] [12]
One of his focuses within movement disorders, particularly with Parkinson's disease, has been Deep Brain Stimulation (DBS). An article in NeurologyToday interviewed him on "20 Years of Monumental Strides in Movement Disorders." In the interview, David Charles hailed that the United States approving DBS in 2016 for mid-stage Parkinson's disease was "one of the biggest advances" in DBS. He also states that DBS is a better alternative to medication, "the data are very clear that DBS plus medicine is superior to medicine alone in controlling symptoms and improving quality of life in mid- and advanced-stage disease," backing this up with his publication, "Subthalamic Nucleus Deep Brain Stimulation May Reduce Medication Costs in Early Stage Parkinson’s Disease." [13] [14]
He has authored over 100 research publications [15] and is currently the principal investigator in the only FDA approved clinical trial testing the efficacy of Deep Brain Stimulation in people with early stage Parkinson's disease. [16]
Neurology is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal cord and the peripheral nerves. Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system.
Deep brain stimulation (DBS) is a neurosurgical procedure involving the placement of a medical device called a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain for the treatment of movement disorders, including Parkinson's disease, essential tremor, dystonia, and other conditions such as obsessive-compulsive disorder (OCD) and epilepsy. While its underlying principles and mechanisms are not fully understood, DBS directly changes brain activity in a controlled manner.
The subthalamic nucleus (STN) is a small lens-shaped nucleus in the brain where it is, from a functional point of view, part of the basal ganglia system. In terms of anatomy, it is the major part of the subthalamus. As suggested by its name, the subthalamic nucleus is located ventral to the thalamus. It is also dorsal to the substantia nigra and medial to the internal capsule. It was first described by Jules Bernard Luys in 1865, and the term corpus Luysi or Luys' body is still sometimes used.
Hyperkinesia refers to an increase in muscular activity that can result in excessive abnormal movements, excessive normal movements, or a combination of both. Hyperkinesia is a state of excessive restlessness which is featured in a large variety of disorders that affect the ability to control motor movement, such as Huntington's disease. It is the opposite of hypokinesia, which refers to decreased bodily movement, as commonly manifested in Parkinson's disease.
Thalamotomy is a surgical procedure in which an opening is made into the thalamus to improve the overall brain function in patients. First introduced in the 1950s, it is primarily effective for tremors such as those associated with Parkinson's disease, where a selected portion of the thalamus is surgically destroyed (ablated). Neurosurgeons use specialized equipment to precisely locate an area of the thalamus, usually choosing to work on only one side. Bilateral procedures are poorly tolerated because of increased complications and risk, including vision and speech problems. The positive effects on tremors are immediate. Other less destructive procedures are sometimes preferred, such as subthalamic deep brain stimulation, since this procedure can also improve tremors and other symptoms of PD.
Hemiballismus or hemiballism is a basal ganglia syndrome resulting from damage to the subthalamic nucleus in the basal ganglia. Hemiballismus is a rare hyperkinetic movement disorder, that is characterized by violent involuntary limb movements, on one side of the body, and can cause significant disability. Ballismus affects both sides of the body and is much rarer. Symptoms can decrease during sleep.
Hypokinesia is one of the classifications of movement disorders, and refers to decreased bodily movement. Hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Hypokinesia is a symptom of Parkinson's disease shown as muscle rigidity and an inability to produce movement. It is also associated with mental health disorders and prolonged inactivity due to illness, amongst other diseases.
In the management of Parkinson's disease, due to the chronic nature of Parkinson's disease (PD), a broad-based program is needed that includes patient and family education, support-group services, general wellness maintenance, exercise, and nutrition. At present, no cure for the disease is known, but medications or surgery can provide relief from the symptoms.
Ablative brain surgery is the surgical ablation by various methods of brain tissue to treat neurological or psychological disorders. The word "Ablation" stems from the Latin word Ablatus meaning "carried away". In most cases, however, ablative brain surgery does not involve removing brain tissue, but rather destroying tissue and leaving it in place. The lesions it causes are irreversible. There are some target nuclei for ablative surgery and deep brain stimulation. Those nuclei are the motor thalamus, the globus pallidus, and the subthalamic nucleus.
Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms become more common. The most obvious early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Cognitive and behavioral problems may also occur with depression, anxiety, and apathy occurring in many people with PD. Parkinson's disease dementia becomes common in the advanced stages of the disease. Those with Parkinson's can also have problems with their sleep and sensory systems. The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit. The cause of this cell death is poorly understood, but involves the build-up of misfolded proteins into Lewy bodies in the neurons. Collectively, the main motor symptoms are also known as parkinsonism or a parkinsonian syndrome.
Parkinsonian gait is the type of gait exhibited by patients with Parkinson's disease (PD). It is often described by people with Parkinson's as feeling like being stuck in place, when initiating a step or turning, and can increase the risk of falling. This disorder is caused by a deficiency of dopamine in the basal ganglia circuit leading to motor deficits. Gait is one of the most affected motor characteristics of this disorder although symptoms of Parkinson's disease are varied.
Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function. Neuromodulation is an evolving therapy that can involve a range of electromagnetic stimuli such as a magnetic field (rTMS), an electric current, or a drug instilled directly in the subdural space. Emerging applications involve targeted introduction of genes or gene regulators and light (optogenetics), and by 2014, these had been at minimum demonstrated in mammalian models, or first-in-human data had been acquired. The most clinical experience has been with electrical stimulation.
Alim Louis Benabid is a French-Algerian emeritus professor, neurosurgeon and member of the French Academy of Sciences, who has had a global impact in the development of deep brain stimulation (DBS) for Parkinson's disease and other movement disorders. He became emeritus professor of biophysics at the Joseph Fourier University in Grenoble in September 2007, and chairman of the board of the Edmond J. Safra Biomedical Research Center in 2009 at Clinatec, a multidisciplinary institute he co-founded in Grenoble that applies nanotechnologies to neurosciences.
Mahlon R. DeLong is an American neurologist and professor at the Medical School of Emory University. His research has advanced the understanding and treatment of Parkinson's disease, dystonia, tremor and other neurological movement disorders.
(Charles) David Marsden, FRS was a British neurologist who made a significant contribution to the field of movement disorders. He was described as ‘arguably the leading academic neurologist and neuroscientist of his generation in the UK’.
The mesencephalic locomotor region (MLR) is a functionally defined area of the midbrain that is associated with the initiation and control of locomotor movements in vertebrate species.
Ali Rezai is a neurosurgeon interested in advancing the use of brain chip implants in deep brain stimulation and neuromodulation to treat Parkinson's disease, obsessive–compulsive disorder, Alzheimer's disease and traumatic brain injury.
Konstantin Slavin is a Professor and Head of the Department of Stereotactic and functional neurosurgery at the University of Illinois College of Medicine. He is a former president of the American Society for Stereotactic and functional neurosurgery and current vice-president of the World Society for Stereotactic and Functional Neurosurgery. His specialties include Aneurysm, Brain surgery, Brain Tumor, Cerebrovascular Disorders, Craniotomy, Dystonia, Essential Tremor, Facial Nerve Pain, Facial Pain, Glioblastoma, Headache disorders, Laminectomy, Lower back pain, Movement Disorders, Multiple Sclerosis, Neck Pain, Neurosurgery, Neurosurgical Procedures, Pain, Parkinson Disease, Spinal Cord Injuries, and Stroke.
Jerrold Lee Vitek is an American neurologist. He is the Head of the Neurology Department, Director of the Neuromodulation Research Program, and Center Director of the University of Minnesota Udall Center of Excellence for Parkinson's Research. Vitek's clinical interests include movement disorders and evaluation for deep brain stimulation (DBS) and his current research activities focus on Parkinson's disease, dystonia, tremor and deep brain stimulation.
Alberto Priori is an Italian neurologist, academic, and author. He is a Professor of Neurology at the University of Milan, Director of Neurology 1 Unit at San Paolo Hospital, and the Founder and Coordinator of Aldo Ravelli Center of the University of Milan. He also serves as President of the Neurophysiopatology Tecniques Course, and Professor of Postgraduate Schools - Medicine, Healthcare, Dental Medicine at the same University.
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