Understanding frontotemporal dementia

helping hand imageFor the past 10 years, I have had the privilege of leading a support group for family caregivers of persons with frontotemporal dementia (FTD) and related disorders.

The group’s creation was based on an observation among our clinicians at the OHSU Aging and Alzheimer’s Clinic that the typical Alzheimer’s Disease support group did not always meet the needs of families dealing with FTD.

A closer look at the hallmark symptoms of frontotemporal degeneration will help explain why this may be so.

While much of the public is familiar with the symptoms of Alzheimer’s disease, there continues to be a general lack of knowledge concerning FTD, the second most commonly diagnosed degenerative dementia.

FTD is a disease that typically affects adults in their 50s and 60s, and because of that it can affect work and family relationships in ways that are different from that of dementia in older adults. It is not unusual for people with FTD to be initially misdiagnosed as having a psychiatric disturbance due to their younger age of onset and unusual behaviors in the presence of generally preserved memory.

While the symptoms may vary from one individual to the next, frequent early signs include changes in personality, poor judgment, language problems or trouble planning and organizing activities. The person’s behaviors may become inappropriate; for example, speaking to strangers openly or engaging in compulsive actions like overeating.

FTD can lead to loss of judgment, inhibition and empathy, resulting in poor financial decisions or disrupted relationships. Often people with frontotemporal degeneration have little insight into their own deficits and thus become a caregiving challenge by engaging in risky activities and resisting offers of help.

For these and many other reasons, family members of persons with FTD and related disorders can experience stress, fatigue and despair. A caregivers’ group can offer not only emotional support in the face of the daily demands of caregiving, but can at times provide practical solutions to problems stemming from difficult behaviors.

The expressions of recognition and empathy among group members as they share with each other challenges of the previous month attest to the fact that no one has to be alone on this most difficult of journeys.


Kathy Wild, Ph.D.



Kathy Wild, Ph.D. has been providing neuropsychological evaluations at the Layton Aging and Alzheimer’s Disease Center for over 25 years.




This article originally appeared in the The Layton Center’s newsletter, the Alzheimer’s Update, a biannual publication that features stories on Layton Center and national research, experiences of volunteers in some of our studies, and cognitive health. Subscribe here.

Caregiver corner: Pleasant Events tool can aid overtaxed caregivers

man and woman singing at pianoA demoralizing effect of Alzheimer’s disease and similar dementias is the gradual loss of ability to engage in enjoyable and meaningful activities. This loss affects the whole family and can lead to depressive symptoms in the care recipient with dementia.

Overtaxed family caregivers know that activity engagement is important, but they often tell me they are exhausted and can’t think of another activity.

To address this concern, Teri and Logsdon (1991) developed the Pleasant Events tool for caregivers with dementia. This tool offers caregivers a variety of pleasant events to engage their family member.

Importantly, Teri and Logsdon advise caregivers to keep it simple.

Reflect on how you feel when someone extends a kind word to you and know that that effect is similar for your family member. For example, a stranger on the tram complimented my dress the other day — it made me feel so good!

When you have a minute, write down a list of activities that you think your care recipient with dementia might enjoy. Keep this list handy for when you both need a boost.

To get you started, Teri and Logsdon have started a list, and caregivers I’ve worked with have added their own ideas. I left a couple of lines for you to write in your ideas. (Let us know what those are in the comments section!)

Pleasant Events:

  • Hug each other
  • Apply hand lotion
  • Go for a walk
  • Look at a scrapbook together
  • Talk with children/grandchildren on the phone
  • Clean out an old toolbox or sewing kit
  • Smile
  • Wink
  • Polish shoes
  • Pop popcorn
  • Sing a familiar song
  • Play an instrument
  • Apply nail polish
  • Pet an animal (or a stuffed animal)
  • Fly a kite
  • Blow up a balloon
  • Wrap a present
  • Unwrap a present
  • _____________________
  • _____________________
  • _____________________


allison lindauer
Allison Lindauer, Ph.D., N.P. is Assistant professor and director of outreach, recruitment and education for the Layton Aging and Alzheimer’s Disease Center.




This article originally appeared in the The Layton Center’s newsletter, the Alzheimer’s Update, a biannual publication that features stories on Layton Center and national research, experiences of volunteers in some of our studies, and cognitive health. Subscribe here.

Meet the minds behind NW Noggin, a K-12 neuroscience outreach program

HANDS-ON Elementary students in Davenport, Wash., investigate pipe-cleaner neurons during a visit by neuroscience education group, NW Noggin. Credit: Bill Griesar

HANDS-ON Elementary students in Davenport, Wash., investigate pipe-cleaner neurons during a visit by neuroscience education group, NW Noggin. Credit: Bill Griesar

At 8 a.m. in an eastern Washington elementary school gymnasium, Bill Griesar, Ph.D. ’01, is in a situation that would make anyone else sweat.

Dr. Griesar has brought his group of neuroscience outreach volunteers – undergraduate and graduate students hailing from OHSU, Portland State University and Washington State University Vancouver – to Davenport, Wash., to teach schoolchildren about brains and neuroscience.

But he has just discovered that the pipe cleaners used to construct neuron models were nearly used up the day before.

Unfazed, Dr. Griesar immediately concocts a new activity and somehow procures rolls of colored butcher paper from the school. Volunteers from NW Noggin rush to arrange paper on the floor to represent different lobes of the brain.

Scott Jones, a fourth-year Ph.D. student in the OHSU School of Medicine’s Behavioral Neuroscience Graduate Program, tapes out an outline of a brain around the paper just as the first classes come into the gym. Dr. Griesar, simultaneously snapping photos, directing students and showing off a model brain, hasn’t stopped grinning.

This isn’t the scene most people picture when thinking of the career of a traditional Ph.D. scientist, but, as Dr. Griesar asked, “What is the traditional career for a Ph.D.?” With the number of Ph.D. graduates who move on to a tenure-track faculty position dropping, graduates are branching out and exploring other career options, some of which offer more flexibility for working parents than traditional academia.

Called to teach

Dr. Griesar and his husband adopted their oldest son, Dominic, at 14 months old when Dr. Griesar was in the middle of writing his dissertation. Somehow, Dr. Griesar found time to write, working during Dominic’s naps.

“I’d write a little more while my friends held him and showed him around the lab,” he said. The day after Dr. Griesar defended, their second son, a four-month-old named Jack, joined their family.

“Suddenly I had a doctoral degree and two young boys, so I was not about to take the so-called traditional route,” he said. Instead, he started teaching science as an adjunct at Portland State University and Washington State University Vancouver and fell in love with the classroom – or, in some cases – the gymnasium.

In the gym at Davenport Elementary, students filter in and cluster around different pieces of paper. Dr. Griesar and NW Noggin volunteers explain that the kids are sitting on a brain. (Some take it literally and wrinkle their noses, looking under their feet.) After NW Noggin volunteers explain how brain functions are localized to specific lobes, students draw depictions of what their brain region does on the paper lobes in front of them. Other groups rotate through activity stations in the back of the room.

NW Noggin targets groups of kids who might not otherwise get exposure to hands-on neuroscience. Davenport, population 1,700, is nestled in Washington’s wheat fields, far from the biomedical hubs of Seattle and Portland. More than half its students qualify for free or reduced meals.

“Neuroscience – and all science in general – will only benefit from having scientists from all sorts of backgrounds,” said Alfredo Zuniga, NW Noggin volunteer and a third-year Ph.D. student in the Behavioral Neuroscience Graduate Program. “Through its outreach, NW Noggin is making sure that students from all demographics are exposed to this field and these sorts of careers at an early age.”

Brains + art

PASSION Jeff Leake (left) and Dr. Bill Griesar co-founded NW Noggin, an arts-influenced outreach group with a mission to turn kids onto the wonders of neuroscience. Should you decide to attend one of the many NW Noggin outreach events, it’s a good bet Dr. Griesar will be there. Just look for the guy with pipe-cleaner neurons.   Credit: Bill Griesar

PASSION Jeff Leake (left) and Dr. Bill Griesar co-founded NW Noggin, an arts-influenced outreach group with a mission to turn kids onto the wonders of neuroscience. Should you decide to attend one of the many NW Noggin outreach events, it’s a good bet Dr. Griesar will be there. Just look for the guy with pipe-cleaner neurons. Credit: Bill Griesar

NW Noggin began as a conversation between Dr. Griesar and Jeff Leake. Leake, a Portland artist who also works at PSU and WSU Vancouver, and Dr. Griesar were trying to figure out what their children could do for the summer.

So they decided to start a volunteer-driven, art-infused neuroscience summer course for middle school students through Multnomah County’s Schools Uniting Neighborhoods program, or SUN.

After planning lessons with students from their PSU and WSU Vancouver classes and using their own children as guinea pigs, Dr. Griesar and Leake found a successful combination.

“No one in that summer SUN program had to attend, and yet we had middle school students back day after day to make art and dissect sheep brains and learn about college and graduate research directly from our volunteers,” said Dr. Griesar.

After seeing how popular art-influenced neuroscience outreach could be, Dr. Griesar and Leake formalized their effort and created the nonprofit Northwest Neuroscience Outreach Group: Growing in Networks, or NW Noggin.

Marrying art and science is part of NW Noggin’s secret sauce. “Arts integration makes learning science personally relevant,” said Dr. Griesar.

“It allows open-ended exploration of scientific concepts, and offers science teachers a broader palette from which they can differentiate their lessons,” added Leake. That successful combination exemplifies the national movement toward STEAM (science, technology, engineering, art and math) education, in which art and design are integrated into traditional STEM curricula.

Now, five years later and thanks in large part to his seemingly limitless enthusiasm, Dr. Griesar estimates that NW Noggin has reached over 12,000 K-12 students. The pipe-cleaner neurons that volunteers build with students have become a hallmark of NW Noggin’s events. These models offer a way for students to conceptualize neuronal structure and understand how neurons function to communicate within the brain. (Plus, they’re an easy way to identify Dr. Griesar in a crowd as he usually has at least one or two in his hands.)

But models aren’t the only thing kids get to handle: NW Noggin events usually feature a real brain for students (and their teachers and parents) to handle. While the squeamish ones shy away, most kids don gloves, hold their noses and wonder at the folds and inner structures of the brains before allowing the next kids in line their turn.

“We’ve definitely tested the longevity of our formalin-fixed specimens!” exclaimed Dr. Griesar.

Presidents, pipe cleaners

On a broader scale, NW Noggin has grown active in science policy. Last October, it was invited to participate in the White House Frontiers Conference in Pittsburgh, Pa., where President Barack Obama encouraged attendees to further U.S. innovation.

PUTTING NOGGINS TOGETHER NW Noggin depends on college and graduate school volunteers to staff its events with multi-layered benefits. “The graduate [students] get teaching experience by mentoring undergrads, the undergrads learn about current research and what grad school is like, and our K-12 kids discover opportunities for education, research and careers they may not have ever considered,” explained Dr. Griesar. Credit: Bill Griesar

PUTTING NOGGINS TOGETHER NW Noggin depends on college and graduate school volunteers to staff its events with multi-layered benefits. “The graduate [students] get teaching experience by mentoring undergrads, the undergrads learn about current research and what grad school is like, and our K-12 kids discover opportunities for education, research and careers they may not have ever considered,” explained Dr. Griesar. Credit: Bill Griesar

A highlight of the trip, said Dr. Griesar, was a brief interaction with the president, who spotted the pipe-cleaner neurons and remarked, “I love those!”

Earlier in 2016, Dr. Griesar, Leake and a group of 26 volunteers traveled to Washington, D.C., to meet with the White House Office of Science & Technology Policy, congressional committees and caucuses. The group discussed why K-12 outreach efforts are important not only to encourage future scientists but also to stoke public appreciation for neuroscience and the value of federal research funding. This fall, NW Noggin hopes to take a larger volunteer group to D.C. to meet with legislators and visit local public schools.

Back in Davenport, volunteers are explaining brain function, answering questions, leading art projects and passing human brains from student to student. “The most rewarding thing about NW Noggin is hearing all the kids’ questions,” said Ph.D. student Scott Jones. “It’s fun to hear what they already know and are excited to learn about.”

After two full days leading sessions that included most of the students in town, the volunteers swap stories over a late lunch. As they compile a list of the questions they received from students, a favorite emerges: “Can you come back next year?”

For more information about NW Noggin, including volunteer accounts and photos of previous outreach events, visit nwnoggin.org.


Rebecca Hood

Rebecca Hood runs experiments as a fourth-year behavioral neuroscience Ph.D. student at OHSU, volunteers for NW Noggin and considers any weekend that includes a campfire a weekend well spent.




This article was originally published in Bridges, a magazine of people, connections and community for alumni of the OHSU School of Medicine.



Taking a seat at the table as an advocate for science

Peter Kalivas, PhD; Christopher Cowan, PhD; Douglas Munoz, PhD; and Mollie Marr (left to right) pause in front of the US Capitol building between meetings with congressmen as part of SfN’s Capitol Hill Day.

Peter Kalivas, Ph.D.; Christopher Cowan, Ph.D.; Douglas Munoz, Ph.D.; and Mollie Marr (left to right) in front of the US Capitol building between meetings with congressmen as part of SfN’s Capitol Hill Day.

Our first meeting on Capitol Hill was in the office of Senator Jeff Merkley.  I was seated across from a staff member with expertise in health policy and next to neuroscience department chairs and researchers with distinguished careers.  Alissa Ortman, Outreach Manager for Society for Neuroscience (SfN), introduced us:

“Here are the neuroscientists.”

The first several times I heard her say it, my stomach dropped. I was there as an Early Career Policy Ambassador and unlike the neuroscientists sitting around the table, I was a first year graduate student with one rotation completed and no idea what I would be studying over the next several years.

I felt completely out of place and out of my depth.  Who am I to sit here and advocate for NIH funding?  What have I done that could possibly qualify me to speak to members of Congress?

“I’m actually just a student,” I clarified when it was my turn to introduce myself. “Who someday hopes to be a neuroscientist.”

After introductions, we went around the table discussing our research and the importance of NIH funding, not only as it related to new discoveries and disease; but also how it impacted local jobs and communities. I did not have concrete research projects to add to the discussion, but I realized I could discuss the role of the NIH in educating future scientists.

Mollie Marr discusses OHSU’s Medical Scientist Training Program with Representative Earl Blumenauer (D-OR 3rd District).

Mollie Marr discusses OHSU’s Medical Scientist Training Program with Representative Earl Blumenauer (D-OR 3rd District).

I talked about Medical Scientist Training Programs (MSTP) like the one I am a part of at OHSU. As an MSTP student, I complete the pre-clinical years of medical school before beginning my PhD coursework. The advantage to this approach is that I enter my PhD program already thinking clinically, my brain primed to make connections between basic science and clinical medicine.

When I eventually return to medical school, after completing my PhD, the opposite will be true—I will be thinking critically about the science underlying the diagnosis and treatment of disease. Ultimately, the goal of MSTP is to create physician-scientists capable of moving between clinical and laboratory settings; using observations and knowledge gained in each area to inform the discovery and delivery of care.

While a loss of funding to these programs might not be felt immediately, the loss of a generation of scientists would have a profound and lasting impact. Science relies on mentorship and apprenticeship, the nurturing and development of future generations; to push the field forward, to build on existing knowledge, to ask deeper questions, and to explore growing complexity. Lost years of training cannot be recovered by an influx of renewed funding even a few years down the line and private industries are not rushing to support educational programs.

U.S. Senator Jeff Merkley (D-OR) and Mollie Marr in Senator Merkley’s office

U.S. Senator Jeff Merkley (D-OR) and Mollie Marr in Senator Merkley’s office.

As I discussed how NIH support impacted me directly as I student, I realized that I did have something to add to the conversation. I was, by far, the least accomplished person sitting at that table, but I was still able to contribute to the conversation.

I share this because I think we often excuse ourselves from participation or advocacy because we do not feel like we possess the right qualifications or experiences. Instead, we defer to people who we believe know more or know better.  I want to challenge that way of thinking.

I want to encourage you to join the conversation and to take a seat at the table.

Participating in SfN’s Capitol Hill Day, I realized that in advocacy, what matters is not your qualifications, but your story—what you have to say. I had a unique perspective that I was able to share and so do you.  It is not worth waiting for someone else to speak on your behalf.  There is no reason for you to give away your power.

 Representative Earl Blumenauer (D-OR 3rd District) and Mollie Marr.

Representative Earl Blumenauer (D-OR 3rd District) and Mollie Marr.

Unfortunately, the fight to protect the future of science is far from over. The President’s Budget Proposal for FY18 calls for drastic cuts to both the NIH (21+%) and NSF (~11%) and I expect future budget proposals to reflect similar cuts.

The good news is that many members of Congress recognize the importance of continuing to support science and education, and they are listening.  We have an incredible opportunity as citizens and scientists to join the conversation.

Take a few moments to share your story with your Senators and Representatives—tell them about your research, your experiences, your hopes for the future; tell them why science matters. Be specific, detailed, and personal.

They need to hear your stories; because when they go to the floor to debate the budget, what sways the audience is not numbers and graphs; but personal stories by constituents who have been directly impacted by NIH-supported research.

The only way they have those personal stories is if someone takes the time to share them. 

I know that there is a desire by the scientific community to stay out of politics, but I believe that the future of science, research, and education is a non-partisan issue.  Within our community, we have generations of experiences, observations, and stories to share.

So pull up a chair and join the conversation. Everyone is welcome (and needed) at the table.

Want to get started?

Remember to make it personal—say why it matters to you.


Mollie Marr is an M.D./Ph.D. student at OHSU. She is currently a first year graduate student in the Department of Behavioral Neuroscience.



New research looks at the influence of race and emotional context on face perception

Reports by some media outlets and community outreach organizations that track and document police violence demonstrate that more than any other demographic group, young black males may be at a particularly heightened risk of fatal police encounters.

The underlying causes for the reported violent interactions between police and black individuals are likely dependent on a number of factors.GettyImages-490545544

To shed light on the issue, one approach taken by psychologists and neuroscientists has been to investigate potential behavioral and intrinsic brain-based biases when perceiving black vs. white faces.

One notable study (B. Keith Payne, 2001) reports that brief displays of black vs white faces as racial cues can actually “prime” a quicker response to weapons or items of danger.

The same manipulation increases misidentification of tools as weapons for black, relative to white, face cues. This occurs even if the face cue was flashed so quickly that the participant doesn’t even know it was there.

These findings point to race as an important construct that drives perception, which may, at least in part, drive the actions taken by law enforcement.

Our research asks an additional question. Are these types of relationships dependent, or even enhanced, based on the emotional state of the subject making quick decisions?

To investigate the effects of race and emotional context on face perception, our study used black and white faces as stimuli in a functional MRI task (emotional go/no-go task) designed to study impulse control in black and white young adults.

Three emotional contexts were induced in participants: rewarding, threatening, or neutral contexts.

Behaviorally, participants exhibited greater impulsive actions (more false alarms) to black faces, which was enhanced in threat contexts. This finding was paralleled in the brain. Brain patterns revealed increased functional MRI activity for black faces in threatening contexts, as opposed to few face differences in neutral and rewarding contexts.

Our results demonstrate the importance of emotional context as an important factor that influences race perception, and subsequent decision-making. Such findings should assist in ongoing efforts to increase awareness of race disparities in law enforcement and ultimately a reduction in preventable violent encounters.


Binyam Nardos
Binyam Nardos is a post-doctoral researcher with Dr. Damien Fair in Behavioral Neuroscience. His research uses behavioral and functional MRI techniques to understand how face perception is influenced by race and socioemotional context.



This research was funded by the John D. and Catherine T. MacArthur Foundation Research Network on Law and Neuroscience.

A manuscript with our findings is in preparation and includes the following authors.

Nardos, B.2, Rubien-Thomas, E.1,  Cohen, A.O.8, Schifsky, E.E. 2, Li, A.3, Cervera, A.1, Lowery, A.1, Dellarco, D.V.4, Rheinschmidt-Same, M.5, Daumeyer, N.1, Camp, N.6, Hughes, B.L.9, Taylor-Thompson, K.A.7, Eberhardt, J.L.6, Fair, D.A.2, Richeson, J.A.1, Casey, BJ1,3, and Fair, DA2

1Department of Psychology, Yale University, New Haven, CT; 2Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR; 3Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, NY; 4Department of Psychology, University of Miami, Miami, FL; 5Department of Psychology, Northwestern University, Chicago, IL; 5Department of Psychology, Northwestern University, Chicago, IL; 6Department of Psychology, Stanford University, Palo Alto, CA; 7New York University School of Law, New York, NY, 8Department of Psychology, New York University, New York, NY, 9Department of Psychology, University of California Riverside, Riverside, CA

Celebrating our ROSE Award winners

_DSC6098We’ve all experienced those magical moments when someone makes your day – by treating you like family, by looking out for your well-being, by making that extra effort that transforms a small act into a big difference.

OHSU’s ROSE Award honors these experiences and celebrates the exceptional acts of service excellence that make our workplace a community.

We recognize these individuals for providing acts of compassion, dedication, tenacity, generosity, communication, and leadership, among others.

The most recent awards ceremony honored two groups within the neurosciences. Please join us in congratulating these groups and help us thank them for going above and beyond.

Read the winning ROSE Award nominations below:

Karen Chiang and Lisa Ledsworth, 7C Neurosciences ICU

Lisa and Karin demonstrated excellent teamwork and excellent nursing care in helping me with my assigned patient, who was very delirious, impulsive and feeling frustrated with being stuck in the Neurosciences ICU (NSICU) for so long.

Lisa was the charge RN and Karin was the stroke response RN. The unit was very busy that day with a lot of post-operative patients, but they still made the time to set my patient up in the nursing station with a little activity table, complete with coloring pages and pens.Untitled-2

When this patient was feeling upset later on, they used patient, kind therapeutic communication and really created safe space for a patient who wasn’t feeling very safe in the moment.

Sometimes on those busy days in the ICU, these crucial holistic nursing interventions aren’t prioritized, but Lisa and Karin showed that even on busy days we can all work together to create a caring environment.

Nicole Fleming, Sylvia Salazar, and Dara Wasserman, Neurology

Nicole Fleming OHSU and Sharon Yip translating_Asian Health and Service Lecture_Cantonese Senior Group_4-11-2017In April, Research Associates, Dara Wasserman, Nicole Fleming and Sylvia Salazar provided eight lectures on brain health and dementia to 263 community-dwelling Asian older adults through a new partnership with the Asian Health & Service Center.

Lectures were translated into Cantonese, Korean, Mandarin and Vietnamese.

This community learned about the work of the OHSU Layton Aging & Alzheimer’s Disease Center and the brain, including different types of memory and what is considered “normal aging” and what may be dementia.

The Layton Center team discussed signs and symptoms of the disease, offered tips for talking to doctors and what patients should expect at a dementia screening appointment.

The Asian Health & Service Center noted that this education was important for a few reasons:

  • In Oregon, as of 2015, Asians had the second-highest rate of mortality among all ethnicities for Alzheimer’s disease and dementia.
  • As a group, Asian-Americans have a longer life expectancy compared to other groups, which raises the risk for age-related conditions such as Alzheimer’s.
  • Finally, some Asian-American community members see signs of dementia as part of the natural aging process and therefore opt against seeking treatment that could help them.

The research associates’ effort was a great example of the way OHSU serves the community by literally translating the amazing work we do, and the knowledge we have.

Nominate an employee, student or volunteer for a ROSE Award. Printed nomination forms are also available in reception areas on our campuses.

A strong neuroscience program is about to get stronger—meet leaders and researchers at the forefront

CROET head

Photo by Aaron Bieleck

Today, neuroscience at OHSU is poised for dramatic growth, driven by emerging areas of research strength in the fields of neurodevelopment and neurodegeneration and a planned investment of at least $100 million.

Led by long-time campus leaders and new luminaries, the university is doubling down on its quest: contribute in a major way to understanding the mystery between our ears and, above all, improve brain health.

On the faculty since 1982, Dennis Bourdette, M.D., F.A.A.N., chairs neurology in the OHSU School of Medicine. He is nationally recognized for important discoveries in multiple sclerosis, directing a team dedicated to curing and treating M.S.

Last year, OHSU selected neurobiologist Marc Freeman, Ph.D., to serve as the latest director of the Vollum Institute. A former Howard Hughes Medical Institute investigator, Dr. Freeman’s lab first described the gene responsible for driving the degeneration of axons after brain injury.

On the faculty since 1981, George Keepers, M.D., chairs psychiatry in the OHSU School of Medicine. He was instrumental in establishing Oregon’s first dedicated emergency psychiatric facility, the Unity Center for Behavioral Health.

The school recruited Bita Moghaddam, Ph.D., from the University of Pittsburgh last year to chair behavioral neuroscience. Dr. Moghaddam has made significant contributions to the study of the cellular basis of cognitive constructs critical to psychiatric disorders, such as schizophrenia.

On the faculty since 2000, Nathan Selden, M.D., Ph.D., chairs neurological surgery in the OHSU School of Medicine. He performed the first transplantation of neuronal stem cells in a human patient and built neurosurgery’s graduate medical education program into a national model.

This group of five will guide OHSU’s growth and investment in neuroscience. First up, an example of promising research in neurodevelopment.


Dr. Bonnie Nagel in the control room at OHSU’s Advanced Imaging Research Center. (Photo by Michael McDermott)

Adolescent ABC’s
Can you understand the mind of a teenager? That rhetorical question posed by exasperated adults across the ages may actually get answered, thanks to a large, groundbreaking study dubbed ABCD or Adolescent Brain Cognitive Development. Established in 2015, it’s an NIH-led examination of more than 10,000 adolescents across the U.S. The unprecedented 10-year effort is tracking the biological and behavioral development of youth ages 9 through young adulthood.

Hundreds of scientists applied to run the study. NIH tapped OHSU to be one of 21 research sites nationally. The OHSU site is co-led by Bonnie Nagel, Ph.D., associate professor of psychiatry and behavioral neuroscience, OHSU School of Medicine.

Teenagers, science tells us, are prone to depression and high-risk, sensation-seeking behaviors. Why do some develop poor outcomes while others don’t? What is a normal teenage brain?

Since her earliest days in science, Dr. Nagel has studied adolescent brain development. “It’s stunning how little we know about this time of extraordinary growth,” she said. “It’s difficult to understand pathology if we don’t know a baseline for normal development. The size and scope of this study will change that.”

Dr. Nagel’s own 8-year-old daughter will be well into her teens by the time the study concludes. By then, Dr. Nagel hopes answers about risk and resilience can transform treatments, helping adolescents chart a positive path to adulthood. It’s just one example of OHSU researchers pushing the frontier of neurodevelopment knowledge.

“A very open question”
On the other side of the spectrum is neurodegeneration. Here, too, a growing body of OHSU research is making its mark on the field.

In the Jungers Center for Neurosciences Research, scientists pursue translational research with a laser focus on disease. Over the last decade, the center has hired promising new faculty like clinician-scientist Vivek Unni, M.D., Ph.D., assistant professor of neurology, OHSU School of Medicine.

Ever since his medical school days at Columbia University, Dr. Unni has enjoyed caring for older people. When he’s not in clinic seeing patients with Parkinson’s disease and other movement disorders, he’s studying neurons in his Jungers lab.

Dr. Unni and his team have already made a name for themselves developing a one-of-a-kind method that allows scientists to longitudinally study individual neurons in a Parkinson’s disease mouse model, greatly condensing the time it takes to observe the disease.

Now, he and his team are boring into a key question: Why does a certain protein called alpha-synuclein clump or aggregate during the onset of Parkinson’s and other neurodegenerative disorders?

“Is it damaging or protecting the cell? Is it neutral?” asked Dr. Unni. “It might be critical to the disease, but we don’t know. It’s still a very open question.”

Any new treatment strategy, he says, could easily make people worse rather than better if the basic biology isn’t understood. So although he wishes for a quickie drug to help his patients, Dr. Unni devotes the time it takes to test emerging knowledge at the bench, in order to maximize the chances of a new drug actually working.

“I love thinking about the brain,” said Dr. Unni. “And I love the opportunity to use that knowledge to make things better for people.”


Written by Rachel Shafer, OHSU School of Medicine


This article was originally published in Bridges, a magazine of people, connections and community for alumni of the OHSU School of Medicine.

Meet Patricia O’Shea, Brain Resource Center volunteer

Patricia O'Shea

Patricia O’Shea, Brain Resource Center volunteer

It’s Volunteer Week here at OHSU. This interview was originally published in 2015, but Patricia O’ Shea is still here and going strong!

She has been volunteering since 2010 and as of April 2017 has put in over 820 hours of volunteer time.

Thank you so much for your continued dedication!

Patricia O’Shea volunteers at our Brain Resource Center and is an active member of our Brain Research Awareness and Information Network (BRAINet).

Why did you become a volunteer for OHSU?

I attended some of the first Brain Awareness events, back when they were held at OMSI.

I’ve always been a very curious person with a strong interest in neuroscience.

I started out volunteering at the OHSU Brain Fair and then became a member of BRAINet, eventually landing here at the resource center.

How long have you volunteered in this position?

I am in my fifth year as a volunteer. There are currently two of us and we could use one more. I work about 4-6 hours per week. It keeps me feeling useful, productive and I’m exposed to a wide circle of very interesting people.

What does your position entail?

I maintain the free resources for OHSU patients regarding various neurological conditions. I always jump up to help patients with whatever they need that day. Sometimes, I’m helping facilitate and orient them to where they can learn more about their condition. I can help explain their condition, but I never give medical advice.

Other times, I’m helping out-of-town visitors get around Portland. I talk to everyone, human-to-human, and help where I can, even if it’s just finding someone a glass of water.

What’s the best thing about being a volunteer?

It’s a very exciting time in brain development research. There are incredible advancements that have been made in imaging techniques and other research that may inform the development of targeted therapies. Researchers are chipping away at finding the underlying causes of various brain disorders. People should feel very hopeful.

The Brain Resource Center is located on the 8th floor of the Center for Health and Healing. 

April Spotlight: Neuroradiology and the fMRI exam

April is host to Neurodiagnostic Week, a time to honor and celebrate the contributions of our neurodiagnostic professionals.

Our Neuroradiology department is an integral part of the diagnostic evaluation process and collaborates with all OHSU clinical and medical teams including but not limited to neurosurgery, interventional neuroradiology, ENT surgery, orthopedic surgery, and vascular surgery.

One of the most advanced techniques we use is a functional magnetic resonance imaging (fMRI) exam. This exam is tailored to the location of the brain lesion, regions of clinical concern, and the normal brain adjacent to it.axial fmri and dti

The goal is to allow the neurosurgeon or clinician to plan the optimal, least invasive approach, and to allow the surgeon to more completely excise a mass or portion of the brain while preserving as much normal function as possible.

How it works:.

Functional MRI is based on changes in blood flow to regions of the brain associated with an activity.

For example, when you move your fingers, the neurons in your brain that tell your finger to move need more oxygenated blood and the body delivers more blood to these cells.

The MRI scanner can measure these very small changes in blood flow and display them on an image. The test is designed to evaluate different tasks such as tapping your fingers or reading/thinking of words.

These tasks allow the MRI to identify these critical areas of the brain cortex before surgery. To identify the “wiring of the brain” or the connections between the cortex and your extremities, we use a technique called diffusion tensor imaging (DTI).

3d dtiThis complex MRI sequence allows visualization of the white matter of the brain and shows where regions of the brain are connected.

The fMRI and DTI images are then incorporated together into the operating room so the neurosurgeon can navigate around these critical areas and perform the surgery without damaging these areas.

An fMRI is often indicated for presurgical planning for many conditions including but not limited to epilepsy and brain tumors.

fMRI allows a patient to better understand the potential risks of having surgery. Many studies have shown reduced morbidity and increased survival rates in patients who have had preoperative fMRI.

I started the current fMRI program in 2008 when I arrived at OHSU from Wake Forest University. In the beginning of the program, all the fMRI exams were audio based. Patients would have to listen to words being read to them while in the scanner.

While the fMRI was often successful, the MRI environment is quite loud so some patients had difficulty hearing the words. The potential of the technology was still demonstrated and many patients had great results.

OHSU realized the potential and made significant investments in hardware and software which allowed patients to see the fMRI data with a large MRI compatible LCD monitor.

Now patients will silently read words or follow instructions on the screen to move their fingers. The visual based fMRI system has allowed many more patients to benefit from the technology. In addition to the hardware upgrade, the new software allowed for seamless integration of the fMRI and DTI data into the surgical environment.

Over 300 patients have since been successfully scanned making OHSU one of the most active fMRI programs on the west coast.

What do our providers have to say about this technology?

“There is no doubt that fMRI has revolutionized our approach to patients with a number of brain conditions.

  1.  Notably, fMRI has allowed a much less invasive and specific evaluation of hemispheric dominance for language which in years past required cerebral arteriography and Wada testing.
  2.  fMRI brain mapping has now completely changed epilepsy surgery and tumor surgery such that the surgeon is now armed with knowledge of the discrete functional areas adjacent to tumors or epileptogenic foci.
  3.  DTI has facilitated tumor surgery by allowing the surgeon to avoid vital tracts.
  4.  DTI has allowed us to begin to understand the behavior of implanted brain electrodes (DBS) with respect to dense fiber tracts such as the internal capsule.

Having been here for almost twenty years before this project was instituted, I could see in 2007 how far fMRI had to go to be to even be on a par with other academic medical centers in the area of functional imaging.  To now be in the forefront of this field on the west coast shows how much has been accomplished.  I am very thankful that we have come so far.”

Dr. Kim Burchiel is an OHSU neurosurgeon and pioneer in deep brain stimulation surgery.

Kim J. Burchiel, M.D., F.A.C.S.

John Raaf Professor and Head
Division of Functional Neurosurgery
Department of Neurological Surgery
Professor, Dept. of Anesthesiology and Perioperative Medicine

“Recent AAN guidelines for use of fMRI in epilepsy surgery evaluation will lead to increased utilization of this technology (and fewer Wada tests).”



David Spencer, M.D.
Director, Comprehensive Epilepsy Center




“fMRI is crucial to delivering the most advanced neurosurgical care in the world, curing disease while preserving function. As part of our new intra-operative MRI brain surgery program at OHSU, we can now bring functional MRI into the operating room itself, offering the most powerful capabilities to the patients who need our advanced care.”


Nathan R. Selden, M.D., Ph.D., F.A.C.S, F.A.A.P.
Campagna Professor and Chair of the OHSU Department of Neurological Surgery.




The Neuroradiology section of Diagnostic Radiology offers a full range of state of the art computed tomography (CT) and magnetic resonance imaging (MRI) services for the neuroaxis including the brain, spinal cord, skull, orbits, sinuses, temporal bone, and neck of the adult and pediatric patient. 




Jeffrey M. Pollock, M.D. is an Associate Professor of Radiology




Interested in seeing more images from our neurodiagnostic technicians as well as other examples of #neuroart?
Follow @ohsu_brain on Instagram.

Parkinson’s patient worried about DBS surgery — but not about the team at OHSU

Dr. Kim Burchiel is an OHSU neurosurgeon and pioneer in deep brain stimulation surgery.

Dr. Kim Burchiel is an OHSU neurosurgeon and pioneer in deep brain stimulation surgery.

Marilee Thompson worried about having surgery to treat her Parkinson’s disease.

She knew the risks of deep brain stimulation surgery were low, she said, but “somebody makes up the statistics” on the few who have complications.

What she didn’t worry about was the surgical team at OHSU.

Thompson knew that Dr. Kim Burchiel, an OHSU neurosurgeon, had been doing deep brain stimulation for a long time. He was the first doctor in the U.S. to treat a patient with DBS, back in 1991, and he’s done it more than 1,000 times since then.

“I had great confidence in Dr. Burchiel because he was part of it so early on and had so much experience,” said Thompson, now 73.

Thompson was considering DBS because, a decade after her diagnosis with Parkinson’s, a progressive brain illness, she was tired of managing symptoms with medication alone. As medication took effect and wore off, she seesawed between having difficulty walking and having useless hands. Even timing a trip to the store became a chore.

Finally, the Beaverton resident thought: “I’m never going to be better than I am today. Can I live with that the rest of my life, maybe 20 or more years? And I just said, ‘No, I couldn’t.’”

* * *

Burchiel studied DBS in France under the neurosurgeon who developed it, Dr. Alim-Louis Benabid, then brought it to the U.S. DBS involves placing tiny electrodes in parts of the brain that control movement, then connecting them to a pacemaker-like device implanted in the chest. For 20 years, patients had to be awake during surgery because the surgeon needed responses from the patient to make sure the electrodes were in the right spots.

YouTube Preview ImageIn 2011, Burchiel became a DBS pioneer in his own right by developing “asleep” DBS. He uses MRI and CT scans to place the electrodes while the patient is under general anesthesia. An OHSU study confirmed the new technique’s precision, and “results have been amazingly good,” Burchiel said. He loves seeing grateful patients after “we’ve effectively turned the clock back” on their symptoms.

“Being able to participate in the development of this procedure means everything to me,” he said. “This is my legacy, to a large degree.”

* * *

Burchiel doesn’t work alone, however. DBS patients at OHSU receive coordinated care from a team of specialists in the nationally recognized Parkinson’s Disease and Movement Disorders Program. The team includes experts in speech therapy, physical therapy, psychology and neurology. Dr. Matthew Brodsky, the medical director of OHSU’s DBS program, is a neurologist who has lectured on Parkinson’s around the world.

“Teamwork is absolutely crucial to this,” Burchiel said. “Other people can do the surgeries that we do. There are other good neurologists in the country. But the fact is, when you put it all together and you have a team that’s been working together for 20 or more years, you really have something special.”

* * *

Marilee Thompson decided to go ahead with DBS at OHSU seven years ago. She’s glad she did.

“I can do so much more and feel so much better,” she said. She still takes medication to manage symptoms, and she’s starting to think about moving from her two-story, 2,500-square-foot home. For now, Thompson, a widow, manages her home and quarter-acre yard with some hired help.

But she also just returned from a two-week trip to Africa — the only continent she hadn’t visited — to see wildlife in Uganda with her sister and the Audubon Society of Portland. “I did everything everyone else did,” she said, including managing steep terrain with only walking sticks.

DBS, she said, enables her to live how she wants. “My outlook on life is just really positive.”

Learn more about DBS, Dr. Kim Burchiel and the care at OHSU on our DBS website.

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