Susan Hayflick, MD

Professor and Chair

Susan Hayflick


Brain iron accumulates in many human neurodegenerative disorders, including Parkinson disease, Alzheimer disease, multiple sclerosis, and HIV encephalopathy. To investigate brain iron dyshomeostasis, we study a group of rare, single gene disorders, called Neurodegeneration with Brain Iron Accumulation (NBIA). We have identified five disease genes that underlie specific forms of NBIA. These genes encode mitochondrial proteins that are important for fatty acid metabolism, and mutations in any of these leads to a distinctive pattern of neurodegeneration and high levels of basal ganglia iron. Animal models of disease have been developed to serve as a resource for genetic, biochemical, radiographic, electrophysiological, and clinical studies. We also work with human subjects to advance understanding of disease pathogenesis since the essential features of NBIA have not been recapitulated in animal models. Much of the success of our work has depended on close and highly valued collaborations with scientists at OHSU and at other academic institutions in the US, UK, Netherlands, Italy, Japan, Australia, Canada, Dominican Republic, Spain, Portugal, France, Belgium, Poland, India, Israel and Germany.

Dr. Hayflick is part of an international consortium of scientists that has been awarded a 5.2 million euro grant to study NBIA. Read the TIRCON press release.


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Neurodegeneration with Brain Iron Accumulation Disorders Overview


1.   Hayflick SJ. Defective pantothenate metabolism and neurodegeneration. Biochemical Society
Transactions. 2014 Aug 1:42(4):1063-8. PMID: 25110003 [PubMed - in process]

2.   Gregory A &Hayflick SJ:Neurodegeneration with Brain Iron Accumulation Disorders Overview in:
GeneReviews at GeneTests: Medical Genetics Information Resource [database online]. Copyright, University of Washington, Seattle, 1997-2015. Available at

 3.   Hayflick SJ, Kruer MC, Gregory A, Haack TB, Kurian MA, Houlden HH, Anderson J, Boddaert N, Sanford L, Harik SI, Dandu VH, Nardocci N, Zorzi G, Dunaway T, Tarnopolsky M, Skinner S, Frucht S, Hanspal E, Schrander-Stumpel C, Mignot C, Héron D, Saunders DE, Kaminska M, Lin JP, Lascelles K, Cuno SM, Meyer E, Garavaglia B, Bhatia K, de Silva R, Crisp S, Lunt P, Hardy J, Meitinger T, Prokisch H, Hogarth P. BPAN: a new X-linked dominant disorder with brain iron accumulation. 2013. Brain 2013 Jun;136(Pt 6):1708-17. PMCID: PMC3673459

 4.   Hogarth P, Gregory A, Kruer MC, Sanford L, Wagoner W, Natowicz M, Egel RT, Subramony SH, Goldman J, Berry-Kravis E, Foulds NC, Desguerre I, Rodriguez D, Wilson C, Diedrich A, Green S, Tran H, Reese L, Woltjer R, and Hayflick SJ. New NBIA subtype: genetic, clinical, pathologic, and radiographic features of MPAN. Neurology 2013 Jan 15;80(3):268-75. PMID: 23269600 PMCID: PMC3589182

 5.   Haack TB, Hogarth P, Kruer MC, Gregory A, Wieland T, Schwarzmayr T, Graf E, Sanford L, Meyer E, Kara E, Cuno SM, Harik SI, Dandu VH, Nardocci N, Zorzi G, Dunaway T, Tarnopolsky M, Skinner S, Frucht S, Hanspal E, Schrander-Stumpel C, Héron D, Mignot C, Garavaglia B, Bhatia K, Hardy J, Strom TM, Boddaert N, Houlden HH, Kurian MA, Meitinger T, Prokisch H, Hayflick SJ. Exome sequencing reveals de novo mutations in WDR45 causing a phenotypically distinct, X-linked dominant form of NBIA. 2012 Am J Hum Genet. Dec 7;91(6):1144-9 PMID:23176820 PMCID:PMC3516593

 6.   Kruer MC, Hiken M, Gregory A, Malandrini A, Clark D, Hogarth P, Grafe M, Hayflick SJ and Woltjer RL. Novel histopathologic findings in molecularly-confirmed pantothenate kinase-associated neurodegeneration (PKAN). Brain 2011 Apr;134(Pt 4):947-58. PMCID: PMC3105492.

 7.   Kruer MC, Paisán-Ruiz C, Boddaert N, Yoon MY, Hama H, Gregory A, Malandrini A, Woltjer RL, Munnich A, Polster BJ,
Palmeri S, Edvardson S, Hardy J, Houlden HH, Hayflick SJ. Defective fatty acid-2 hydroxylase leads to a novel form of NBIA. Annals of Neurology 2010 Nov 68(5):611-8. PMID: 20853438.

 8.   Rana A, Seinen E, Siudeja K, Muntendam R, SrinivasanB, van der Want JJ, Hayflick SJ, Reijngoud D-J, Kayser O and Sibon OCM. Pantethine rescues a Drosophila model for pantothenate kinase-associated neurodegeneration. Proceedings of the National Academy of Sciences 2010 Apr 13, 107(15):6988-9. PMCID: PMC2872433

9.   Gregory A, Westaway SK, Holm IE, Kotzbauer PT, Hogarth P, Sonek S, Coryell JC, Nguyen TM, Nardocci N, Zorzi G,
Todriguez D, Desguerre I, Bertini E, Simonati A, Levinson B, Dias C, Barbot C, Carrilho I, Santos M, Malik I, Gitschier J, Hayflick SJ. Neurodegeneration associated with genetic defects in phospholipase A2. Neurology 2008 71 18):1402-9 PMCID: PMC2676964

10. Morgan NV, Westaway SK, Morton JEV, Gregory A, Gissen P, Sonek S, Cangul H, Coryell JC, Canham N, Nardocci N, Zorzi G, Pasha S, Rodriguez D, Desguerre I, Mubaidin A, Bertini E, Trembath RC, Simonati A, Schanen C, Johnson CA, Levinson B, Woods CG, Wilmot B, Kramer P, Gitschier J, Maher ER, Hayflick SJ. The calcium-independent phospholipase A2 gene, PLA2G6, is mutated in a spectrum of childhood neurodegenerative disorders with high brain iron. Nature Genetics 2006 38(7):752-4 PMCID:PMC2117328

11. Kuo Y-M, Duncan J, Westaway SK, Yang H, Nune G, Xu EY, Hayflick SJ, Gitschier J. Deficiency of pantothenate kinase 2 in a mouse model for Hallervorden-Spatz syndrome leads to retinal degeneration and azoospermia. Human Molecular Genetics 2005 14(1):49-57 PMCID: PMC2117329

12. Johnson MA, Kuo YM Westaway SK, Parker SM, Gitschier J, Hayflick SJ. Mitochondrial localization of human PANK2 and hypotheses of secondary iron accumulation in pantothenate kinase-associated neurodegeneration. Annals of the New York Academy of Sciences 2004 1012:282-298 PMID: 15105273 

13. Hayflick SJ, Westaway SK, Levinson B, Zhou B, Johnson MA, Ching KHL, Gitschier J. Genetic, clinical and radiographic delineation of Hallervorden Spatz syndrome. New England Journal of Medicine 2003 348(1):33-40 PMID: 12510040

14. Ching KHL, Westaway SK, Gitschier J, Higgins JJ, Hayflick SJ. HARP syndrome is allelic with pantothenate kinase associated neurodegeneration. Neurology 2002 58(11):1673-4 PMID: 12058097