2024 Department of Neurology Annual Report : simplebooklet.com

2024 Annual Report IU School of Medicine Department of Neurology2Communications Manager: Ben Middelkamp Designer: Stephanie JohnsonPhotographer: Tim Yates TABLE OF CONTENTSLETTER FROM THE CHAIR ................................................. 3DEPARTMENT NEWSDepartment News .......................................................... 5New Faculty Members ...................................................... 8 CLINICAL CAREBrain Health Program ...................................................... 10Telestroke Pilot ........................................................... 12 Neuro-oncology ........................................................... 14 New MEG Technology at Riley .............................................. 16 RESEARCHILEADS Expansion ........................................................ 18Wilcock ARIA Grant and Research ........................................... 20 Niacin Alzheimer’s Basic Finding Leads to Clinical Trial ........................ 22 MINT Registry ............................................................ 24EDUCATIONFellowships ............................................................... 26 Neurology Residents and Fellows ........................................... 28 FACULTY ............................................................... 29 PHILANTHROPY ......................................................... 30

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IU School of Medicine Department of Neurology 2024 Annual Report 3Colleagues,This past year has been another strong one for the Department of Neurology at the Indiana University School of Medicine. We have continued to build on our strengths in clinical care, education and research with outstanding faculty and residents. Our nationally recognized clinical and research expertise is key to the department’s ongoing growth.Several notable events occurred in 2024. Our dementia bench-to-bedside research program caught the attention of the Gates Venture team and resulted in a visit from Microsoft co-founder Bill Gates. We had notable outside speakers for several conferences, including National Institutes of Neurological Disorders leader Richard Benson, MD, PhD, for our engagement and inclusion lecture and Je Saver, MD, as keynote for the Long Family Invitational Lecture and Annual Cerebrovascular Diseases Symposium. The department has welcomed seven new faculty members in research and clinical care over the past year, bringing the total number to 92. In addition to a strong general adult and child neurology program, specialties represented in our department include epilepsy, dementia, headache, movement disorders, multiple sclerosis and neuroimmunology, neuroinfectious disease, neuromuscular disorders, neuro-oncology, neurotoxicology, sleep disorders and stroke.Our multi-disciplinary and complex care clinics include the care of patients with primary brain tumors, brain metastatic disease, neuromuscular disorders, Huntington’s disease and Parkinson’s disease. Other clinical highlights include launching a telestroke pilot to assist the critical access hospitals across our health system and a brain health program to treat patients with new Alzheimer’s disease therapeutics.Several of our faculty experts lead multi-center research programs, including in Alzheimer’s disease and related dementia as well as neurointerventional care. The director for the Center of Neuro-oncology in the IU School of Medicine-IU Health Neuroscience Institute was recruited in 2024 to grow neuro-oncology basic science clinical research.Training for residents and fellows expanded with new fellowships in neuroimmunology, neuro-ophthalmology — kindly funded through philanthropy — and vascular neurology. Our clinical trials numbers continue to increase in both depth and breadth, allowing us to oer our community access to cutting-edge research and clinical care in neurologic disorders.As we continue our care of and research into neurological disorders that aect people across the lifespan, we hope you enjoy reading some 2024 highlights in this annual report. Thank you for your support and dedication to the Department of Neurology as we keep growing and innovating our clinical care, research and education mission.Sincerely,Laurie Gutmann, MDChair, Department of NeurologyCo-director, IU School of Medicine-IU Health Neuroscience InstituteLETTER FROM THE CHAIRLaurie Gutmann, MDChair, Department of NeurologyCo-director, IU School of Medicine- IU Health Neuroscience Institute

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IU School of Medicine Department of Neurology 2024 Annual Report 5Bill Gates visits the IU School of Medicine to learn about Alzheimer’s disease research programsIU School of Medicine NewsroomPulling on a white lab coat and protective gloves, Bill Gates was ready to get a hands-on feel for some of the most leading-edge Alzheimer’s disease research happening in the world.The co-founder of Microsoft spent an afternoon in August 2024 touring labs at the IU School of Medicine and meeting with key faculty members, looking to learn more about the sweeping scope of the Alzheimer’s disease research taking place in Indianapolis.The comprehensive approach to Alzheimer’s research — paired with the IU School of Medicine’s deep roots of collaboration with industry leaders like Eli Lilly and Company and the Indiana Biosciences Research Institute, along with its health system partner IU Health — was what drew Gates to visit the medical school’s Indianapolis campus. A leading global health philanthropist, Gates has set his sights on Alzheimer’s disease.Gates met with key members of the Department of Neurology faculty — Jared Brosch, MD; Je Dage, PhD; Donna Wilcock, PhD; and Dustin Hammers, PhD — to learn more about their work in research and treatment of patients with Alzheimer’s disease and related dementias. The department spearheads biomarker research, several clinical trials in Alzheimer’s disease and a new brain health program advancing new therapies for the disease.More than 6.7 million Americans are living with Alzheimer’s disease or related dementias, with millions more worldwide. The IU School of Medicine has more than 100 faculty experts focused on researching these diseases, supported by $87 million in funding from the National Institutes of Health. These experts work collaboratively across disciplines and focus areas, ranging from basic science to translational research, from drug development to delivery of care.DEPARTMENT NEWSBill Gates, the co-founder of Microsoft (left) meets with Tatiana Foroud, PhD, executive associate dean for research aairs at the IU School of Medicine, (center) and Je Dage, PhD, senior research professor of neurology (right), during a visit Gates made to the school to learn about the comprehensive Alzheimer’s research program.

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2024 Annual Report IU School of Medicine Department of Neurology6Kincaid named an inspirational educator John C. Kincaid, MD, the Kenneth L. and Selma G. Earnest Professor of Neurology, was awarded an Inspirational Educator Award from the IU School of Medicine for professors teaching more than 10 years at the university.Kincaid began his tenure in Department of Neurology in 1980 when he set up an electromyography (EMG) lab at IU. He embarked on his professional medical journey at the IU School of Medicine in the early 1970s, where he completed his medical degree, internship and neurology residency. During his second year of residency, the chair of the department of neurology at the time recognized a need for someone with specialized fellowship-level training in EMG. Encouraged by the chair, Kincaid pursued a fellowship in EMG at Mayo Graduate School of Medicine in Rochester, Minnesota, then returned to his roots in Indiana and dedicated his career to the advancement of neuromuscular disorders and electrodiagnostic medicine. Kincaid continues to serve as an attending neurologist for patients with neuromuscular disorders; is in the EMG lab each week; and is involved with education of medical students, neurology and physical medicine and rehabilitation residents, and neurophysiology fellows. He also enjoys educating students about Indiana history and geography.John C. Kincaid, MD, (right) receives an inspirational educator award from the IU School of Medicine at the 2024 Fall All School Meeting. Laurie Gutmann, MD, chair of the Department of Neurology (left) joined Kincaid in support at the meeting.Teaching award winners Robert Blake, MD, and Derryl Miller, MD, assistant professors of clinical neurology, received the Bhuwan P. Garg Teaching Award. The award is given to child neurology faculty who receive the most votes by the senior residency class.Alex Karel, MD, assistant professor of neurology practice, received the John Kincaid Teaching Award. The award is given to an adult neurology faculty member who receives the most votes by the senior residency class.Isaac Lamb, MD, PGY3 for Neurology, received the Joanne Wojcieszek Teaching Award. The award is given to a neurology resident who receives the most votes by the third-year clerkship students.Robert Blake, MDAlex Karel, MDDerryl Miller, MDIsaac Lamb, MD

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IU School of Medicine Department of Neurology 2024 Annual Report 7Gutmann receives distinguished alumni awardLong Lecture features expert in brain healthThe 2024 Department of Neurology Long Family Invitational Lecture and Annual Cerebrovascular Diseases Symposium welcomed Je Saver, MD, a distinguished professor and the Carol and James Collins Chair of the Department of Neurology at the UCLA David Geen School of Medicine. Saver, who is also the director of the UCLA Stroke and Vascular Neurology Program, is a behavioral/cognitive and vascular neurologist dedicated to improving brain health through research advances and clinical care. His major research interests are the neurocognitive consequences of brain vascular disease, acute stroke treatment, stroke prevention, brain imaging, and clinical trial design. Saver is a profound researcher and has served as the principal investigator of multiple National Institutes of Health and other national trials.The annual lectureship also features talks about the latest advances in vascular neurology at the IU School of Medicine from faculty leaders in the department.Je Saver, MD, (third from left) presented at the annual Long Lecture, where he spoke about his expertise in brain health and vascular neurology to department faulty and trainees.West Virginia University School of MedicineLaurie Gutmann, MD, chair of the Department of Neurology, was named the 2024 Distinguished Alumnus from the West Virginia University School of Medicine.Gutmann earned her medical degree from the West Virginia University School of Medicine in 1986, and she served as her class president at the medical school. Gutmann’s neurology residency and neuromuscular fellowship at University of Virginia established her clinical skills and her interest in clinical research. In 1993, Gutmann joined the West Virginia University School of Medicine Department of Neurology. During her 20 years as faculty, she was the clinical neurophysiology fellowship director, the neurology residency program director and developed the department’s clinical research program. Establishing the ALS clinic was an early accomplishment for Gutmann. She also served as director of the university’s comprehensive stroke center, bringing together basic, translational, and clinical scientists to provide more clinical research in stroke.In 2013, Gutmann joined the Department of Neurology faculty at the University of Iowa to become the vice chair of clinical research. In 2020, she became chair of the Department of Neurology at the IU School of Medicine, where she also serves as the co-director of the IU School of Medicine-IU Health Neuroscience Institute.Laurie Gutmann, MD, (third from left) receives the 2024 Distinguished Alumnus from the West Virginia University School of Medicine.

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2024 Annual Report IU School of Medicine Department of Neurology8Ashley Miller, DOAssistant Professor of Clinical NeurologyDr. Miller is an adult neurologist who specializes in pediatric and adult headache medicine. She earned her medical degree at Des Moines University in 2019 and completed an adult neurology residency at IU School of Medicine in 2023, followed by a fellowship at the University of Texas Southwestern Medical Center in 2024. Dr. Miller practices predominantly at Eskenazi Hospital, and her clinical and research interests are in trigeminal autonomic cephalalgias and women’s health.Lisa Nobel, MD, PhDAssistant Professor of Clinical NeurologyDr. Nobel specializes in vascular neurology. She earned an MD/PhD degree at the University of Massachusetts where her research focused on quality of life and disparities in acute coronary syndrome. Dr. Nobel completed her neurology residency training at the University of Massachusetts Medical School and completed two years of fellowship training at the University of Cincinnati in both vascular neurology and clinical research. Dr. Nobel, who is also an epidemiologist, has strong clinical research interests in disparities in stroke. She is interested in using both community-engaged research methods and implementation science to develop eective interventions.Mariah Ozkir, MDAssistant Professor of Clinical NeurologyDr. Ozkir is a pediatric neurologist specializing in epilepsy. She trained at the IU School of Medicine for her residency in child neurology and a neurophysiology fellowship. Originally from Kentucky, Dr. Ozkir earned her medical degree at the University of Kentucky. Her clinical practice includes treating general neurological disorders of children and adolescents, and her clinical focus is epilepsy, particularly complex, genetic, and drug-resistant epilepsies, as well as functional neurological disorders including psychogenic nonepileptic spells. Dr. Ozkir is passionate about advocating for patients with epilepsy and their families, as well as equity in healthcare for neurodiverse and disabled children, teens and adults.Lev Vaisman, MD, PhDAssistant Professor of Clinical NeurologyDr. Vaisman specializes in epilepsy of adult patients. He obtained initial higher education in biomedical engineering at the University of Toronto and later completed medical school — an MD-PhD program — at Boston University School of Medicine in Boston, Massachusetts. This was followed by an intern year at Bridgeport Hospital in Bridgeport, Connecticut, and a neurology residency at Boston Medical Center. Dr. Vaisman pursued fellowship training in epilepsy and clinical neurophysiology at Thomas Jeerson University Hospital in Philadelphia, Pennsylvania. Following the completion of post-graduate training, he was a faculty member at the University of Cincinnati. Dr. Vaisman’s clinical interest is epilepsy, specically presurgical evaluation of patients with medication-refractory epilepsy.Alex Barboi, MDProfessor of Clinical NeurologyDr. Barboi is a neurologist specializing in neuromuscular disorders. He graduated from the University of Medicine and Pharmacy Carol Davila in Bucharest, Romania. After medical school, Dr. Barboi completed a categorical internal medicine residency at West Suburban Hospital in Oak Park, Illinois, followed by a neurology residency and clinical neurophysiology fellowship at Rush University in Chicago. Dr. Barboi is a dedicated educator, and his clinical care and research focus is in autonomic and neuromuscular disorders. He is board certied in internal medicine, neurology, clinical neurophysiology, neuromuscular medicine and autonomic disorders.Na Tosha Gatson, MD, PhDProfessor of NeurologyDr. Gatson is the senior medical director of neuro-oncology and director of the Center for Neuro-oncology in the IU School of Medicine-IU Health Neuroscience Institute. Dr. Gatson completed undergraduate studies at IU Fort Wayne before spending the next 15 years training at The Ohio State University College of Medicine, completing an MD/PhD (MSTP) degree in molecular virology, immunology and medical genetics with a major emphasis on neuroimmunology. She also completed an internal medicine internship, a neurology residency, and an enfolded NIH/R25 neurosurgical oncology postdoctoral research fellowship. Dr. Gatson studied as a neuro-oncology fellow at the University of Texas MD Anderson Cancer Center in Houston, Texas. Dr. Gatson’s practice philosophy is rooted in compassionate and evidence-based care that extends a quality life. Her research is focused on population science, brain tumor imaging, and the Neuro-Oncology of Women (N.O.W.). Shannon Harris, PsyDAssistant Professor of Clinical NeurologyDr. Harris is a neuropsychologist specializing in the clinical care of patients with mild cognitive impairment, dementia, movement disorders and is interested in how neuropsychiatric symptoms can impact these conditions. Dr. Harris, born and raised in Indiana, studied at Butler University as an undergraduate and obtained her doctorate in psychiatry from the University of Indianapolis. She left Indiana briey to complete her predoctoral internship in neuropsychology at the VA North Texas Health Care System in Dallas, Texas. Dr. Harris returned home and completed fellowship training in adult neuropsychology at the IU School of Medicine.Neurology adds 7 new faculty members in 2024

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2024 Annual Report IU School of Medicine Department of Neurology10Brain health program fuels clinical and research advancements of new Alzheimer’s disease treatmentsOver the past year-and-a-half, more than 100 people have received new disease-modifying drugs for Alzheimer’s disease at the IU Health Neuroscience Center in downtown Indianapolis, and that number grows weekly.The Food and Drug Administration approved drugs, lecanemab and donanemab, remove the buildup of amyloid protein plaques in the brain — a hallmark of Alzheimer’s disease. While the drugs do not stop the disease or lead to cognitive improvement, they can “freeze” a person in their current functional state, potentially providing several additional years of independence if the disease is caught early, said Jared Brosch, MD, associate professor of clinical neurology.“It’s exciting that we’ve given that opportunity to our patients to be on the cutting edge,” he said.The Center for Neurodegenerative Disorders in the IU School of Medicine- IU Health Neuroscience Institute oversees the administration of the drugs through its Brain Health Program. The initiative, which began in 2023, connects patients and their families with a brain health navigator to work with them throughout their treatment journey.Donna Wilcock, PhD, the Barbara and Larry Sharpf Professor of Alzheimer’s Disease Research in the Department of Neurology and the director of the Center for Neurodegenerative Disorders, said the program has screened more than 300 people since 2023. Nearly one third of those screened have received the treatment, which is administered through intravenous infusions every two weeks. After the seventh infusion, the patients can visit one of the IU Health suburban Indianapolis infusion centers if it’s more convenient than traveling to downtown Indianapolis.In 2023, lecanemab, marketed as Leqembi, was the rst amyloid beta-directed monoclonal antibody to receive traditional approval from the FDA. Next came donanemab, marketed as Kisunla by Indianapolis-based Eli Lilly and Company, which received FDA approval in 2024. These two approvals marked a shift in how clinicians approach their care for Alzheimer’s patients.The program collaborates with a comprehensive team of faculty experts in the Department of Neurology, the Department of Medicine’s Division of General Internal Medicine and Geriatrics, as well as the Department of Family Medicine to refer and pre-screen patients for the program.The program’s brain health navigators CLINICAL CAREJared Brosch, MD, associate professor of clinical neurology, explains how new disease-modifying drugs for Alzheimer’s disease are being oered to patients.

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IU School of Medicine Department of Neurology 2024 Annual Report 11help guide patients and their families from the initial screening process throughout treatment, Wilcock said. The navigator rst reviews a patient’s medical record and gives an overview of the treatment expectations. Patients then receive: • A cognitive battery test to assess memory, attention and language • An MRI to check for pre-existing vascular injuries, like mini-strokes or microbleeds • A lumbar puncture (spinal tap) or an amyloid PET scan to conrm amyloid in the brain • Genotyping for a common risk variant for Alzheimer’s disease (APOE4) • Consultation with a behavioral neurologist to review the screening results“ THROUGH THE SCREENING REVIEWS AND CLINICAL TRIAL DATA, WE’RE SETTING APPROPRIATE EXPECTATIONS FOR TREATMENT AND ANY ADVERSE EFFECTS OF THE DRUGS,” WILCOCK SAID. “THEN IT’S SHARED DECISION MAKING BETWEEN OUR TEAM AND THE PATIENT AS TO WHETHER THEY WANT TO PURSUE THE THERAPY.”In 2024, the program hired a social worker who has developed patient support groups and care partner support groups.“Patients receiving these novel therapies have many questions, as do their loved ones,” Wilcock said. “By adding a social worker and support groups, they can share experiences, ask questions about their disease and treatment and get access to resources as their care needs change. This has been an important addition to enhance the care of our patients and their families.”Wilcock leads a basic science study on the adverse eects of the drugs — called amyloid-related imaging abnormalities (ARIA) — which can cause edema and microhemorrhages in the brain. Physicians identify these changes in the brain on MRI scans. In clinical trials, between 20% and 30% of participants had ARIA, but only about 3% to 6% had symptoms.While Wilcock’s research investigates the adverse eects in animal models, the brain health program team has seen a low the rate of ARIA in patients — about 8% — through their dedication to patient education about cardiovascular risk factors and blood pressure.Near the end of 2023, Eli Lilly gave a presentation at a conference about a machine learning model that identied high blood pressure as the second highest risk factor for ARIA. Following the presentation, Wilcock said the team created a plan to counsel patients about monitoring their blood pressure at home if they take an antihypertensive medication. Patients also get their blood pressure taken before they start an infusion. If it’s elevated and remains high after a period of rest, then they do not receive an infusion that day, Wilcock said.“We’re doing a really good job of preventing ARIA by making sure patients are well educated and are proactive with cardiovascular risk factors,” she added.Wilcock said as the brain health program continues to grow, so have advancements in the treatments. In the next year or so, lecanemab is anticipated to be oered as a subcutaneous injection as well as the traditional infusion. This will open availability of the drug more broadly, Wilcock said, especially to rural Hoosiers who cannot travel to Indianapolis.“This would be something they could probably pick up in the pharmacy,” Wilcock said. “So, we’re going to have to ramp up our screening process for eligibility and the capacity of the brain health program to be able to operate on a broader scale and do it virtually and at remote sites.”The success of the brain health program’s administration of these drugs could lend itself to other treatments for neurodegenerative disorders. Wilcock said the group, in coordination with movement disorders specialists at the IU School of Medicine, is exploring adapting the program’s model to the administration of a Parkinson’s disease treatment.ADULT NEUROLOGYLinda Gonzalez, RN, (left) and Meredith Tobar, RN, (right) brain health navigators, meet with a patient at the IU Health Neuroscience Center after he receives an infusion of lecanemab, a disease-modifying drug to treat Alzheimer’s disease.

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IU School of Medicine Department of Neurology 2024 Annual Report 13AAt the press of a button, emergency room physicians can virtually connect patients experiencing a stroke at their local hospital with a board-certied vascular neurologist, providing expert care within minutes — rather than potentially hours — and improving the patient’s long-term health.Ann Jones, MD, assistant professor of clinical neurology at the IU School of Medicine, spearheaded the launch of the telestroke pilot program at IU Health in August 2024 at three rural IU Health hospitals in the southern region of Indiana: Bedford, Paoli and Morgan. Between August 2024 and March 2025, vascular neurologists from IU Health in Indianapolis and Bloomington — a combined 10 physicians at both locations — conducted more than 75 telestroke visits at the three critical access hospitals, averaging two to three calls a week, Jones said. The program, which has been well accepted at health systems across the country for more than 20 years, Jones said, is shown to increase the number of treatments of a blood thinning medication for stroke patients and decrease the amount of time it takes to receive the medicine.“We know having an expert see the patient right way can have a huge impact on outcomes for people,” Jones said. “If things could have been done dierently in that rst hour, their lifetime could be dierent.”Patient outcomes are oftentimes based on location, Jones said, so vascular neurologists at IU want to help change how those patients can receive care.“Stroke care is going to be vastly dierent in Indianapolis than in Bedford,” Jones said. “In Indianapolis, we’ll see them right away, and we have people in the Neuroscience Center tracking every step of their visit to hospital, which allows us as physicians to target places of improvement and change. Telestroke is a solution despite the location to help equalize the playing eld.”If a patient starts to show stroke symptoms at a local hospital and needs treatment, the emergency department physician and nursing sta can start connecting with the vascular neurologist on call in Indianapolis or Bloomington. A telestroke cart, equipped with a video display, is wheeled to the patient with the neurologist on the other end, ready to conduct the virtual visit. “We’ll see the patient, order imaging and can make the treatment decisions with them,” Jones said. “Patients seem to receive it pretty well, and that’s a trend that’s been seen nationwide. Although it might seem depersonalized over a screen, people do OK with it.”Some patients may be transferred to IU Health Methodist Hospital or IU Health Bloomington Hospital dependent on their level of care, and radiologists are contacted to read CT scans.The telestroke program has shown success at the three southern Indiana hospitals, Jones said, adding that they hope to expand it to all other critical access IU Health hospitals over time. Jones said the program has also helped grow the academic and research missions of the Department of Neurology at the IU School of Medicine. The department began a new vascular neurology fellowship program in 2024, and telestroke is a rotation during the one-year program. In 2026, the department will add a second fellow to the program. Telemedicine is a standard practice at most health facilities, Jones said, and some neurologists do it full time.“Providing that educational opportunity is vital for the next steps in what the goals of our fellows might be,” she said.The program might also improve the already robust clinical research in the department, Jones said, through new connections with potential participants across the state. The department had nearly 70 open clinical trials in 2024, including several focused on stroke research.“When patients are sitting at these facilities, we see them and have consultations,” Jones said. “If they qualify for a clinical trial, we can talk about it and get them in touch with our clinical research team.”The stroke eld has been rapidly growing as new medications and recommendations are released on improvements in care, Jones said. IU joining other health systems in the county with telestroke is another step in further developing the vascular neurology program at IU Health and the IU School of Medicine as a premier location for expert care, research and education.Ann Jones, MD, assistant professor of clinical neurology at the IU School of Medicine, spearheaded the launch of the telestroke pilot programs across the state.ADULT NEUROLOGY

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2024 Annual Report IU School of Medicine Department of Neurology14AAn estimated 200,000 people in the United States are diagnosed each year with central nervous system metastases, according to the American Brain Tumor Association. This type of cancer, which spreads to the brain or spinal cord from tumors elsewhere in the body, is 10 times more common than primary brain tumors.A team of experts from the IU School of Medicine lead one of the only brain and spine metastases multidisciplinary clinics in the state of Indiana at IU Health. Patients meet with neuro-oncology, neurosurgery and radiation oncology physicians during a single visit to discuss their diagnosis, treatment options, healthcare goals and important next steps.“The metastases multidisciplinary clinic is an opportunity to meet patients who are already navigating the challenges of a cancer but are now faced with tumors of the central nervous system,” said Na Tosha Gatson, MD, PhD, professor in the Departments of Neurology and Medicine. “Our work to protect the functions of the brain and spine is an eort to preserve the essence of humanness, and we are dedicated to delivering innovative treatment approaches and work to uphold the values of our patients.”Neuro-oncology program leads multidisciplinary brain metastases clinicNeuro-oncologists in the Department of Neurology spearhead a clinic where physicians from multiple specialties meet with patients during a single visit.

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IU School of Medicine Department of Neurology 2024 Annual Report 15Gatson, who is also the director of the Center for Neuro-oncology in the IU School of Medicine-IU Health Neuroscience Center, is joined by Kathryn Nevel, MD, assistant professor; and Edward Dropcho, MD, professor; in the Department of Neurology’s neuro-oncology section.The metastases multidisciplinary clinic is designed for patients with newly diagnosed metastases, suspected progression or conrmed progression of disease, Gatson said. The clinic also has a unique oering to patients or providers who wish to have a second opinion. The program’s clinical workow, Gatson said, emphasizes the value of a unied team approach and limits mixed messaging and excessive time spent moving from one physician to another. In addition to specialists in the Departments of Neurology, Neurological Surgery and Radiation Oncology, the clinic collaborates with the Departments of Medicine Physical Medicine and Rehabilitation.“These are highly complexed cases and balancing their overall wellness in a collaborative fashion is paramount,” she said.Three specialists meet with a patient in one room during a clinic visit. They are also joined by a nurse navigator who helps with information gathering and post-appointment scheduling. The navigator helps guide patients through the healthcare system and advocates for them, making sure the patient has access to resources and support during their cancer journey, Gatson said.The team has developed patient-centered folders that detail the mission, vision and specialty background training of the clinic specialists, Gatson said. Patients also have an opportunity to meet with specialists in palliative care, chaplaincy, social work and other allied health teams, adding value to the group’s comprehensive care approach.ADULT NEUROLOGYNa Tosha Gatson, MD, PhD, professor of neurologyKathryn Nevel, MD, assistant professor of neurologyEdward Dropcho, MD, professor of neurologyNEURO-ONCOLOGY CLINICAL TRIALSDepartment of Neurology has grown its neuro-oncology clinical research. Kathryn Nevel, MD, leads many of the clinical trials that aim to test potential therapeutics for patients with tumors. • Site for a study on the medication mirdametinib in children and adults with neurobromatosis type 1 (NF1) and plexiform neurobromas, which are tumors that develop along nerves and are commonly associated with NF1. NF1 is a genetic disorder that causes tumors to grow on nerve tissue. Nevel was a co-author of a paper publishing results of the study, which led to the drugs receiving approval from the Food and Drug Administration. This is the rst FDA-approved therapy for patients with NF1 and plexiform neurobromas. • The Sonobird study for patients with recurrent glioblastoma — the most common and aggressive type of brain tumor in adults — has recruited several participants. This study oers patients an opportunity for a novel therapy for their cancer, in a scenario where there is no standard of care. • The program opened a NF1 study looking at a new drug, HLX-1502, for patients with symptomatic plexiform neurobromas.The Department of Neurology collaborates with the Departments of Neurological Surgery, Radiation Oncology, Medicine and Physical Medicine and Rehabilitation in the neuro-oncology multidisciplinary clinic.

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2024 Annual Report IU School of Medicine Department of Neurology16Riley Children’s HealthFrom research to patient care, pediatric neurologists and neurosurgeons at Riley Children’s Health are multifaceted innovators who work diligently to pursue new therapies for children. These experts at Riley Children’s and the IU School of Medicine have introduced new magnetoencephalography (MEG) technology, a state-of-the-art modality used to evaluate seizures. This novel, non-invasive test, garnering promising presurgical evaluation, represents a signicant milestone for patients experiencing medically intractable focal epilepsies.With its ability to detect brain signals using a specialized helmet, MEG monitors both normal and abnormal brain activity while patients are at rest or engaged in specic tasks. The advanced technology, available for both adults and children, provides a whole-head view of brain activity by using sensors and advanced computing, allowing neurologists and neurosurgeons to identify the exact location of seizures. Such detailed mapping is crucial for planning complex surgical treatment and ongoing medical management.“ With on-site access to MEG, our comprehensive epilepsy program, and our level 4 Epilepsy Center, will oer a unique medical home to children with epilepsy,” said Makram Obeid, MD, assistant professor in the Department of Neurology. “MEG complements our existing advanced technologies to better map the areas of the brain that generate seizures.”Beyond brain mapping, MEG provides structured information and detailed functional insights through magnetic eld recordings – an advantage that sets it apart from the traditional MRI and other diagnostic technologies.“Data from MEG renes the accuracy of intracranial electroencephalogram recordings, facilitating presurgical workup,” Obeid said. “Our multi-disciplinary team of experts will be able to take care of the most dicult epilepsies more eciently.”MEG is oered at only a handful of healthcare facilities in the United States, including Riley Children’s, according to the American Clinical MEG Society (ACMEGS), a nonprot organization supporting MEG centers by providing education, resources and knowledge to members involved.“The addition of MEG to our diagnostic toolkit represents a signicant advancement in our ability to provide personalized and eective care for adults and children with neurological disorders,” said Alison Kostandy, MD, assistant professor of clinical neurology and medical director for MEG. “By accurately mapping brain activity and identifying seizure foci, we can tailor treatment strategies and improve outcomes for our patients.”While MEG remains a transformative resource for pinpointing brain activity, the technology is a major steppingstone for patients nationwide. Specialists at Riley Children’s will continue integrating the tool, improving the overall quality of care for patients with epileptic conditions.In addition to MEG, pediatric neurologists and neurosurgeons oer a range of surgical evaluations and treatments to manage seizures. Particularly, the Comprehensive Epilepsy Program at Riley Children’s, comprised of enhanced technologies and clinical experts, is actively involved in research to treat medically refractory epilepsy.New MEG technology delivers hope for medically refractory epilepsyCHILD NEUROLOGYA nurse places a specialty helmet on a pediatric patient as they ready him for a magnetoencephalography technology procedure at Riley Children’s Health.Makram Obeid, MD, assistant professor of neurology, meets with a pediatric patient before a magnetoencephalography technology procedure at Riley Children’s Health. The technology evaluates the management of seizures.

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2024 Annual Report IU School of Medicine Department of Neurology18TThe largest study of early-onset Alzheimer’s disease in the United States is expanding internationally, becoming one of the largest programs of its kind in the world. The Longitudinal Early-Onset Alzheimer’s Disease Study (LEADS), headquartered at the IU School of Medicine, is growing to include ve new sites in Europe and South America, in addition to its 18 existing sites in the U.S.Global expansion of the study (International Longitudinal Early-Onset Alzheimer’s Disease Study, or iLEADS) is supported by a two-year, more than $700 thousand grant from the Alzheimer’s Association, which was funded entirely by the association’s Greater Indiana Chapter. The grant will support new sites in Buenos Aires, Argentina; Amsterdam, the Netherlands; Barcelona, Spain; London, England; and Malmö, Sweden.“The Greater Indiana Chapter is honored to fund this important research and incredibly proud of Indiana’s global leadership in the ght against Alzheimer’s disease and all other dementias,” said Natalie Sutton, executive director for the Alzheimer’s Association Greater Indiana Chapter.Early-onset Alzheimer’s disease is a rare form of Alzheimer’s, aecting only 5% of the more than 6.5 million Americans living with the neurodegenerative disease. It typically appears in people ages 40 to 64, many of whom don’t have a family history of the disease.These are people who might be in the height of their career or have children still living at home, but, since early-onset Alzheimer’s disease progresses much faster than the late-onset form of the disease, it quickly hampers a person’s ability to work or manage their home. The disease not only aects a person’s memory but also their language, logic and reasoning skills. NEUROLOGY RESEARCHLiana Apostolova, MD, (left) meets with clinical research participants at the IU School of Medicine.IU-led early-onset Alzheimer’s disease research study expands globally

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IU School of Medicine Department of Neurology 2024 Annual Report 19“ Although the U.S. is a really nice melting pot, we might see that populations within other countries present dierently for early-onset Alzheimer’s disease,” said Liana Apostolova, MD, MS, an IU Distinguished Professor and the Barbara and Peer Baekgaard Professor of Alzheimer’s Disease Research in the Department of Neurology at the IU School of Medicine. “We have already developed a knowledge base of all these dierent modalities of research — cognitive, clinical, genetics, pathology and imaging. Our goal is to seamlessly include the international data into one larger repository and study the disease globally.”LEADS, which ocially launched in the U.S. in 2018, is a 700-person study of early-onset Alzheimer’s disease in people between the ages of 40 and 64. There are 100 cognitively normal participants, as well as 600 participants who have cognitive impairment — largely due to early-onset Alzheimer’s disease or mild cognitive impairment from Alzheimer’s disease.Apostolova, who is also the associate dean of Alzheimer’s disease research at the IU School of Medicine, leads the study with her co-principal investigators Gil Rabinovici, MD, of the University of California-San Francisco; Brad Dickerson, MD, of Massachusetts General Hospital and Harvard Medical School; and Maria Carrillo, PhD, of the Alzheimer’s Association.LEADS researchers use cutting-edge technologies to advance their understanding of the disease through neuroimaging, uid biomarkers, genetics and cognitive and clinical assessments. All data collected in LEADS is openly shared with physicians and scientists. The study has amassed $78 million in grant funding since 2017 and was the largest National Institutes of Health grant to the IU School of Medicine from 2017 to 2023.iLEADS will support new partnerships with leading dementia experts at its new international sites. Apostolova said these experts are already clinically assessing and treating rare presentations of early-onset Alzheimer’s disease, such as the language and visual variants of Alzheimer’s disease.“LEADS and iLEADS give us great hope that we can better understand early-onset Alzheimer’s disease,” said Heather M. Snyder, PhD, vice president of medical and scientic relations at the Alzheimer’s Association. “By studying Alzheimer’s in this younger group, we can identify new potential paths to treatment in both younger- and late-onset forms of the disease.”iLEADS will expand the largest study of early-onset Alzheimer’s disease in the United States to ve countries on two continents.RESEARCHBUENOS AIRES, ARGENTINAAMSTERDAM, THE NETHERLANDSBARCELONA, SPAINLONDON, ENGLANDMALMÖ, SWEDEN

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2024 Annual Report IU School of Medicine Department of Neurology20WWith the emergence of promising treatments that slow the cognitive decline of Alzheimer’s disease in patients, there are still questions surrounding side eects of the drugs. An IU School of Medicine researcher is among the few neuroscientists investigating these adverse events, which can cause brain swelling and bleeding.Donna Wilcock, PhD, the Barbara and Larry Sharpf Professor of Alzheimer’s Disease Research in the Department of Neurology, received a three-year, $3.36 million grant from the National Institute of Neurological Disorders and Stroke (NINDS) to study why edema and microhemorrhages occur in the brains of some people who receive Alzheimer’s therapies.Physicians identify these changes in the brain, called amyloid-related imaging abnormalities (ARIA), on MRI scans.“In the Alzheimer’s research eld, we don’t understand why this is happening,” Wilcock said. “This grant will aim to investigate the causes of these abnormalities and how to stop them from happening.”Over the past few years, three potential Alzheimer’s disease treatments have garnered attention as drugs that target the removal of amyloid plaques in the brain — a hallmark of Alzheimer’s disease — in people who are diagnosed with an early or mild stage of Alzheimer’s disease. • Lecanemab is the rst amyloid beta-directed monoclonal antibody to receive full approval from the Food and Drug Association (FDA) and be available for patients to take in the clinic. It signicantly removed plaques in a person’s brain during clinical trials. • Donanemab — a drug being developed by Eli Lilly and Company that received full approval by the FDA in 2024 — has also shown promising results in its clinical trials. • Aducanumab was discontinued by its manufacturer, Biogen. It received accelerated FDA approval in 2021 and later was suspended to verify the drug’s clinical eectiveness.ARIA symptoms may include headache, confusion, nausea and dizziness. About 20% of people receiving lecanemab during clinical trials were found to have ARIA, with 3% of people experiencing symptoms. Nearly one third of clinical trial participants who took donanemab had ARIA, and 6% of those had symptoms. More than 40% of people who received aducanumab in phase 3 studies had ARIA, and 25% had symptoms.More than two decades ago, Wilcock published one of the rst papers showing that older mouse models that received an anti-amyloid therapy saw fewer plaques but had microhemorrhages in the brain. However, Wilcock said basic science investigations — like hers — that initiated research into ARIA stopped as antibody therapies started to enter clinical trials around that same time.But now, as ARIA cases have arisen in clinical trials and there are treatments either approved for the market or pending approval, Wilcock said her research team is studying what they rst learned Katelynn Krick, a PhD candidate, works in the Wilcock lab in the Stark Neurosciences Research Institute. The lab actively researches amyloid related imaging abnormalities — brain bleeding and swelling — that can occur in patients who receive new Alzheimer’s disease treatments. Researchers investigating brain bleeding, swelling that occurs in quarter of patients who receive Alzheimer’s disease treatment

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IU School of Medicine Department of Neurology 2024 Annual Report 21in the early 2000s about hemorrhages in mouse models and applying that to today’s research eld. They’ll use new technologies to study the makeup of cells and proteins and new mouse models that better resemble the disease.Wilcock, the director of the Center for Neurodegenerative Disorders in the IU School of Medicine-IU Health Neuroscience Institute and a primary member of Stark Neurosciences Research Institute, will use mouse models from the Model Organism Development and Evaluation for Late-Onset Alzheimer’s Disease (MODEL-AD) at IU School of Medicine and an anti-amyloid monoclonal antibody immunotherapy from Eli Lilly.The mouse models will receive the antibody, and researchers will perform MRI scans to identify ARIA in the brain using a state-of-the-art PET-MRI scanner, located in the Roberts Translational Imaging Facility at Stark Neurosciences Research Institute. Wilcock said the research team will use single-cell transcriptomic analysis to study what processes are happening around blood vessels that might be driving ARIA events in the brain.“There’s a lot of evidence to suggest that ARIA is being driven by a neuroinammatory event,” Wilcock said. “The microglial cells in the brain are activated, and that’s a good sign when it’s close to amyloid plaques to clear plaques out of the brain, but when that activation happens near blood vessels, it damages the blood vessels.”Wilcock said the project will also investigate the role of an enzyme called MMP9 that’s been studied extensively in stroke that degrades the tight junctions — what holds cells together — and basement membranes — what maintains the structure — of blood vessels in the brain. The enzyme is signicantly activated when given antibody immunotherapies, she said.“Our hypothesis in the grant is that MMP9 is a downstream product of this inammatory response. When that’s active in the blood vessels, it degrades them,” Wilcock said. “We’re also testing the hypothesis that if they can prevent the initial inammatory response in the blood vessels, we may be able to prevent the downstream ARIA.”The research team will use both antibody therapies and FDA-approved anti-inammatory drugs to see if they prevent ARIA in the brain without slowing down the removal of amyloid plaque.Wilcock said that since administering lecanemab to the rst patient in September 2023, dozens of patients have received the therapy at IU Health, and dozens of U.S. health systems are giving the treatment to Alzheimer’s disease patients across the country.Being at high risk of developing ARIA is the biggest risk factor for taking the drug, Wilcock said, and patients are weighing the risk-benet of the therapy. Some patients can’t receive these treatments due to a high risk of ARIA because of medications they take or signatures on damaged blood vessels that are detected on MRIs. Wilcock said physicians and researchers want to ensure these drugs are accessible and safe for patients.“If we had a means of saying to someone, you’re at a higher risk of ARIA, but we know if we give you an adjunct therapy of a drug that’s already approved, it will reduce or eliminate your ARIA risk,” Wilcock said, “that would open the therapy to a much broader population.”RESEARCHDaniel Rivera, PhD, a postdoctoral researcher, analyzes data in the Wilcock lab.Abigail Wallace, lab manager, studies cell cultures in the Wilcock lab.

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2024 Annual Report IU School of Medicine Department of Neurology22AA novel therapeutic target to treat Alzheimer’s disease identied in 2022 by IU School of Medicine researchers will now be translated to a clinical trial, spearheaded through a collaboration between scientists and clinicians.The trial, funded by more than $950 thousand grant from the Alzheimer’s Association Part the Cloud grant program, will evaluate the treatment of niacin through a U.S. Food and Drug Administration-approved drug for patients who have mild to moderate symptoms of Alzheimer’s disease.Gary Landreth, PhD, the Martin Professor of Alzheimer’s Research, and Miguel Moutinho, PhD, assistant research professor of anatomy, cell biology and physiology, led the scientic research in their lab at the Stark Neurosciences Research Institute at the IU School of Medicine. Jared Brosch, MD, associate professor of clinical neurology at the school, will lead the clinical trial in the Department of Neurology.The research team found that, in the brain, niacin — a B vitamin that’s mainly obtained through a typical diet but can also be taken in supplements and cholesterol-lowering drugs — interacts with a highly-selective receptor, HCAR2, that’s present in microglia associated with amyloid plaques. In the study, they found that after Alzheimer’s disease animal models received niacin, the HCAR2 receptor was activated and led to fewer plaques and improved cognition.Moutinho and Landreth collaborated with Brosch to further the translational research of niacin and develop a clinical trial to test an FDA-approved formulation of niacin for Alzheimer’s disease patients.“This is a huge achievement for any basic research laboratory — to see their ndings translated into the clinical setting with the expectation that patients can benet from the work developed in the lab,” Moutinho said. “We are fortunate to work at Stark Neurosciences Research Institute and the IU School of Medicine because they harness and promote translational research scientic discussions with clinicians.”Brosch, who has administered more than 30 clinical trials over the last decade, said the niacin trial is targeted toward people with mild to moderate symptoms of Alzheimer’s — a group that has historically had few treatment options other than drugs that have been around for 25 years.“ What excites me the most is that this trial represents the ideal path of discovery,” Brosch said. “Here at IU School of Medicine, we are unique in that we have the expertise, the active clinic of wonderful patients willing to volunteer and an experienced clinical trial team. This is why IU School of Medicine continues to lead the world in Alzheimer’s research and drug development.”Alzheimer’s disease basic science nding leads to clinical trialResearchers and clinicians at the IU School of Medicine have partnered to translate a novel therapeutic target from the lab to clinical trials.Jared Brosch, MD

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IU School of Medicine Department of Neurology 2024 Annual Report 23RESEARCHThe IU School of Medicine is ranked No. 6 in funding from the National Institute on Aging (NIA), the largest branch for Alzheimer’s disease research within the National Institutes of Health (NIH). In 2024, the school received $87 million in grants to fund Alzheimer’s disease research.Brosch said without funding from Part the Cloud, the niacin trial may not have gotten o the ground. The grant program, which has invested $67.9 million in 68 trials to investigators across the country for more than a decade, provides an opportunity for early-stage clinical trials to be funded to broaden the understanding of Alzheimer’s disease and to hopefully generate new and innovative treatments.As the IU School of Medicine-led clinical trial is still in its beginning stages, Moutinho said the lab is furthering their investigation into niacin and the eects of HCAR2 activation in tauopathy models, which mimic important aspects of Alzheimer’s disease, and in other neurodegenerative conditions.Miguel Moutinho, PhD, assistant research professor of anatomy, cell biology and physiology, helped lead the scientic research at the Stark Neurosciences Research Institute at the IU School of Medicine. “ THIS IS A HUGE ACHIEVEMENT FOR ANY BASIC RESEARCH LABORATORY — TO SEE THEIR FINDINGS TRANSLATED INTO THE CLINICAL SETTING WITH THE EXPECTATION THAT PATIENTS CAN BENEFIT FROM THE WORK DEVELOPED IN THE LAB,” MOUTINHO SAID. “WE ARE FORTUNATE TO WORK AT STARK NEUROSCIENCES RESEARCH INSTITUTE AND THE IU SCHOOL OF MEDICINE BECAUSE THEY HARNESS AND PROMOTE TRANSLATIONAL RESEARCH SCIENTIFIC DISCUSSIONS WITH CLINICIANS.”

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2024 Annual Report IU School of Medicine Department of Neurology24AA multicenter study led by an IU School of Medicine neuroendovascular surgeon found that a novel device used to surgically treat patients with large vessel occlusions — a severe type of ischemic stroke — is a safe and eective way to remove blood clots in the brain during a stroke.Kaustubh Limaye, MD, associate professor of clinical neurology, neurological surgery and radiology and imaging sciences, spearheaded the study with faculty physicians and researchers at 12 institutions across the United States. The novel device they investigated, a Food and Drug Administration-approved macrowire, developed by Aristotle Colossus, is used in lieu of the traditional mechanical thrombectomy — a surgery removing blood clots from inside an artery inside the brain of stroke patients — that uses a microwire and a microcatheter to deliver an aspiration catheter by crossing the clot to perform the surgery.“There are multiple benets, but key procedural benets are that you don’t have to disrupt thrombus, and you don’t have to cross the clot with the microwire, which can cause complications,” Limaye said. “This study of the macrowire is the rst in line with a new philosophy within the eld of vascular neurology of how we can revamp the procedure of mechanical thrombectomy to make it more streamlined, safe and eective.”Every 70 to 90 seconds, someone in the U.S. has a stroke or a mini stroke. Large vessel occlusions, which require a thrombectomy, account for 10-15% of total ischemic strokes, Limaye said. As a fellowship-trained neuroendovascular surgeon, Limaye regularly performs the procedure at IU Health Methodist Hospital in downtown Indianapolis.Limaye, who joined the IU School of Medicine in 2021, has been involved in initial testing of the macrowire product. Once it received FDA clearance, Limaye said a group of neuroendovascular surgeons across the country decided to develop the rst study to evaluate using the macrowire alone to deliver the aspiration catheter.Called the Macrowire for Intracranial Thrombectomy (MINT) Registry, the multicenter, observational study recruited more than 125 patients at 10 high-volume hospitals over the course of a year to study the feasibility of the device. The registry collected patient clinic, demographic and imaging data, as well as the rate of success and number of complications.In the initial experience published, surgeons were able to successfully advance the aspiration catheter to 92% of the patients using the macrowire, Limaye said, resulting in a rate of complications much lower than the traditional method in this sample.The team of researchers published their ndings and the study design in “Interventional Neuroradiology” and “Stroke: Vascular and Interventional Neurology,” respectfully.“Using the traditional method, if your microwire or microcatheter is going in that area that crosses the clot, you are guiding yourself with your anatomical knowledge, rather than a set direction of where that wire is going as you lose the roadmap,” Limaye said. “Those cases can cause complications by perforating the small artery or cause distal embolization in a new territory. We completely negate that using the macrowire by not crossing the clot at all — so there’s a signicant number of technical advantages.”While the initial funding for the MINT Registry was limited to one year of evaluating patients, Limaye said the registry’s investigators are studying the downstream eects of this new procedure on timing and clinical outcomes of patients in comparisons with the standard of care practice. Additionally, they plan to continue studying MINT technique for eectiveness with delivery of ultra-large bore catheters, safety and potential cost savings.The group is also looking into how to safely conduct throm-bectomies for distal medium vessel occlusions, blockages in smaller arteries that have more branches, Limaye said.Kaustubh Limaye, MDAn illustration of a traditional mechanical thrombectomy that uses a microwire and a microcatheter.An illustration of the novel FDA-approved Aristotle Colossus macrowire used to surgically treat patients with large vessel occlusions that was evaluated through the MINT Registry.Neuroendovascular surgeon leading nationwide registry to evaluate eectiveness of novel tool to remove blood clots of stroke patients

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2024 Annual Report IU School of Medicine Department of Neurology26Heeding his father’s advice, New Hampshire native Nicholas Levergood, MD, brought the skills he learned on the East Coast to Indiana, broadening the IU School of Medicine and IU Health expertise on neuro-ophthalmology, which addresses vision disorders of the brain and nerves.Levergood is the rst neuro-ophthalmology fellow at the IU School of Medicine, a program funded through a generous donation to the IU Health Foundation from the Homan and Koorsen families. The department also welcomed Shaney Peña, MD, as the rst vascular neurology fellow at the IU School of Medicine in several decades. The Department of Neurology oers fellowships in clinical neurophysiology, behavioral neurology and neuropsychiatry, neuro-ophthalmology, neuroimmunology, movement disorders and vascular neurology. Fellows experience an in-depth training environment in clinical care and research alongside faculty experts in their specialties for each of the fellowships.Nicholas Levergood, MDLevergood earned his undergraduate degree at Brandeis University, outside of Boston, where he studied chemistry. He stayed in Boston for medical school at Tufts University, where he focused on general surgery — but ophthalmology quickly caught his eye.“ I’VE ALWAYS BEEN DRAWN TO A CHALLENGE,” LEVERGOOD SAID. “OPHTHALMOLOGY DREW MY ATTENTION BECAUSE IT USES MICRO-SURGICAL TECHNIQUES. THE ANATOMY WAS FASCINATING, AND IT JUST FELT LIKE SUCH A HIGH IMPACT ORGAN SYSTEM TO WORK IN.”Levergood decided to specialize further within that specialty: to train in neuro-ophthalmology. Fellowships within neuro-ophthalmology are rare and highly competitive — there are fewer than 40 fellowships in the eld across the United States.“My father grew up in Indiana,” Levergood said. “He has very fond memories of growing up here. When I was looking at programs, he encouraged me to look in the Midwest.”Over the course of the academic year, Levergood rotates between neuro-ophthalmology clinic at the IU Health Neuroscience Center in downtown Indianapolis, the Circle City Neuro-Ophthalmology at Midwest Eye Institute in Carmel, and the Eskenazi Ophthalmology Clinic. He regularly works alongside neurology faculty members Devin Mackay, MD, associate professor of neurology and fellowship director, and Melissa Ko, MD, professor of neurology.“They’re both extremely qualied and committed to excellent patient care,” Levergood said. “Dr. Mackay is so methodical in the way he approaches problem solving. I’ve learned a lot from him. Dr. Ko is such a compassionate Nicholas Levergood, MD, (left) is the rst neuro-ophthalmology fellow at the IU School of Medicine. He works closely with the fellowship director, Devin Mackay, MD (right).New neurology fellowships boost training opportunities

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IU School of Medicine Department of Neurology 2024 Annual Report 27and skilled doctor. She’s so intelligent and relates so well to patients and their families.”Levergood plans to work at IU Health and the IU School of Medicine after his fellowship.Shaney Peña, MDAs a child, Peña often played doctor and enjoyed learning about science. This curiosity for medicine from a young age propelled Peña to pursue a career as a physician. Peña earned her medical degree in 2020 from the IU School of Medicine and later matched at the school for her adult neurology residency. Initially not interested in neurology, Peña said her perspective changed after a rotation as a third-year medical student.“ MY MOM COULD TELL HOW EXCITED I WAS ABOUT NEUROLOGY,” PEÑA SAID, RECALLING CONVERSATIONS OVER THE PHONE SHE OFTEN HAD WITH HER MOTHER ABOUT CLINICAL ROTATIONS IN MEDICAL SCHOOL. “SHE RECOGNIZED A LIGHT AND HOW HAPPY I WAS. EVEN WHEN THINGS WEREN’T GOING RIGHT, I ALWAYS WANTED TO TRY AGAIN AND GET BETTER AS I PURSUED A CAREER IN NEUROLOGY.”Peña said she developed a deeper interest in stroke patients over the course of her residency. Combined with her admiration for the vascular neurology faculty in the department, she decided to pursue an opportunity to become the rst vascular neurology fellow at the school in decades.Her fellowship is spent rotating through a variety of subspecialty and multidisciplinary clinics and services at the IU Heath Methodist Hospital, the IU Health Neuroscience Center and the Richard L. Roudebush Veterans’ Administration Medical Center. The stroke section also operates a Mobile Stroke Unit and a Telestroke program, oering more learning opportunities.As a fellow, Peña participates in research projects — she presented two posters at the International Stroke Conference — and helps instruct neurology residents and medical students alongside faculty.“I have enjoyed working with students and residents and have participated a little more in teaching, which I have found particularly rewarding,” Peña said.Ann Jones, MD, assistant professor of clinical neurology, is not only the director of the vascular neurology fellowship program, but she’s also been a mentor to Peña since the start of her education journey in the Department of Neurology.“ SHE BALANCES BEING SUPPORTIVE WHILE ALSO MANAGING TO CHALLENGE AND PUSH ME,” PEÑA SAID. “DR. JONES HAS VALUED MY OPINION AS THE FIRST VASCULAR FELLOW THAT HAS ATTENDED IU IN DECADES, WHICH HAS BEEN VERY IMPORTANT AS WE NAVIGATE THIS NEW ROLE WITHIN THE SYSTEM. THIS HAS ALLOWED FOR A SMOOTH TRANSITION AND A POSITIVE AND SUPPORTING ATMOSPHERE.”Like Levergood, Peña plans to join IU School of Medicine/ IU Health after her fellowship.Contributing Source: IU Health, IU Health FoundationShaney Peña is the rst vascular neurology fellow at the IU School of Medicine in several decades.EDUCATION

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2024 Annual Report IU School of Medicine Department of Neurology28Neurology Residents and FellowsNeurology FellowsClinical NeurophysiologyMarina E. Giovannini, DOSarah J. Mace, DONeuro-ophthalmologyNicholas R. Levergood, MDVascular NeurologyShaney N. Pena, MDAdult Neurology ResidentsPGY 4Haley L. Basinger, MD, MSCameron Duner, MDJohn W. Fanta, MDJohn L. Flach, DOThomas O. Keneld-Kelleher, DODaniel R. Kotfer, MDXyryl Chriscella Pablo, MDWeston B. Wright, MDPGY3Amanda Arand, DO, MSOlivia M. Cummings, MDAshli B. Elrod, MD, MSPerry Grin, MDBryan R. Hyatt, MDUsama K. Khan, MDIsaac Lamb, MDIshi Nalamolu, DOPhalgun C. Narla, DOMadison G. Ott, MDPGY2Aislin M Betts, MDNeck Henthorn, MDFatiha Iqbal, DOArjun Kumar, MDMackenzie C. Langdon, DO, MSErica N. Lumpkin, DO, MSKelli J. Manikowski, DO, MSHussein Moussa, MDMaham Nadeem, MDAlaina M. Singer, MDPGY1 Ayesha Amiri, DOParker D. Brady, MD, MPHEdson K. DeOliveira, MD, MSAlicen Engler, DODerek L. Jones, MDKasyap Kondury, MDMadison E. Little, MDMichael McGill, MDMadison Q. Nelson, MDRamsey Omari, MDChild Neurology ResidentsPGY5Grace E. Eib, DOJerilyn M. Summay, MD, MAPGY4Jaskiran Kaur, MDKabir Sheikh, DOPGY3Jonathan Go, DOPGY2Emily B. Matney, MDClaire V. Weaver, MDPGY1Nick Clement, DO, MSMiles Grigorian, MDNeurodevelopmental Disabilities ResidentsPGY6Kristin D. Fauntleroy-Love, MA, MBBSPGY5Kayleigh D. Avery, MDPGY4Sarah Fine, DO, MPHPGY3Laxhmi Ramjit, DOIndigo D. Yeager, DOPGY2Kaitlyn H. Cocuzzo, MD, MSPGY1Micailya L. Hall, MDThao Tran, DO

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IU School of Medicine Department of Neurology 2024 Annual Report 29EDUCATIONAdult Neurology FacultyFacultySergiu Abramovici, MDRobert J. Alonso, MDLiana G. Apostolova, MD, MSAlex Barboi, MDJay R. Bhatt, MDCynthia L Bodkin, MDJared R. Brosch, MDPaul F. Bustion, MDDavid G. Clark, MDKyle J. Coleman, MD, MSAdam D. Comer, MD, MScRobin Conwit, MDEdward J. Dropcho, MDMartin R. Farlow, MDJames T. Fesenmeier, MDJames D. Fleck, MDNa Tosha N. Gatson, MD, PhDWhitney E. Gauen, MDJaison A. Grimes, MDLaurie Gutmann, MDMichael A. Hans, MDDavid W. Harvey, MDChristopher J. Hill, MDKatie Hutchins, MDC. Simona Ivan, MDChristopher W. James, MDAnn M. Jones, MDAlison Kostandy, MDJohn C. Kincaid, MDMelissa Ko, MDKaustubh Limaye, MDDevin D. Mackay, MDJason S. Mackey, MD, MSOmkar N. Markand, MDAshley K. Miller, DOKathryn Nevel, MDLisa M. Nobel, MD, PhDPamela K. O’Dea, MDPatricia A. Olson, MD, PhDRyan T. Overman, MDRobert M. Pascuzzi, MDStefanie J. Rodenbeck, MDSadia Saba, MDDragos Sabau, MDVicenta Salanova, MDRichard V. Scheer, MDChelsea D. Schmoll, DOSara M. Takacs, MDEvan J. Templeton, MDLaura M. Tormoehlen, MDLev Vaisman, MD, PhDLinda S. Williams, MDJoanne M. Wojcieszek, MDS. Elizabeth Zauber, MDChild Neurology FacultyRobert B. Blake, MDSusan C. Conrad, MD, MSCelanie K. Christensen, MD, MSSarah Isis R. Delima, MDMarcia V. Felker, MDChristopher T. Jackman, MDBittu D. Majmudar-Sheth, MDDerryl J. Miller, MDMatthew A. Miller, MDAshley A. Moeller, MDMakram Obeid, MDMariah R. Ozkir, MDLisa H. Smith, MDDeborah K. Sokol, MD, PhDFlorence Sun, DOLaurence E. Walsh, MDJessica Win, MDSarah E. Wing, MDNeuropsychology FacultyElizabeth L. Begyn, PhDJana B. Dykstra, PhDAnne-Marie N. Fleckenstein, PhDPatricia Garcia, PsyDDustin Hammers, PhDShannon I. Harris, PsyDEmily J. Kalscheur, PhDDavid A. Kareken, PhDSarah A. Koch, PhDBrenna C. McDonald, PsyDTy Owens, PhDChristopher C. Stewart, PhDNeurology Basic ScientistsJe Dage, PhDYansheng Du, PhDMario Dzemidzic, PhDHuiying Gu, MS, BMNaazneen Khan, PhDAnn E. Kosobud, PhDErica M. Weekman, PhDDonna M. Wilcock, PhD

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2024 Annual Report IU School of Medicine Department of Neurology30Support the Department of Neurology at the IU School of MedicineThere are many other ways to support the department through the IU Foundation, including annual giving, created endowed funds and gifts of assets. If you would like to discuss how you can be part of this critical work, please contact Andrea Spahn-McGraw, executive director of advancement, neuroscience, at anspahn@iu.edu or 317-278-2124.For more than 75 years, the Department of Neurology at the IU School of Medicine has been a leader in clinical care, research and education of neurologic disorders. The IU School of Medicine is recognized for encouraging interest in the eld of neurology, with the highest percentage of its medical students choosing this specialty as a residency path. Nationally and internationally recognized experts in the department receive millions of dollars each year in grants to advance basic, translational and clinical research — especially in the areas of Alzheimer’s disease and dementia, neuromuscular disorders and epilepsy. Gifts from alumni, patients and friends helps us support our groundbreaking research programs and training our learners in the latest in neurological technology and techniques in clinical care. When you make a gift to the Department of Neurology, you enable our team to provide academic expertise, conduct groundbreaking research and make a dierence in our community. Two recent funds to the department showcase its breadth of expertise.

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IU School of Medicine Department of Neurology 2024 Annual Report 31ALS Clinical ResearchThe Koorsen Family Charitable Fund supports an ALS research coordinator in the IU School of Medicine Department of Neurology. This gift is in memory of the late Randy Koorsen, president of Koorsen Fire & Security, who died in January 2024. The coordinator position will assist with multiple ALS clinical research trials and work closely with faculty principal investigators as they recruit and assist clinical trial participants. Over the past 10 years, the IU School of Medicine has established one of the leading ALS clinical trials programs in the United States. The research team has established a reputation for quality of performance in numerous multi-center clinical trials in ALS, and with their patients, have consistently provided important contributions to advance the state of knowledge of new treatment strategies for ALS. The center is currently participating in the rst ALS platform trial, a groundbreaking approach that cuts the time to nd an eective treatment in half. They are also launching a new ALS consortium, All ALS, to provide a large-scale, centralized and readily accessible infrastructure for the collection and storage of a wide range of patient data.Precision Medicine for Aging-related DiseasesThe laboratory of Je Dage, PhD, senior research professor of neurology at the IU School of Medicine, is dedicated to the discovery and development of tools to enable precision medicine for neurodegenerative diseases associated with aging, such as Alzheimer’s disease. Dage has consistently been at the forefront of identifying, developing and applying novel technologies to address disease-relevant biological questions encountered during drug discovery and clinical development. Notably, he led the discovery and development of measuring phosphorylated tau (P-tau181 and P-tau217) in blood, a groundbreaking biomarker that aids in the diagnosis of Alzheimer’s disease and is now used worldwide. This blood test has proven invaluable for identifying Alzheimer’s disease pathology and assessing the risk of cognitive decline. Donors have a unique opportunity to collaborate with researchers at the IU School of Medicine, contributing to the advancement of new tests that pave the way for precision medicine through the Precision Medicine for Aging Research Fund.PHILANTHROPYStay ConnectedIU School of Medicine Department of Neurology@iuneurology@iuneurology

2024 Department of Neurology Annual Report

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