Multiple sclerosis has been a central focus of the University of Chicago Neurology Department for over 35 years. The clinic is busy, with over 3000 patient visits per year. Most patients come from the Chicago metropolitan region, which has a population of 8 million. A significant number of Neurologist-referrals and self-referrals are from the Midwest, continental US, and from many foreign countries.
The MS clinic has been the site of approximately 70 clinical MS trials. We were participants (and contributed significantly to the design) in the first large multicenter trials of Cyclosporin A and interferon-β-1b. We are currently involved in multicenter Phase I, II, III, and IV MS trials of all interferons, FTY720/fingolimod, alemtuzumab, glatiramer, estriol, ocrelizumab, recovery from relapses, and myelin repair in relapsing and progressive MS, and symptomatic therapies. In internally designed and executed studies, we demonstrated hypothalamic-pituitary-adrenal axis and sympathetic nervous system abnormities, and defined the role of retinoids, β-adrenergic agonists, and prostaglandin analogues on the course of MS or on MS symptoms. For instance, the prostaglandin analogue, misoprostol, reduced severity of EAE and also abrogated the pain of trigeminal neuralgia in MS patients who had been refractory to all other drug and surgical interventions.
This fellowship consists of learning the art of MS diagnosis, manifestations, differential diagnosis, and therapy with internationally-recognized MS experts. Didactic classes on ethics, trial design, and statistics are paired with an in-depth focus on the fellow’s specific clinical and research interests.