Neuroimmunology/Multiple Sclerosis Division

The Neuroimmunology Division healthcare providers include Drs. Rock Heyman, Islam Zaydan, Zongqi Xia, Cigdem Isitan, Kavita Thakkar, Mr. Ryan Orie, PA-C and Emily Eiben, CRNP. 

This active division has a comprehensive outpatient clinical care program that has earned awards for its excellence. The MS program is designated as a Comprehensive MS Care Center by the National MS Society, recognizing comprehensive clinical, research, and educational programs. The program includes comprehensive care for all aspects of care with close affiliations with many services at UPMC and throughout the region to meet the needs of people with MS at all levels of disease severity. Other immunologic conditions such as neuromyelitis optica (NMO), Myelin Oligodendrocyte Glycoprotein (MOG) antibody disease, autoimmune encephalitis, and CNS involvement by Sjogren's syndrome, sarcoidosis and mixed connective tissue disease are also evaluated and treated by us. We see patients with these conditions from throughout the region, country and international regions.  We provide ongoing care as well as second opinion services.  A full spectrum of diagnostic and treatment options is available. Dr. Kavita Thakkar of pediatric neurology works on site with us from the pediatric neurology division. Lumbar punctures using the best techniques and standards are performed on site for patients of ours and associated physicians.  Other testing including ocular coherence tomography (OCT) and post void bladder ultrasonography are performed in our suite.  We have ready access to state-of-the-art MRI scanning including 3Tesla magnets and refined protocols, evoked potentials, and neuropsychological/cognitive testing.  Dr. Morgan Faeder of neuropsychology and counselor Connie Crain are embedded in our department to high quality management of mood and behavioral disorders. We have access to a large team of subspecialists including Physical Medicine and Rehabilitation (baclofen pumps, focal neurolytic treatments, orthotics, power mobility, assistive technology, adaptive driving), Neuro-urology, Neuro-gastroenterology, Neurosurgery (for  trigeminal neuralgia rhizotomies, cyber-knife, or decompressive procedures), Neurovestibular, swallowing disorders evaluations (including modified barium swallows and flexible endoscopic evaluation of swallowing), and neuro-auditory specialists who closely work with us. We work closely with rehabilitation professionals from the Center for Rehabilitation Services with subgroups of their Physical and Occupational therapists who have additional training in MS and related disorders and interact closely with us. Speech pathologists from this group help provide care for cognitive, communication and swallowing disorders.

Division research continues and includes involvement in multi-center studies of novel oral, injectable, and infusion therapies for MS. We have been a part of numerous studies leading to the approval of most of the agents used in current MS and NMO treatment.  We have a variety of ongoing studies and Dr. Xia has a large ongoing long-term observational research study to understand how individuals with MS and related disorders differ from one another. Specifically, we want to investigate the factors that influence individual variations in disease course and treatment response among people with multiple sclerosis. Participants can have an established diagnosis of MS, a first central nervous system demyelinating episode with a positive MRI scan, or abnormal MRI scans characteristic of MS but no clinical symptoms of the disease. We are also enrolling control participants who can be cohabitants (sharing the same living environment but not related), family members, or general population. This study has already led to addition projects to better understand many aspects of MS.

Educational programs by division staff are directed towards people with MS, caregivers, allied health professionals, medical students, residents, and physicians. Medical students and neuroscience students are frequently present in the office with our professionals and student nurses often work with our infusion Center nurse staff. We have providers clinical fellowship training for neurologists wishing to sub-specialize in MS care.  Division personnel frequently lecture to the numerous support groups throughout the region and often nationally. Recent presentations by divisional professional staff at the AAN, ACTRIMS and CMSC meeting encompassed many areas of MS care. Division educational conferences occur every Thursday morning for the entire team (including front desk and back room authorization staff as well as medical assistants, nurses, advanced practice providers, physicians, research staff and administrators).  Addition provider conferences include every other week neuroradiology case conferences, a lecture series and journal club.  Weekly patient care “huddles” occur separately by nurses and providers to best optimize care

We work to advance MS care. Diagnosis and treatment of people with MS often has been hampered by many administrative, financial and bureaucratic barriers. The division works with regional and national health insurance organizations to try to minimize non-scientific barriers to MS care and seek to decrease the costs of providing such care. We work closely with the National Multiple Sclerosis Society on a variety of issues in some of these areas. We work closely with out integrated delivery system at UPMC to provide additional supports to decrease barriers to care, maximize outcomes and improve quality of life for the patients who trust us with their care.