Forensic Psychiatry; Geriatric Psychiatry; Neurology; Psychiatry; Multiple Sclerosis; Alzheimer Disease / Memory Disorders; Neurodegenerative disorders; Neuropsychology
I direct two UBMD clinics: an outpatient neuropsychology practice at the Buffalo General Medical Center and an inpatient consultation service at the Erie County Medical Center. In addition, I provide services for patients at the Jacobs Multiple Sclerosis Center and the UB Alzheimer’s Disease and Memory Disorders Center. Our clinical mission is to provide compassionate, state-of-the-art care for patients and families affected by a wide range of neurological and psychiatric disorders. Our top-rate neuropsychological services are based on the integration of neurological, psychiatric and imaging findings and structured to meet the needs of our patients and their caregivers. Our neuropsychology service is dedicated to the teaching mission of UB. We support the departments of neurology and psychiatry as well as the rehabilitation services in the orthopaedic, occupational therapy and physical therapy divisions at our UB-affiliated hospitals. Students, residents and fellows have a rich learning experience with us and see a wide range of diseases such as personality disorder, malingering, depression, head trauma, concussion, multiple sclerosis (MS), stroke, dementia, epilepsy and pervasive developmental disorders. Medical students have the opportunity to work with both children and adults during didactics, and they may choose to focus on the evaluation of either patient population based on their clinical focus. My research mission is to employ behavioral psychometrics to understand how cerebral disease affects personality, cognition, and psychiatric stability. Two memory tests I developed, the Brief Visuospatial Memory Test Revised (BVMTR) and the Hopkins Verbal Learning Test Revised (HVLTR), are widely used in neuropsychology, especially in the areas of multiple sclerosis, head injury, and schizophrenia, and they are included in consensus panel test batteries for athlete concussions in the NHL and NFL. I work to develop new tests in order to understand more about the effect of cerebral injuries and disease. I also focus my research in multiple sclerosis (MS) and have conducted several studies on pharmacological treatments for cognitive function in MS patients. I have contributed in noteworthy studies as the lead author on a consensus battery for MS patients (the Minimal Assessment of Cognitive Function in MS), which is a gold standard in the literature, and as a major contributor to the idea that brain atrophy is the primary driver of cognitive impairment in MS, and in particular, deep gray matter atrophy. My major findings also include that personality changes can be assessed in MS patients, are more common in MS dementia, and relate to clinical outcomes, that self-report is not a valid indicator of neuropsychological status in MS, and that Symbol Digit Modalities Test is a reliable and valid marker for cognitive outcomes in clinical trials.
Epilepsy; Multiple Sclerosis; Neurology; Neuropsychology; Pediatrics
As a neuropsychologist with training in both child and adult neuropsychology, my clinical practice focuses on the comprehensive neurocognitive and psychological evaluation of children, adolescents and adults. My primary focus is in pediatric neuropsychology; I see children ages 3 to 18 with a variety of developmental and neurological disorders. I also evaluate adults with developmental disorders and epilepsy. One of my areas of expertise is in pre- and post-surgical assessment, primarily for patients with intractable seizure disorder. As a consultant with our epilepsy unit at Women and Children’s Hospital of Buffalo, I work with patients’ neurologists and neurosurgeons regarding seizure focus, cognitive integrity and prognostic factors related to surgical outcome. I also serve as the primary neuropsychologist for the Pediatric MS Center of Excellence, one of six such centers in the U.S. designated by the National Multiple Sclerosis Society that offers comprehensive, multidisciplinary evaluation and care for children with demyelinating conditions. I provide neuropsychological assessment for the children and conduct research in the center and with collaborating sites within the network. In addition, I have extensive training and experience in assessment and diagnostic clarification for children with neurodevelopmental disorders. In my outpatient clinic at Buffalo General Medical Center, I focus on thorough evaluations of neurocognitive function to provide not only diagnostic clarification, but a better understanding of specific areas of strength and weakness to help guide my patients’ medical treatment, school interventions and other therapeutic interventions. Given findings from the neuropsychological evaluation, I provide specific recommendations to help my patients achieve the greatest degree of success possible. My research interests include understanding neurocognitive functioning in pediatric patients with demyelinating disorders and epilepsy treatment and surgical outcomes. Conducting clinical research allows me to use information from my clinical work to guide research questions, improve understanding of patient populations and provide better care and guidance regarding treatment interventions to my patients. As a teacher, I work with medical residents and psychology graduate students to improve their understanding of neurocognitive functioning and neurocognitive assessment in children and adults with a variety of disorders such as MS, demyelinating disorders, epilepsy, head injury and autism spectrum disorder. I also tailor training if a resident/student has a particular area of interest. In addition, I serve as a mentor for neurology residents and psychology graduate students on research projects and offer more extensive training in neuropsychological assessment and diagnostics. I am also available to work with recently graduated undergraduates and master’s students who would like to gain research experience.