Alberto Espay, MD, MSc

Alberto Espay

Affiliated to teaching/tutoring

Dr. Alberto Espay is Professor and Endowed Chair of the James J. and Joan A. Gardner Center for Parkinson’s disease at the University of Cincinnati.

About me

Dr. Alberto Espay is Professor and Endowed Chair of the James J. and Joan A. Gardner Center for Parkinson’s disease at the University of Cincinnati. He has published over 270 research articles and 7 neurology textbooks, including Common Movement Disorders Pitfalls, which received the Highly Commended BMA Medical Book Award in 2013, and the public-readership book Brain Fables, the Hidden History of Neurodegenerative Diseases and a Blueprint to Conquer them, coauthored with Parkinson patient and advocate Benjamin Stecher, selected by the Association of American Publishers for the PROSE Award honoring the best scholarly work in Neuroscience published in 2020. He has served as Chair of the Movement Disorders Section of the American Academy of Neurology, Associate Editor of Movement Disorders, and in the Executive Committee of the Parkinson Study Group (PSG). He currently serves the International Parkinson and Movement Disorders Society (MDS) as Chair of the Task Force on Technology and as Secretary of its Pan-American Section. 

Research description

As of May 2021, I have published 275 peer-reviewed articles (H index = 50), 31 invited book chapters, and 8 books. Key categories with selected publications are below.

Complete List of Published Work in PubMed: http://www.ncbi.nlm.nih.gov/pubmed/?term=espay+a

 

1. Re-evaluation of neurodegenerative nosology: I helped identify pitfalls of biomarker-development programs to lay the foundations for a phenotype-agnostic biomarker discovery program (CCBP) and reconfigure the design of disease-modifying treatment strategies for patients with neurodegenerative disorders.

Key publications:

  1. Espay AJ, Vizcarra JA, Marsili L, Lang AE, Simon DK, Merola A, Josephs KA, Fasano A, Morgante F, Savica R, Greenamyre JT, Cambi F, Yamasaki TR, Tanner CM, Gan-Or Z, Litvan I, Mata IF, Zabetian CP, Brundin P, Fernandez HH, Standaert DG, Kauffman MA, Schwarzschild MA, Sardi SP, Sherer T, Perry G, Leverenz JB. Revisiting protein aggregation as pathogenic in sporadic Parkinson and Alzheimer diseases. Neurology 2019 Feb 12;92(7):329-337.
  2. Espay AJ, Schwarzschild MA, Tanner CM, Fernandez HH, Simon DK, Leverenz JB, Merola A, Chen-Plotkin A, Brundin P, Kauffman MA, Erro R, Kieburtz K, Woo D, Macklin EA, Standaert DG, Lang AE. Biomarker-driven phenotyping in Parkinson's disease: A translational missing link in disease-modifying clinical trials. Mov Disord 2017 Mar;32(3):319-324.
  3. Merola A, Rosso M, Romagnolo A, Comi C, Fasano A, Zibetti M, Lopez-Castellanos JR, Cocito D, Lopiano L, Espay AJ. Peripheral neuropathy as marker of severe Parkinson's disease phenotype. Mov Disord 2017 Aug;32(8):1256-1258.
  1. Espay AJ, Da Prat GA, Dwivedi AK, Rodriguez-Porcel F, Vaughan JE, Rosso M, Devoto JL, Duker AP, Masellis M, Smith CD, Mandybur GT, Merola A, Lang AE. Deconstructing normal pressure hydrocephalus: Ventriculomegaly as early sign of neurodegeneration. Ann Neurol. 2017 Oct;82(4):503-513.

 

2. Therapeutics of Parkinson’s disease: I have helped examine the role of novel and repurposed therapies for PD (e.g., SURE-PD2 and SURE-PD3, IPX-066 [extended release oral levodopa] and infusion systems Duopa [levodopa enteral infusion], Neuroderm [subcutaneous levodopa infusion], and apomorphine SQ infusion) and evaluated the effect of chemodenervation with botulinum toxin to treat levodopa-induced cervical dyskinesia in PD, methylphenidate for freezing of gait in PD, and placebo effect of cost. Some clinical observations in other disorders have turned into therapeutic strategies (e.g., retrainment in functional tremor and orthotic devices for writer’s cramp and primary writing tremor).

 

Key publications:

  1. Espay AJ, Norris MM, Eliassen JC, Dwivedi A, Smith MS, Banks C, Allendorfer JB, Lang AE, Fleck DE, Linke MJ, Szaflarski JP. Placebo effect of medication cost in Parkinson disease: A randomized double-blind study. Neurology 2015 Feb 24;84(8):794-802
  2. Espay AJ, Dwivedi AK, Payne M, Gaines L, Vaughan JE, Maddux BN, Slevin JT, Gartner M, Sahay A, Revilla FJ, Duker AP, Shukla R. Methylphenidate for gait impairment in Parkinson’s disease: a randomized clinical trial. Neurology, 2011;76(14):1256-62.
  3. Espay AJ, Vaughan JE, Shukla R, Gartner M, Sahay A, Revilla FJ, Duker AP. Botulinum Toxin type A for levodopa-induced cervical dyskinesias in Parkinson’s disease: Unfavorable risk-benefit ratio. Mov Disord, 2011;26(5):913-4
  4. Espay AJ, Baram Y, Dwivedi AK, Shukla R, Gartner M, Gaines L, Duker AP, Revilla FJ. At-home training with closed-loop augmented-reality cueing device for improvement of gait in patients with Parkinson’s disease. J Rehabil Res Dev, 2010;47(6):573-82

 

3. Integration of technology into PD and movement disorders: I uncovered the differential contribution of impairments in speed and amplitude of movement to the response to levodopa and to motor disability, leading to the creation of a validated stand-alone bradykinesia rating scale. These efforts have helped inform the interpretation of data from wearable monitoring technology, which are being adopted as important endpoints of motor function in clinical trials for PD.

 

Key publications:

  1. Heldman DA, Espay AJ, Lewitt PA, Giuffrida JP. Clinician versus machine: Reliability and responsiveness of motor endpoints in Parkinson's disease. Parkinsonism Relat Disord 2014;20(6):590-5
  2. Espay AJ, Fasano A, van Nuenen BFL, Payne M, Snijders AH, Bloem BR. “On” state freezing of gait in Parkinson’s disease: A paradoxical levodopa-induced complication. Neurology 2012;78(7):454-7
  3. Espay AJ, Giuffrida JP, Chen R, Payne M, Mazzella F, Dunn E, Vaughan JE, Duker AP, Sahay A, Kim SJ, Revilla FJ, Heldman DA. Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson’s disease. Mov Disord 2011 Dec;26(14):2504-8
  4. Espay AJ, Bonato P, Nahab FB, Maetzler W, Dean JM, Klucken J, Eskofier BM, Merola A, Horak F, Lang AE, Reilmann R, Giuffrida J, Nieuwboer A, Horne M, Little MA, Litvan I, Simuni T, Dorsey ER, Burack MA, Kubota K, Kamondi A, Godinho C, Daneault JF, Mitsi G, Krinke L, Hausdorff JM, Bloem BR, Papapetropoulos S; Movement Disorders Society Task Force on Technology. Technology in Parkinson's disease: Challenges and opportunities. Mov Disord 2016 Sep;31(9):1272-82.

 

4. Functional movement disorders (FMD): With my team, I have examined the pathophysiology, diagnosis and treatment approaches for FMD, among the most disabling, common, and costly movement disorders. Our recently-completed 12-week CBT study for patients with functional tremor yielded almost 80% remission or improvement (1K23MH092735), the largest magnitude of benefit ever reported in FMD.

 

Key publications:

  1. Espay AJ, Ries S, Maloney T, Vannest J, Neefus E, Dwivedi AK, Allendorfer JB, Wulsin LR, LaFrance WC Jr, Lange AE, Szaflarski JP. Clinical and neural responses to cognitive behavioral therapy for functional tremor. Neurology 2019;93(19):e1787-e1798.
  2. Espay AJ, Maloney T, Vannest J, Norris MM, Eliassen JC, Neefus E, Allendorfer JB, Chen R, Szaflarski JP. Dysfunction in emotion processing underlies functional (psychogenic) dystonia. Mov Disord 2018 Jan;33(1):136-145.
  3. Espay AJ, Edwards MJ, Oggioni GD, Phielipp N, Cox B, Gonzalez-Usigli H, Pecina C, Heldman DA, Mishra J, Lang AE. Tremor retrainment as therapeutic strategy in psychogenic (functional) tremor. Parkinsonism Relat Disord 2014;20(6):647-50.
  4. Espay AJ, Morgante F, Purzner J, Gunraj C, Lang AE, Chen R. Cortical and spinal abnormalities in psychogenic dystonia. Ann Neurol 2006;59(5):825-834

Academic honours, awards and prizes

Dr. Espay has received numerous awards, including the Dean’s Scholar in Clinical Research award, the Dystonia Coalition Career Development award, the NIH-funded K23 Career Development award, the Cincinnati Business Courier’s Forty Under 40 award, the Health Care Hero award, the Patients’ Choice and Compassionate Doctor awards, the Excellence in Mentoring award, and the Spanish Society of Neurology’s Cotzias award. With colleagues at the University of Cincinnati, he recently launched the first biomarker study of aging (CCBPstudy.com), designed to match people with neurodegenerative disorders to available therapies from which they are most biologically suitable to benefit, regardless of clinicopathologic diagnoses.

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