Naval Medical Center Portsmouth Observes World Multiple System Atrophy Day

Photo By Petty Officer 2nd Class Paul Wu | 171003-N-NR803-011 Portsmouth, Va. (Oct. 3, 2017) Lt. Cmdr. Glen Cook is a Naval Medical Center Portsmouth (NMCP) clinical neurophysiologist and the autonomic disorders specialist in NMCP’s Autonomic Disorders Testing Laboratory. Due to the rarity of autonomic disorders, Cook’s work keeps NMCP and the Department of Defense at the forefront of understanding and treating autonomic disorders across the medical community globally. (U.S. Navy photo by Sonar Technician Surface 3rd Class Paul Wu/released)  

PORTSMOUTH, VA, UNITED STATES

10.03.2017

Story by Petty Officer 3rd Class Paul Wu 

Naval Medical Center - Portsmouth

Naval Medical Center Portsmouth’s (NMCP) Autonomic Disorders Clinic invites patients and providers to join the clinic’s fight against Multiple System Atrophy (MSA) and autonomic disorders in observance of World MSA Day on Oct. 3.
The autonomic disorders clinic, led by Lt. Cmdr. Glen Cook, NMCP clinical neurophysiologist and the DOD’s sole autonomic disorders specialist, was originally pioneered by Cook and staff at Walter Reed National Military Medical Center in December 2014. NMCP now houses the only autonomic disorders clinic.
Due to the rarity of autonomic diseases like MSA, the practice and treatment conducted by Cook and his staff keeps NMCP and the DOD at the forefront of being a leader in sharing the latest knowledge on MSA and autonomic disorders across the medical community globally.
“We’re actively getting data and analyzing data that’s giving us lots of information that we haven’t had before,” Cook said.
MSA is known as a rare progressive neurodegenerative disorder that affects the autonomic nervous system, also known as the system that controls the involuntary actions in the human body, such as blood pressure or digestion.
The disease is additionally categorized by how it impacts a patient’s movement with the affected movement being classified in either two categories: cerebellar movement issues (movement issues relating to coordination) or Parkinsonism movement issues (issues relating to a patient’s ability to initiate movement or a patient having slowed movement).
Cook will be presenting a case study that came out of NMCP’s autonomic disorders clinic in November at the American Autonomics Society. He regularly educates DOD residents across multiple disciplines on how to recognize, diagnose and manage autonomic disorder like MSA and he’s also the command’s official representative to Dysautonomia International, a non-profit organization that advocates, creates awareness and promotes research advancements on autonomic disorders.
“Because the command supports these types of activities it helps us maintain a high standing among our peers and lets us support the mission of broader education to both the medical community and the public,” Cook said.
After it’s induction at Walter Reed, the autonomics disorders clinic moved with Cook to NMCP with the initial autonomic disorders testing lab remaining at Walter Reed and an additional testing lab being added at NMCP with Cook’s transfer.
Cook emphasized the importance for providers in different areas of medicine to be at the forefront of identifying possible symptoms of autonomic disorders like MSA.
“Because the autonomic nervous system is throughout the body and the body’s function, we often interface with colleagues in gastroenterology, cardiology and urogynecology,” Cook said, “These diseases [like MSA] present themselves with various manifestations and so a multi-disciplinary approach is needed.”
Cook said possible symptomatic manifestations in MSA can appear with impaired movement or coordination, urinary/bowel dysfunction, sweating abnormalities, sleep disorders, sexual dysfunction, cardiovascular issues and psychiatric health.
Once identified, MSA is treated symptomatically, however, Cook stated that there are no current treatments to cure and arrest the progressive neurodegeneration of MSA.
Currently, autonomic disorders cases like MSA, take on average about five years to receive diagnosis due to the disease’s complexity, making timing of the essence for providers to catch possible symptoms early on.
Once referred, depending on the condition, patients at NMCP with autonomic disorders like MSA undergo a possible series of ancillary tests in one of two of the DOD’s autonomic testing labs.
Possible tests taken include quantitative evoked sweat measurements, beat-to-beat blood pressure measurements, or electro-audiographic measurements with various deep breathing.
However, Cook said the most effective tool in diagnosing or developing a treatment plan for MSA is giving ample attention toward listening to the patient.
“Patients will tell us the story and help us sniff out the trail. If the trail starts going cold in one direction, we start going into another direction using guided questions,” Cook said, “We’re [autonomic disorder specialists] more just observers and we need to let the patients talk and tell us what’s going on.”
Cook and his staff presently have three active protocols with patients with MSA. Cook said about a third of autonomic disorders the clinic sees represent active duty personnel across the DOD.
In regard to what people can do to promote health and reduce risk of neurodegenerative diseases like MSA, Cook said that science is still relatively limited, but some things can be said for certain.
“Sleep well. Eat well. Exercise,” Cook said, “It’s that basic stuff that I could say for all the diseases I treat.”
Cook specified that eating well is defined by eating whole foods like vegetables and fruits and notes for people to be cognizant of foods containing pesticides and herbicides. In addition, he further explains that studies have shown that poor sleep is related to increased measures of neurodegeneration.
Cook said that studies reflecting the effectiveness of exercise is limited with autonomic disorders but have shown good data reflecting that exercise improves outcome overtime for patients with Parkinson’s disease, another autonomic disorder that is plagued by abnormal deposits of the alpha-synuclein protein like MSA.
NMCP remains committed to continuing the fight against autonomics disorders like MSA going forward. The command continues to fund and build on the DOD’s second autonomics testing lab, purchasing equipment and supplying staff to continue work on autonomic diseases and furthering research to understand each autonomic disorders’ rarity and complexities. Cook said he’s proud that the lab will remain open in perpetuity even after he leaves NMCP and says that the staff is working on a telemedicine project that will allow him to be involved remotely with the lab after he transfers.
For more information on MSA, visit www.multiplesystematrophy.org/about-msa or refer to the NMCP’s Autonomic Disorder’s Clinic.

• Date Taken: 10.03.2017
• Date Posted: 10.03.2017 15:02
• Story ID: 250436
• Location: PORTSMOUTH, VA, US