2024 Rush Parkinson’s Disease Donor Impact Report
Building on a Strong Foundation
Your Impact on the Rush Parkinson’s Disease and Movement Disorders Program
With Your Support, We’re Improving Lives
At the Rush Parkinson’s Disease and Movement Disorders Program, the care we provide our patients is informed by the discoveries we make in our laboratories. And the questions we ask in those labs are informed by our patients’ lived experiences.
This model — known as translational, or bench-to-bedside, research — is what we do best. By nurturing our physicians, clinicians and students as they undertake groundbreaking research projects, our care remains at the leading edge in the Chicago area and nationwide.
Our program’s deep foundation and the accomplishments built upon it over the past year were made possible by the partnership of our donor community. Your belief in the care we provide, the research we conduct and the education we offer the next generation sustains our program’s excellence and breaks down barriers to help us further advance our field.
In the following pages, you will read about the exciting progress our program has made and the important initiatives we are focused on as we continue our search for preventive treatments and even cures for Parkinson’s disease and other movement disorders.
At the heart of all we do, we aim to improve patients’ lives. This essence of our program was instilled in us by Christopher G. Goetz, MD, who we recognize on Pages 6-7 of this report. Dr. Goetz led and grew our program for 30 years, and in June 2025, he will enjoy a well-deserved retirement.
After working side by side with Dr. Goetz for more than a decade, I will have the great honor of continuing to carry out the legacy of the program that he so carefully and compassionately built. Our program is at the forefront of Parkinson’s disease and movement disorders care, research and education because of Dr. Goetz’s leadership — and it’s all fueled by your support.
As we look ahead to all we’ll accomplish together in the next 30 years, I want to thank you for supporting our continued growth.
Sincerely,
Deborah A. Hall, MD, PhD
The Parkinson’s Foundation Chair of Neurological Sciences and Director of the Rush Parkinson’s Disease and Movement Disorders Program
By the Numbers
12,445 patients treated in fiscal year 2024
140 active research projects in the Parkinson’s Disease and Movement Disorders Program
4 fellows and visiting scholars in fiscal year 2024
43 research articles published by faculty in 2023
9 posters and presentations by Rush faculty and trainees at the 2024 International Congress of Parkinson’s Disease and Movement Disorders
61 team members
Focused on a Disease-Free Future
Seeking
the root causes of Parkinson’s disease and related movement disorders
Through the years, Rush physician-researchers have advanced science and clinical practice to improve treatments for the motor and nonmotor symptoms of Parkinson’s disease. These advancements have resulted in improved quality of life for many patients, but the question remains: What could patients’ lives look like if physicians could treat the root cause of the disease?
To create disease-modifying therapies and preventive strategies, experts must first understand the disease’s mechanisms and the biomarkers of disease progression. It is well understood that misfolded aggregations of the protein alpha synuclein, known as Lewy bodies, clump together in the brain, leading to the development of Parkinson’s disease and
related movement disorders. But work remains to determine why the protein misfolds.
Rush scientists are at the helm of important efforts to understand and treat the root causes.
Aspiring to treat Parkinson’s disease with a toothpaste
Researchers at Rush were among the first in the world to reveal the links between the gastrointestinal tract and the brain. Over the past 13 years, their work has evolved and contributed to the field’s understanding that imbalances in the intestinal, nasal and oral microbiomes, or the collections of microorganisms that live in the body, are linked to neuroinflammation and neurodegeneration.
Researchers have also identified significant associations between gum disorders and Parkinson’s disease, including the presence of alpha synuclein in saliva and gum cells. A team of Rush physician-scientists is further examining these associations in hopes of identifying an oral target for disease prevention or treatment — potentially through a toothpaste.
The team is enrolling 60 patients with Parkinson’s disease and household controls in a study to evaluate the following hypotheses:
• Patients with mild and moderate Parkinson’s disease exhibit more severe periodontal inflammation than household controls.
• Among patients with Parkinson’s disease, oral microbiome dysbiosis correlates with the severity of their disease.
The team will also use participants’ serum and oral cavity samples to assess inflammatory biomarkers.
Examining alpha synuclein pathology through the olfactory bulb
As the U.S. population ages, the prevalence of Parkinson’s disease, Lewy body dementia and multiple system atrophy is projected to increase. These related neurodegenerative diseases are known as synucleinopathies, as they share similar pathology of aggregated clusters of alpha synuclein. Their most significant risk factor is aging.
Recognizing the importance of discovering a source and treatment for alpha synuclein pathology, Rush faculty developed a novel technique, called BAR-PSER129, to chemically label and analyze the many interactions between Lewy bodies and other proteins in brain tissue. Their work has been published in leading-edge journals, earned grant funding from the National Institutes of Health and gained the collaboration of the Massachusetts Institute of Technology’s Whitehead Institute. Further, our team has vast experience studying the olfactory bulb — the neural structure near the front of the brain that is increasingly viewed as the likely origin of alpha synuclein pathology.
To advance this work, our team plans to study the effect of aging on alpha synuclein function in the olfactory bulb and the susceptibility of aging cells in the mouse brain. Olfactory bulb dysfunction resulting in loss of smell is an early symptom of Parkinson’s disease, and autopsies of people with synucleinopathies reveal significant Lewy pathology in the olfactory bulb. These and other observations strongly suggest this is where the disease may originate.
Our research team also plans to use donor tissue to study Lewy body molecular interactions with the human olfactory bulb. Our experts have successfully conducted these
analyses in other parts of the brain where Lewy pathology is observed, and examination of the olfactory bulb will be novel in the field.
Targeting movement disorders at the genetic level
Advances in neurogenetics are revolutionizing the field of movement disorders. Genes are rapidly being discovered that increase the risk of or are related to movement disorders, such as Parkinson’s disease, dystonia and ataxia. Increasingly, this knowledge is actionable, with genetic testing becoming a standard practice in the movement disorders clinic and informing more personalized approaches to treatment.
Most exciting, however, is the curative potential of gene therapies. Breakthrough gene therapy approaches now offer a functional cure for certain genetic neurological diseases, such as spinal muscular atrophy. Similarly exciting gene therapies for movement disorders such as Parkinson’s disease are on the horizon, and Rush experts are poised to lead this transformation.
Rush leads Illinois’ largest program for Huntington’s disease and is one of just six sites in the U.S. studying the safety and efficacy of an adeno-associated virus-based gene therapy for this condition. We were part of the discovery team for the first gene linked to Parkinson’s disease in Black patients.
Rush faculty are leading multiple studies of targeted therapies for genetic forms of Parkinson’s disease. Our data, tissue and clinical repositories are known as some of the nation’s largest, with many DNA samples accessible for research. The Rush Movement Disorders Brain Bank also sets us apart, with a growing number of brains from generous donors allowing for basic and translational research opportunities few other institutions can pursue at our scale.
With appropriate staff and equipment resources, our team plans to grow its gene therapy efforts and advance personalized medicine in movement disorders.
Honoring Christopher G. Goetz, MD
The force behind Rush’s powerhouse Parkinson’s disease and movement disorders program
Christopher G. Goetz, MD, has dedicated his entire career to improving the lives of people with movement disorders. Since graduating from Rush Medical College in 1975, he has cared for thousands of patients, mentored and inspired countless physicians, authored hundreds of publications to advance neurological science, and served in numerous leadership roles for national and international movement disorders organizations.
After residencies at Rush and Michael Reese Medical Center, Dr. Goetz joined Rush full time. He led the Rush Parkinson’s Disease and Movement Disorders Program for 30 years, recognizing the value of gathering specialists in one suite to collaborate and garnering international acclaim in the process.
After 50 highly productive years in medicine, he will enjoy a well-deserved retirement at the end of June 2025. Deborah A. Hall, MD, PhD, the Parkinson’s Foundation Chair of Neurological Sciences, will carry on the program’s legacy. Philanthropic funding from the Dr. Goetz Endowed Research and Education Fund will support Dr. Hall and her team to that end.
Contributing major developments to the field
Throughout his career, Dr. Goetz witnessed and contributed to groundbreaking treatments and developments in our understanding of movement disorders.
He observed some of the first clinical applications of the drug levodopa in the early 1970s and the dramatic success of deep brain stimulation for tremor treatment in more recent years. Each markedly helped patients who experienced debilitating symptoms before the treatments. He also contributed to the field’s groundbreaking discovery that aggregations of the protein alpha synuclein cut off oxygen supply to dopamine cells, leading to the development of Parkinson’s disease and other movement disorders.
When a dopamine cell bursts, fragments of the synuclein clump act like a virus or bacteria and may penetrate other cells, creating a propagating illness.
“We don’t know exactly how this process starts yet, but we’ll crack that,” Dr. Goetz said. “We need to figure out what is causing the first aggregation of alpha synuclein. To be able to treat and stop the disease from getting any worse would be heroic. We’re starting to do that with antibody research programs.
“To me, seeing all three of these advances in one career and to have participated in all of them is pretty thrilling.”
Among his most prominent contributions to the field, Dr. Goetz led the development of the Movement Disorder Society-
Unified Parkinson’s Disease Rating Scale, a standardized tool for physicians worldwide to evaluate and measure changes in patients’ motor and nonmotor symptoms. This scale is now the gold standard in the field.
Training the next generation
While Dr. Goetz’s research and academic work have crossed international lines, so, too, has his mentorship, especially through the Rush Movement Disorders Fellowship and the International Parkinson and Movement Disorder Society’s Training Scholars Leadership Program.
Gian Pal, MD, associate professor in the Division of Movement Disorders at Rutgers Robert Wood Johnson Medical School, credits Dr. Goetz with advancing his success as a clinicianscientist. While most early-career faculty positions require frequent clinical time, Dr. Goetz advocated for the creation of a unique position that protected 40% of Dr. Pal’s time for research, helping him advance his work to secure grant funding from the National Institutes of Health.
“This springboarded my career,” Dr. Pal said. “I’ve always modeled myself after him. Even the most devastating diagnosis he could deliver with such care. He didn’t sugarcoat but struck a balance between being compassionate and realistic.
“To this day, when I’m delivering those kinds of diagnoses to patients, I channel his voice. He’s a dynamic force. There are few people like him, with his work ethic and desire to help teach and advance science.”
Perennially providing top-tier patient care
Throughout his career, Dr. Goetz oversaw scientific advancement consistently rooted in the needs of his patients.
“He puts my interests first and advocates for me, and I appreciate that,” said Tom Meagher Jr. “I’ve gone to him with many questions over the past few years, and he’s always been insightful with his responses. He stands by his convictions, has high standards and is highly ethical.”
Dr. Goetz always found joy in the science of medicine and laboratory work, but the gratitude he received from patients was unparalleled.
“I think of this whole family of people who all have basically the same disease, but each is facing challenges with his or her own courage and integrity,” Dr. Goetz said. “There is no real ‘the
Parkinson’s.’ It’s ‘my Parkinson’s’ with each personal version being a valid and treatable challenge that the doctor and patient face together.
“When a patient and family say thank you, it is a cherished gift. The thanks you receive for one’s fidelity over many years — that’s a very special kind of message to a doctor.”
Where is the field heading?
In the immediate future, the challenge Dr. Hall, the Rush team and their colleagues worldwide face is to keep advancing science toward a preventive treatment or even a cure for Parkinson’s disease — work that will take both money and time. And, at a larger scale, deeper questions about the brain and its evolution remain.
“By evolutionary standards, our cortex has evolved enormously, but the brain stem has not,” Dr. Goetz said. “Even if we crack the synuclein issue, we still have an evolutionarily compromised brain stem, and we’re not going to get around that. Cultural evolution is much more rapid than cellular or molecular evolution, and so society is moving forward, demanding new things, new technology, new skills — using your thumb for your iPhone and doing things that, even 10 years ago, people didn’t have to do.
“We’re dealing with a problem that is really part and parcel of the human state, and we’re not going to get around it. We’re still going to have brain stem disease. Will it look like Parkinson’s? I don’t know, but I think that it will.”
And, for that reason, movement disorders specialists will always be needed. Building upon Dr. Goetz’s instrumental contributions to the field, Rush remains committed to training future clinicians, advancing research and — above all — providing the highest-quality patient care.
“I’m proud of what I’ve accomplished, and I’m proud to pass the baton,” Dr. Goetz said. “I think our group is strong, but it needs to carry on with a new leader. Deborah is the right person to do that.”
Research Driven by Collaboration
Multiple minds working together can often discover better solutions than one mind alone.
Over the past five decades, especially under the leadership of Christopher G. Goetz, MD, director of strategic growth and innovation, the Rush Parkinson’s Disease and Movement Disorders Program has emphasized collaboration.
Rush researchers approach the field’s predominant questions from a place of curiosity and open-mindedness in hopes of moving the needle on patient outcomes. Their collaborations span specialties within the program, across Rush and well beyond at institutions around the nation and world.
The following highlights represent just a few of our program’s fruitful research collaborations.
Seeking improved and expanded uses for focused ultrasound treatments
Rush’s MR-guided focused ultrasound program is the busiest in the Midwest and among the top five in the country. Led by Neepa Patel, MD, director of Rush’s interventional Parkinson’s disease program, and Sepehr Sani, MD, neurosurgeon, the program trains surgeons from around the world. MR-guided focused ultrasound is a minimally invasive, incisionless procedure that is used to treat essential tremor and advanced motor symptoms of movement disorders.
The program is engaged in two domains of research: improving the technology so it is safer and more readily usable for various indications and evaluating the safety and efficacy of the technology for treating other diseases, such as pain and psychiatric disorders.
“We are developing projects to help understand and ultimately reduce the impact of side effects of patients undergoing focused ultrasound specifically related to gait and balance,” Dr. Patel said.
Joanne O’Keefe, PhD, PT, associate professor in the Department of Occupational Therapy, is partnering with
Dr. Sani to conduct a gait and balance study in patients with essential tremor who receive focused ultrasound treatment. To advance this work, Dr. O’Keefe submitted an application for grant funding to the National Institutes of Health, which is expected to be reviewed soon.
Leaders of the program, which is currently offered at Rush Oak Brook, plan to expand the technology to Rush University Medical Center by installing a new research unit there. By doing so, researchers can deepen collaborations with colleagues across the institution to advance the study of the technology for other conditions, including potentially using it to open the blood-brain barrier for novel brain tumor drug delivery.
Exchanging the latest findings on fragile X
Rush is home to some of the country’s foremost leaders in fragile X syndrome care and research. Fragile X is a genetic disorder characterized by developmental disabilities, physical abnormalities and behavioral challenges. It affects approximately 1 in 7,000 males and 1 in 11,000 females. Fragile X-associated tremor/ataxia syndrome, or FXTAS, is a progressive movement disorder that can occur in adults with fragile X syndrome and lead to issues with movement and cognition.
In October, Rush hosted the 2024 Midwest Fragile X Research Exchange, inviting researchers from around the region to share their latest discoveries and network with others in the field.
Rush presenters focused on FXTAS included Deborah A. Hall, MD, PhD, the Parkinson’s Foundation Chair of Neurological Sciences; Dr. O’Keefe; Emily C. Timm, doctoral candidate trainee with Dr. O’Keefe; and Michelle Tosin, PhD, MSN, research scientist.
Dr. Hall reported on a first-of-its-kind feasibility study to determine if the presence of FMRpolyG, a protein involved in the development of FXTAS, is present in skin biopsies. Dr. Hall and her team biopsied 566 patients who met the diagnostic criteria for FXTAS and found that the protein is identifiable through skin biopsies.
Dr. O’Keefe presented on the impact of executive function on gait, balance and falls in FXTAS. Timm’s presentation built on Dr. O’Keefe’s, delving into work to examine the neural mechanisms underlying gait and cognitive impairments in FXTAS in an effort to design more effective treatments and rehabilitative strategies. With funding, Dr. O’Keefe and her
team hope to build on their research by pursuing the use of transcranial magnetic stimulation to improve gait, balance and cognitive function in FXTAS.
Dr. Tosin presented a longitudinal study examining the course of FXTAS in 18 patients over one year. She found that patients’ tremors and balance issues worsened, while other motor symptoms improved or remained stable. Further research with larger cohorts is needed to better understand the disease’s progression and to develop improved treatments.
Investigating the bidirectional gut-microbiota-brain axis
Rush recently received a prestigious UO1 grant from the National Institutes of Health to further assess the hypothesis that disruptions in the gut-microbiota-brain axis, or GMBA, contribute to Parkinson’s disease (as explained on page 4 of this report). This grant fuels a collaboration between Rush’s gastroenterology and neurology research centers, the Medical College of Georgia, the Mayo Clinic, the University of Chicago and Stanford University.
The group posits that a comprehensive model incorporating validated clinical measures and pathophysiological markers of GMBA disruption will predict disease severity, progression and onset. Researchers aim to illuminate the mechanisms underpinning Parkinson’s disease to identify new therapeutic targets and approaches through the collaborative power of existing samples collected with consent from Rush patients, a newly recruited group of study participants and the National Institute of Diabetes and Digestive and Kidney Diseases Consortium.
This project and the deep collaborations that make it possible are expected to vertically shift the field to improve treatments and, ideally, outcomes for patients.
Welcoming Two New Faculty Members to the Rush Parkinson’s Disease and Movement Disorders Team
Over the past few months, the Rush Parkinson’s Disease and Movement Disorders Program welcomed two new physicians to its ranks. Each brings their own expertise and focuses to the program, enriching the breadth and depth of our skilled team.
Christina Swan, MD, PhD, was born and raised in New Jersey. She obtained her medical degree and PhD in biomedical engineering from Duke University. Her graduate research focused on understanding how deep brain stimulation changes the brain to improve symptoms of Parkinson’s disease. She completed a general neurology residency at the University of Pennsylvania and finished her movement disorders fellowship at Rush in June 2024. Her fellowship focused on deep brain stimulation surgical evaluation and management, and she served as chief fellow.
Dr. Swan joined the Rush Parkinson’s Disease and Movement Disorders faculty in July 2024. She co-directs the Movement Disorders Fellowship. Outside of her time in the clinic, she enjoys exploring Chicago’s activities for young families with her 2-year-old daughter, niece and nephews.
Pierpaolo Turcano, MD, was born and raised in Italy, where he obtained his medical degree from the University of Pisa. He moved to the United States following graduation and worked as a researcher for three years in Mayo Clinic’s Movement Disorders Division. He completed his neurology residency and movement disorders fellowship at Mayo Clinic and went on to join the Rush Parkinson’s Disease and Movement Disorders faculty in September 2024.
Dr. Turcano’s research focuses on understanding the cause of Parkinson’s disease to provide a better quality of care for his patients — particularly those who develop Parkinson’s disease at a young age. Outside of work, he enjoys traveling and spending time with his wife and their 4-year-old corgi.
In Gratitude
A cherished part of my career is friendship.
Excellence in science and medicine is fundamentally a lonely pursuit, with long hours and many periods of slow progress. Having true friends as colleagues whom I trust and who trust me has been a very important part of the happiness I have experienced in my career. And special relationships established at the local, national and international levels have fostered richness that otherwise would have been impossible.
The ultimate goal of every investigation and collaboration was to improve patients’ lives. I am honored to have cared for so many patients throughout my career who put their trust in me on what were sometimes some of their most difficult days.
As I pass the baton to Dr. Hall, I trust in her leadership to continue building on our success. There is much work left to do to achieve better outcomes for those we treat.
Likewise, the fidelity of my family has been an important component of my success. My wife and children, who have lived through each phase of my career, have provided the nest of support for me to pursue scientific questions with the time and concentration needed.
To our community of philanthropic supporters who have invested in our work to make life better for people living with Parkinson’s disease and other movement disorders, thank you. We have made significant advancements because of your support.
I think we all accept that one’s career can only be lived alone, but I, nonetheless, say thank you to those close people who have embraced me with support, without jealousy, and in the spirit of warmth and encouragement.
Sincerely,
Christopher G. Goetz, MD Director, Strategic Growth and Innovation
All we have built, the work we undertake day to day and the discoveries we’ve yet to make are bolstered by your support. Together, we are working to eliminate the boundaries preventing people from living the healthiest lives possible. We hope you take pride in your role in the accomplishments enclosed. The enduring foundation on which we continue to build is made stronger by your partnership.
To support the Parkinson’s Disease and Movement Disorders Program at Rush or learn how you can continue your legacy of support through an estate gift, scan the QR code, visit rushgiving.com/pdimpact or contact:
Brigid Mullen Executive Director of Development
(312) 942-4460
brigid_t_mullen@rush.edu
