Behavioral & Cognitive Neurology

Areas of Operation

University of South Florida Clinics
James A Haley VA Hospital
Tampa General Hospital

"A cross disciplinary center for excellence in clinical cognitive neurosciences for patient care and research"

Introduction

Cerebrovascular disease and neuropsychiatric disorders are the leading causes of disability worldwide. There is evidence that cognitive impairment is present in the majority of stroke, transient ischemia attack patients and even non-stroke patients that have cerebrovascular risk factors. Cognitive disorders are also a feature of most neurological, psychiatric and neurosurgical conditions and their ascertainment important to monitoring, treatment and rehabilitation. A particular challenge of cognitive disorders is that they may present with a myriad of symptoms, signs and syndromes, which frequently leads to diagnostic uncertainty and misdiagnosis. Among the most frequent are various kinds of executive dysfunctions, a common subtype of frontal disorder. Traumatic Brain Injury, stroke, multiple sclerosis and frontotemporal lobe disorders and often Alzheimer’s disease all primarily manifest with frontal syndromes. New diagnostic tools, both neuropsychological and neuroradiological, are available to zero in on these manifold disorders.

Program Provider

• Michael W. Hoffmann, M.D.

Specific Areas of Clinical Operations

1. Traumatic Brain Injury Focus
   Emerging consciousness program at the James A Haley VA Hospital
   Inpatient and outpatient bedside and cognitive metric testing
   
2. Cognitive Vascular Focus
   Outpatient TIA and stroke clinic
   In-patient stroke patient testing
   
3. Alzheimer’s, Frontotemporal Lobe Ddisorders and Other Dementias
   USF Cognitive Clinics and Memory clinic
   
4. Other Neurological Disorders and Cognition Assessment
   Most notably Multiple Sclerosis, Parkinson’s, epilepsy, neurotoxicological syndromes
   
5. Public Health Focus
   Testing of patients at risk – no stroke but with vascular risk factors or family history of dementia
   
6. Procedures
   Both bedside and psychometric tests administered including several computerized tests such as the Wisconsin Card Sorting Test, Emotional Intelligence Test and the Iowa Gambling Test.
7. Neuroimaging and Doppler Studies
   • Multimodality MRI including diffusion tensor imaging and MR perfusion scanning
   • Functional scans: PET and SPECT brain imaging
   • Sonography: Cerebrovascular reserve testing (a type of cognitive stress test) in appropriate patients
8. Research
   • USF Cognitive Neurology Registry (IRB # 106113. PI; M. Hoffmann).
     A cognitive, digitized database for student and resident teaching, as well as pilot data for grant applications and generation of quality control data. Both physician initiated trials and industry sponsored trials are being developed. The repository of cognitive data provides for meaningful clinical material beyond individual cases and case reports for student and resident tuition.
   • Transcranial Magnetic Stimulation. “Can We Facilitate Consciousness after Severe Traumatic Brain Injury?”
     Sponsor and senior investigator: Theresa Pape PhD, North Western University, Chicago.
     
9. Cognitive Teaching Rounds
   • Cognitive Rounds, Polytrauma Center, James A Haley VA Hospital
     Thursdays 9:00 AM - 11:00 AM
   • USF Clinics and Tampa General Hospital
     First Friday of the month, 10:30 AM -11: 30 AM