After unexplained pain, stiffness and abnormal movements led to dystonia diagnoses, Mayo Clinic specialists tailored deep brain stimulation and ongoing care to Emma and Lauren Fink's individual symptoms and goals. 

In September 2024, 14-year-old Emma Fink reached for a volleyball during gym class when something suddenly went wrong. 

"I went to bump the ball, and my shoulder blade popped out of place," Emma says.  

Her right shoulder blade shifted sharply upward and remained fixed in place. She describes the pain as feeling like "someone was punching me over and over." 

At the emergency department, imaging showed that Emma's shoulder was not dislocated. The cause of her shoulder blade's fixed position remained unclear, and muscle relaxants provided no relief. 

Watch: Deep brain stimulation helps sisters with dystonia return to the activities they love

Journalists: Broadcast-quality video (4:49) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

When Emma's symptoms pointed to a movement disorder 

For months, Emma could not raise her arm, sleep comfortably, write with her dominant hand or wash her hair. Emma, a normally laid-back teenager who loved drawing, archery and spending time with friends, had to relearn everyday tasks with her left hand while living with constant pain. 

Emma was initially treated for a suspected sports injury. When her shoulder did not improve with treatment, Mayo Clinic sports medicine specialists in Rochester, Minnesota, contacted Dr. Amy Rabatin, a physical medicine and rehabilitation specialist at Mayo Clinic. 

Before seeing Emma in person, Dr. Rabatin was brainstorming with the sports medicine team, reviewing photographs, considering ways to control Emma's pain and asking another question: Who else needed to be involved? 

Suspecting a neurologic cause, Dr. Rabatin helped connect Emma with Dr. Keith A. Coffman, a Mayo Clinic neurologist who specializes in pediatric-onset movement disorders. 

Dystonia diagnosis brings answers 

When Dr. Coffman evaluated Emma, he recognized signs of dystonia, a movement disorder that can cause involuntary muscle contractions and painful, sustained tightening. He compares the sensation to a charley horse that does not release. 

Dystonia can affect any voluntary muscle and can look very different from one person to the next. Emma's presentation was especially unusual, Dr. Coffman says, because her arm had remained locked in position for months. 

The diagnosis brought clarity but not a quick fix. Drs. Rabatin and Coffman continued coordinating Emma's medication management, rehabilitation and evaluation of additional treatment options to address her pain, movement and function. 

Considering deep brain stimulation for dystonia 

When medications did not adequately control Emma’s worsening symptoms, Dr. Coffman recommended deep brain stimulation (DBS). 

DBS uses implanted electrodes to deliver adjustable electrical stimulation to areas of the brain involved in movement. It can lessen symptoms of dystonia, but it is not a cure.

For Emma and her family, the next step did not require starting over with a new care team. Dr. Coffman could evaluate her for DBS alongside Dr. Kai Miller, a Mayo Clinic neurosurgeon, through Mayo Clinic's Pediatric Deep Brain Stimulation Program in Rochester. 

At first, Emma was hesitant about brain surgery. 

Dr. Coffman and Dr. Miller talked with Emma and her parents, Angie and Andy Fink, about the potential benefits, limitations and risks. They also addressed Emma's questions, including how much of her hair would need to be shaved. As the physicians answered her questions, Emma became more comfortable considering the procedure. 

"I just wanted to be better," Emma says. "Anything to make me better." 

Emma notices a change after DBS activation 

Dr. Miller performed Emma's DBS surgery in April 2025. When Dr. Coffman activated the device several weeks later, Emma felt the muscles around her shoulder release. 

"I could feel my shoulder shift down, and then all my muscles finally relaxed," she says. "It felt like it was floating." 

Within minutes, Emma could move an arm she had been unable to use for nearly eight months. 

After watching Emma live with persistent pain, Angie struggled to believe the change could last. 

"I remember thinking, 'We're going to wake up tomorrow, and it's going to be back to the way it was. This can't be real,'" Angie says. "I had some disbelief that it worked so well, so quickly, and then gratitude that we had the expert team to make it happen for her." 

The moment affected Emma's care team too. 

"When we turned Emma's device on and she got relief, we all cried," Dr. Coffman says. 

A second dystonia diagnosis in the family 

As Emma recovered and rebuilt her strength through occupational therapy with Katie Cossette, OT, and physical therapy, her younger sister, Lauren, began experiencing rapid blinking and unusual movements of her head and neck. 

She also had a long history of tightness and pain in her legs that worsened with activity. 

During one of Emma's DBS programming appointments, Angie described Lauren's symptoms. Dr. Coffman asked to see Lauren and later confirmed that she, too, had dystonia. 

Their specific condition is classified as presumed monogenic dystonia, meaning it is likely tied to a change in a single gene that has not yet been identified. Dr. Coffman says this is the second most common form of dystonia in children. 

Individualizing care for each sister 

Sharing the same condition did not mean Lauren's treatment would mirror Emma's. Still, like her sister, Lauren wanted to try medication before considering DBS. 

The team gave her time to make the decision on her own terms. But as Lauren's symptoms worsened, the effects became harder to ignore. Softball, a sport she loves, grew more difficult as her bat speed slowed and fatigue set in more quickly. 

After watching her sister benefit from DBS and talking through her own concerns with her care team, Lauren underwent DBS surgery in February 2026. 

When her device was activated, Lauren noticed almost immediately that walking felt easier. 

"I didn't realize I wasn't supposed to feel that uncomfortable tightness in my legs when I moved," she says. 

Fine-tuning deep brain stimulation over time 

As Emma and Lauren grow and their symptoms change, they return to Dr. Coffman to fine-tune their DBS settings around the activities that matter most to them. For Lauren, that means softball. 

During a recent appointment, she stood in the clinic swinging a bat while Dr. Coffman adjusted her DBS settings on a tablet. With each change, she described what she felt. 

When the stiffness eased and her swing felt natural again, they knew they had found the right setting. 

Returning to school, sports and everyday life 

Across specialties, Emma and Lauren's care team continues to share updates about their symptoms, rehabilitation and personal goals, so their treatment can adjust as their needs evolve.  

Although the family may meet with each specialist separately, Angie says their care has never felt divided. 

"It feels like when we talk to one of them, we're talking to all of them," she says.  

Today, Emma is returning to archery, drawing and time with friends. Lauren continues to practice softball, work on her strength training and has plenty of energy for her family and friends. 

Looking back on how far both girls have come, Angie and Andy say they are grateful for the Mayo Clinic care teams that helped Emma and Lauren return to the rhythms of teenage life. 

"Through this all, we felt like we were in good hands," Andy says. "If there’s any place in the world we would have wanted this done, it would have been right here."

The post Deep brain stimulation helps sisters with dystonia return to the activities they love (VIDEO) appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have identified a potential new approach to treating glioblastoma that could help the immune system fight the aggressive brain cancer while improving the effectiveness of existing chemotherapy.

The preclinical research, published in Nature Communications, found that inhibiting the enzymatic activity of a protein called MALT1 can reprogram immune cells surrounding glioblastomas, shifting them from a state that helps protect the cancer to one that promotes an antitumor immune response.

Researchers also found that treatment with a MALT1 inhibitor slowed tumor growth in preclinical models and that combining MALT1 with temozolomide, the chemotherapy most commonly used to treat glioblastoma, enhanced temozolomide effectiveness. In one preclinical model, median survival substantially increased when this chemotherapy was combined with MALT1 inhibition in comparison to treatment with temozolomide alone.

"Glioblastoma is extraordinarily difficult to treat, in part because the tumor is able to manipulate the immune cells around it and create an environment that protects the cancer. Our findings point to a potential approach to disrupting that protection and, importantly, to making an existing treatment more effective," says Juliana (Hofstatter Azambuja) Yerneni, Ph.D., lead author and researcher in the Department of Laboratory Medicine and Pathology at Mayo Clinic.

Glioblastoma is the most common and aggressive primary cancerous brain tumor in adults and accounts for roughly 5% of malignant brain tumors in children. Despite surgery, radiation and chemotherapy, the cancer remains incurable and almost always returns.

The findings raise the possibility of a future approach that could help patients get more benefit from existing treatments.

"Our goals are to discover how glioblastoma communicates with the immune cells surrounding the tumor in order to dampen the antitumor immune response and to use these discoveries to identify new treatments that enhance antitumor immune response and improve outcomes for patients with this devastating disease," says Linda McAllister-Lucas, M.D., Ph.D., pediatric oncologist, enterprise deputy director for pediatric cancer programs of the Mayo Clinic Comprehensive Cancer Center and co-senior author of the study with Peter Lucas, M.D., Ph.D., vice chair for research in the Department of Laboratory Medicine and Pathology at Mayo Clinic.

More research is needed to determine which specific subtypes of glioblastoma may be most likely to respond to MALT1-targeted therapy and to evaluate its potential for use in patients.

Review the study for a complete list of authors, disclosures and funding.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic researchers find a way to reprogram immune cells and boost chemotherapy response in glioblastoma appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I recently read that Mayo Clinic researchers discovered DNA changes linked to Alzheimer's disease. Does this mean scientists are getting closer to preventing or curing Alzheimer's disease? 

ANSWER: Research advances are helping scientists better understand Alzheimer's disease, but no single study has found a cure or identified a single cause. Instead, studies like the one discovering DNA changes linked to Alzheimer’s provide important clues that may help guide future treatments.  

Alzheimer's disease is the most common cause of dementia. It affects memory, thinking, behavior and the ability to carry out everyday activities. More than 7 million Americans are living with Alzheimer's disease, and that number is expected to grow as the population ages. 

Scientists know that age is the greatest risk factor for Alzheimer's disease, but aging alone doesn't explain why some people develop the condition while others do not. Genetics, lifestyle factors and environmental influences also appear to play a role. Researchers are working to understand how these factors interact in the brain. 

For many years, Alzheimer's research has focused on two proteins found in the brain: amyloid and tau. The buildup of these proteins is one of the best-known features of the disease. While these proteins remain important, researchers now recognize that Alzheimer's is a complex disease involving many biological processes beyond amyloid and tau. 

A recent Mayo Clinic study explored another piece of the puzzle: changes in how the brain turns genes on and off. 

Genes are sections of DNA that provide instructions for how cells work. Cells can control which genes are active and which remain inactive, allowing them to carry out different functions without changing the underlying DNA sequence.  

Scientists call this process epigenetics. These chemical changes can influence how cells behave and respond to aging, disease and environmental factors. 

In the study, researchers examined brain tissue from hundreds of people with Alzheimer's disease and looked for patterns in these gene-regulating changes. They identified several changes strongly linked to the tau protein.  

The research also highlighted the possible importance of oligodendrocytes — brain cells that support nerve cells by producing myelin, a protective layer that helps signals move efficiently. When myelin is damaged, communication in the brain may be disrupted. 

The findings suggest that Alzheimer's disease may involve not only damage to nerve cells but also changes in the systems that support how those cells communicate with one another. This growing understanding is encouraging researchers to look beyond traditional explanations of the disease. 

So, what does this mean for patients today? 

These findings are not expected to change how Alzheimer's disease is diagnosed or treated right now. Scientists must confirm the findings, better understand how these changes affect the brain and determine whether the discoveries can lead to safe and effective treatments. 

One reason researchers are excited about epigenetics is that, unlike inherited DNA changes, some gene-control changes may be reversible. While much more research is needed, the findings so far suggest that future therapies could target these biological processes. 

Studies like this also help identify new areas for investigation and may reveal why Alzheimer's disease affects people differently. As researchers learn more, they move closer to developing more personalized approaches to prevention and treatment. 

The Mayo Clinic team that did research on the DNA changes associated with the disease also created a free online tool that allows researchers worldwide to explore the study's data. Called the Multiomic Atlas of AD Brain Endophenotypes, the searchable resource lets scientists look up specific genes and view results in interactive tables and graphs. By making these findings widely available, researchers hope to accelerate discoveries and support the development of improved treatments for Alzheimer's disease and other neurological conditions.  

There's still no cure for Alzheimer's disease, but researchers continue to make progress. Each discovery helps them better understand the disease and brings them closer to finding ways to prevent, slow or treat it. 

Nilüfer Ertekin-Taner, M.D., Ph.D., chair, Department of Neuroscience, Mayo Clinic; Department of Neurology, Mayo Clinic, Jacksonville, Florida 

The post Mayo Clinic Q&A: What do DNA changes in Alzheimer’s disease mean for patients and families?  appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My mother gets headaches from time to time, but recently she's been reading that some headaches can be signs of serious medical problems. What's the difference between a headache that's just a nuisance and one that needs immediate medical attention? 

ANSWER: Most headaches aren't a symptom of a life-threatening condition. Common headaches, including tension headaches and migraines, can be painful and disruptive, but they usually aren't medical emergencies. However, certain headache symptoms shouldn't be ignored because they can signal a serious underlying condition, such as a stroke, bleeding in the brain, meningitis or, less commonly, a brain tumor. Knowing the warning signs can help you decide when to seek emergency care. 

You should contact your healthcare team if you experience: 

• Headaches that wake you from sleep or are present when you wake up. 

• Headaches that become more frequent or progressively more severe. 

• Headaches that don't improve with over-the-counter medications such as acetaminophen or ibuprofen. 

A severe headache can be described as the "worst headache of your life" — one that develops suddenly and reaches maximum intensity within seconds or minutes. This can be a sign of a medical emergency. 

Go to the emergency department or call 911, especially if your headache is accompanied by: 

• Weakness or numbness. 

• Slurred speech. 

• Confusion. 

• Loss of consciousness. 

• Double or blurred vision. 

• Severe dizziness or difficulty walking. 

• Fever and a stiff neck. 

While serious causes of headaches are uncommon, they do occur. For example, headaches can be associated with brain aneurysms, although these headaches are typically sudden and severe, and they may be accompanied by loss of consciousness. 

Brain tumors are rare, but about half of the people who are diagnosed with one experience headaches. These headaches often become progressively worse over time, and may occur in the morning or wake someone from sleep. They're frequently accompanied by nausea or neurological symptoms, such as weakness, numbness or vision changes. 

Headaches with vision changes can have several causes. Some people with migraines experience visual disturbances. In other cases, vision changes and headaches may be related to inflammatory conditions such as giant cell arteritis, which is an immune disease that causes swelling and narrowing of medium- and large-sized arteries, and it can cause blindness.  

If you're over the age of 50, you should always discuss new headaches with your healthcare professional. Most primary headache disorders, including migraines and tension headaches, begin much earlier in adulthood. 

You also should seek medical evaluation if headaches consistently occur with coughing, sneezing or straining, or if they're triggered by exercise and continue to recur. Although these headaches are often benign, they sometimes can signal an underlying structural condition. 

After a head injury, it's common to develop headaches. Many go away with rest and over-the-counter pain relievers. However, seek medical care after a head injury if you lose consciousness, have memory loss or repeated vomiting, take blood thinners, are age 65 or older, have obvious head trauma, or were injured in a significant fall or by a direct blow to the head. 

If you're being evaluated for headaches, be prepared to describe: 

• How severe the headache is. 

• When it started and how long it lasted. 

• Whether it wakes you from sleep. 

• Whether it's different from your usual headaches. 

• Any associated symptoms, such as fever, weakness, numbness or vision changes. 

• What treatments you've tried and whether they helped. 

Depending on your symptoms, your healthcare team may recommend imaging, such as a CT scan or MRI, to help identify the cause. 

The bottom line is that most headaches aren't dangerous, but some require immediate attention. Remember the key warning signs. And when in doubt, it's always safest to seek medical evaluation. 

Grant Mallory, M.D., Spine Care, Neurosurgery, Mayo Clinic Health System, La Crosse, Wisconsin

The post Mayo Clinic Q&A: Headaches that should never be ignored appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My spouse will tell me occasionally that their hands and feet "fall asleep," and they experience numbness, tingling and a pins-and-needles sensation. Is this normal, or does it require medical attention?  

ANSWER: Most people experience numbness or the familiar pins-and-needles sensation from time to time. Often, it's harmless and happens because you've been sitting, standing or sleeping in a position that puts temporary pressure on a nerve. Once you change positions, the sensation usually goes away within a few minutes. 

However, these symptoms can sometimes signal an underlying medical condition. They can occur when a nerve is damaged, compressed or irritated. The nerve itself may not be functioning properly, a condition called neuropathy. In other cases, pressure on a nerve, such as in the spine or somewhere along its path through the arms or legs, can cause numbness and tingling. 

Pinched nerves can occur in several places. Nerves can become compressed in the spinal canal, a condition known as spinal stenosis, or further along their path, such as carpal tunnel syndrome. 

Other health conditions also can damage nerves. Diabetes is one of the most common causes. Diabetic neuropathy often begins in the feet, causing numbness, tingling or burning sensations that usually affect both sides of the body equally. Symptoms often spread in a pattern similar to wearing socks or gloves. 

Vitamin deficiencies, kidney disease, heavy alcohol use, exposure to certain toxins and some medications, particularly chemotherapy drugs, also can contribute to numbness and tingling. 

Anxiety and stress can trigger numbness or tingling, as well. During periods of stress, some people breathe more rapidly than usual, which can lead to tingling around the mouth or in the hands. Panic attacks also may cause these sensations. 

You should schedule an appointment with your healthcare team if numbness or tingling: 

• Becomes constant. 

• Gets worse over time. 

• Interferes with your daily activities. 

• Occurs along with pain, weakness, balance problems or difficulty walking. 

While many causes aren't emergencies, persistent symptoms should be evaluated to identify and treat any underlying conditions. Some symptoms require immediate medical attention. 

Sudden numbness affecting one side of the face, arm or leg, especially when accompanied by weakness, can be a sign of a stroke. If this occurs, call 911 or seek emergency medical care immediately. 

You also should seek emergency care if you develop numbness in the groin or genital area, particularly if it occurs along with difficulty controlling your bladder or bowels, trouble urinating or weakness in your legs. These symptoms can indicate a serious problem, such as a spinal cord injury, that requires prompt treatment. 

When numbness or tingling needs further evaluation, your healthcare professional will begin by asking detailed questions about your symptoms, including when they started, what makes them better or worse, and whether you have other symptoms such as pain or weakness. 

A physical examination helps evaluate how your nerves and muscles are functioning. Depending on the findings, additional testing may be recommended. This could include imaging tests, such as X-rays, ultrasound or MRI, to look for structural problems around the nerves. Nerve studies, including electromyography, can help determine how well your nerves are sending and receiving signals. 

For mild episodes related to body position, simply changing positions, improving your posture or gently moving the affected arm or leg may be enough. When symptoms are more persistent, physical therapy can help improve strength, mobility and function. 

Other treatments may include medications to manage nerve pain, injections to reduce inflammation around pinched nerves, or surgery when nerve compression is severe. Some nerve problems, such as those caused by spinal stenosis, may improve with treatment. Others, including diabetic neuropathy, are often permanent, so treatment focuses on managing symptoms and preventing further nerve damage. 

The most important step is talking with your healthcare team. Identifying the cause early allows you to begin the right treatment and, in many cases, prevent symptoms from getting worse. 

Occasional numbness and tingling that go away quickly after you change positions are usually nothing to worry about. But if symptoms persist, worsen, interfere with your daily life or occur with weakness or other concerning symptoms, don't ignore them. Early evaluation can help identify the cause and guide the most appropriate treatment. 

Megan Everson, M.D., Neurosurgery, Spine Care, Mayo Clinic Health System, Eau Claire, Wisconsin 

The post Mayo Clinic Q&A: When to worry about numbness and tingling appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — An international study led by Mayo Clinic researchers has identified interleukin-6 (IL-6) receptor blockers as a promising option for preventing relapses in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). MOGAD is a rare autoimmune neurological disorder that can cause vision loss, paralysis and other serious neurological complications.

The study, published in JAMA Neurology, provides one of the largest real-world evaluations to date of IL-6 receptor blockade in patients with MOGAD and offers new evidence to help guide treatment decisions while randomized clinical trials are underway.

MOGAD occurs when the immune system mistakenly attacks myelin, the protective coating surrounding nerve fibers in the brain, spinal cord and optic nerves. In some patients, the disease causes repeated inflammatory attacks, or relapses, that can lead to accumulating neurological disability. Although several therapies are used off-label, there are currently no treatments approved specifically for preventing relapses in MOGAD.

The study focused on two medications, tocilizumab and satralizumab, that belong to a class of drugs known as IL-6 receptor blockers. Researchers believe the immune signaling protein IL-6 plays an important role in the inflammation that damages myelin in people diagnosed with MOGAD. By blocking that immune signaling pathway, these medications are designed to reduce inflammation and help prevent future relapses.

"Interleukin-6 receptor blockers appear to be a promising treatment option for people living with MOGAD," says Eoin Flanagan, M.B., B.Ch., a neurologist at Mayo Clinic and senior author of the study. "While we await results from randomized clinical trials, these findings provide additional evidence that these medications may help limit the neurological disability that can accumulate with repeated attacks.”

Researchers evaluated 116 patients treated with IL-6 receptor blockers across multiple centers in North and South America, making it the largest observational study of its kind. Most participants received tocilizumab, which is widely available around the world, while a smaller number received satralizumab. The study found that patients had substantially fewer relapses after starting treatment and that the medications had a generally favorable safety profile, though infections remain an important consideration for clinicians.

Because MOGAD is uncommon, individual medical centers often care for relatively small numbers of patients, making it difficult to study new treatments. This multinational collaboration allowed researchers to evaluate outcomes across various patient populations while expanding the evidence for IL-6 receptor blockade in MOGAD.

"Rare diseases require collaboration," says Andreu Vilaseca Jolonch, M.D., first author of the study and a neurology fellow at Mayo Clinic. "By bringing together patients and researchers across multiple countries, we were able to generate stronger evidence than any single center could produce alone. That collaboration not only strengthened this study but also created a foundation for future research."

Multiple clinical trials evaluating treatments for MOGAD are underway, and observational studies such as this one help provide important evidence while physicians await those results.

"There is growing optimism for patients with MOGAD," Dr. Flanagan says. "New treatments are emerging, and we're trying to bring the best treatment options to patients while continuing to learn which therapies work best."

This research was supported by the National Institutes of Health (R01NS113828). One patient included in the study was supported by National Institutes of Health grant R01AI170863-01A1.

 For a complete list of authors, disclosures and funding, review the JAMA Neurology article.

###

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post International study identifies promising therapy to prevent relapses in rare neurological disease appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A visit from a therapy animal may do more than lift spirits. A new study in Mayo Clinic Proceedings highlights how animal-assisted treatment can support inpatient stroke rehabilitation. Patients who interacted with therapy animals showed greater engagement in their treatment, increased physical activity and longer mobility compared with those who did not.

The findings suggest a promising approach to addressing common barriers patients face with stroke recovery, including limited motivation, reduced energy, lack of companionship and decreased interest in therapy activities. By incorporating trained therapy dog-handler teams into rehabilitation care, patients can do a variety of activities including walking, playing fetch, and petting or brushing the dog.

"The presence of a therapy dog can change the entire dynamic of a rehabilitation session," says Whitney Romine, manager of animal-assisted services at Mayo Clinic. "Patients often share that they feel more grounded, safe and empowered to engage in therapy activities, which can make a meaningful difference in their recovery experience."

The paper, "The Impact of Animal-Assisted Treatment on Inpatient Stroke Rehabilitation," shows how patient care could be improved using a clinical care delivery model that includes qualified animal handler teams. The study also explores how these changes could be applied across a variety of medical specialties and patient populations.

"Stroke recovery can be challenging, particularly when patients face barriers such as low motivation or limited energy," says Brent Bauer, M.D., a physician in internal medicine at Mayo Clinic. "This research demonstrates that animal-assisted treatment may offer a practical and effective way to enhance engagement and support better rehabilitation outcomes."

Watch: Dr. Brent Bauer discusses the benefits of therapy dogs

Journalists: Sound bites and broll with Dr. Bauer are in the downloads at the end of the post. Please courtesy: "Brent Bauer, M.D./General Internal Medicine/Mayo Clinic."

This research was conducted in collaboration with Nestlé Purina PetCare. For a complete list of authors, disclosures and funding, review the study.

###

About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a peer-reviewed medical journal that publishes original research and reviews across clinical and translational science.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic study highlights benefits of animal-assisted treatment in stroke rehabilitation (VIDEO) appeared first on Mayo Clinic News Network.

For years, some patients diagnosed with multiple sclerosis (MS) weren't getting better despite receiving the right treatments. The problem wasn't the therapy. It was the diagnosis. 

A new episode of "Tomorrow's Cure" podcast explores how the discovery of myelin oligodendrocyte glycoprotein antibody-associated disease, or MOGAD, transformed the understanding of autoimmune neurologic disease. Once mistaken for MS, MOGAD is now recognized as a distinct condition with its own diagnostic criteria, treatment approaches and emerging therapies. 

The episode features Eoin Flanagan, M.B., B.Ch., an autoimmune neurologist at Mayo Clinic whose research has helped shape how MOGAD is diagnosed and treated, and Brenda Banwell, M.D., a pediatric neurologist at Johns Hopkins Children's Center who led the international effort to develop the first diagnostic criteria for the disease. Together, they discuss how decades of collaboration among researchers, clinicians and patients helped redefine the disease and improve care for people who had spent years searching for answers. 

"It was life-changing for them to have an actual diagnosis and an identity," says Dr. Flanagan, describing patients who spent decades seeking answers before MOGAD was recognized as a distinct disease. 

The conversation also explains why distinguishing MOGAD from multiple sclerosis is critical. Although the conditions can present similar symptoms, including vision loss and spinal cord inflammation, they follow different disease courses and require different treatment strategies. Advances in antibody testing and internationally accepted diagnostic criteria help physicians identify MOGAD earlier and begin more targeted care. 

Researchers are also making progress toward more precise therapies. Clinical trials targeting the immune pathway known as interleukin-6 have reported encouraging early results, although treatments for MOGAD are still emerging.  

"Diagnosis matters," says Dr. Banwell. "Prompt treatment of an acute attack matters because your recovery from that first attack really dictates how you're doing." 

Listen to the latest episode of "Tomorrow's Cure" to learn how one discovery reshaped the diagnosis of autoimmune neurologic disease and how ongoing research is opening the door to more personalized treatment for people with MOGAD. You can also explore the show's full library of episodes and guests on the show's playlist.  

The post When it’s not MS: Inside the discovery of MOGAD appeared first on Mayo Clinic News Network.

The brain relies on carefully coordinated electrical signals to control everything from movement and memory to thought and emotion. When those signals become too active or poorly regulated, they can contribute to neurological disorders such as epilepsy. Researchers are working to better understand these abnormal patterns of brain activity and develop new ways to measure and safely influence them without surgery. 

Brian Lundstrom, M.D., Ph.D., is a Mayo Clinic neurologist and physician-scientist whose research focuses on cortical excitability — how active or responsive the brain is — and how noninvasive brain stimulation may help improve the diagnosis and treatment of epilepsy and related neurological disorders.  

As a member of Mayo Clinic's BIONIC (Bioelectronic Neuromodulation with Innovation to Cure) initiative, Dr. Lundstrom shares how advances in bioelectronic medicine are shaping the future of personalized neurological care. 

Watch: BIONIC: AI, Brain Stimulation, and the Future of Neurotechnology

Journalists: Sound bites and with Dr. Brian Lundstrom are in the downloads at the end of the post. Please courtesy: "Brian Lundstrom, M.D., Ph.D./Neurology/Mayo Clinic."

Q: What does it mean when the brain is "hyperexcitable" or has abnormal cortical excitability? 

A: Cortical excitability is one way to describe how responsive the brain is to activity. The cortex is the outer layer of the brain, and neurons — the brain's fundamental cells — communicate with each other through electrical signals. 

In some neurological diseases, the brain can become too excitable. Epilepsy is one example. During a seizure, the brain's electrical activity becomes abnormally high. Many neurological conditions may involve brain activity that is either too high, too low or not properly regulated. 

Q: Your research explores ways to stimulate the brain without surgery. How do these technologies work, and how could they help people with conditions like epilepsy? 

A: Because the brain communicates through electricity, we can also use electrical or magnetic stimulation to try to better understand brain activity. One way is through transcranial magnetic stimulation (TMS). TMS uses magnetic pulses delivered outside the head to stimulate targeted brain regions.  

Another method is transcranial direct current stimulation (tDCS), which uses low levels of electrical current applied through the scalp. These approaches are considered noninvasive because they do not require surgery or implanted devices. 

The goal is to use these targeted, noninvasive stimulations to influence brain activity, helping us better understand brain activity and, ultimately, correct abnormal patterns that contribute to conditions like epilepsy. 

Q: What makes noninvasive stimulation especially appealing compared with traditional approaches for epilepsy, such as medication, surgery or implanted devices? 

A: While medications are highly effective for many people, they don't work for everyone, and some patients experience side effects that affect their daily lives. Our goal is to move beyond that trial-and-error approach by using measurable changes in brain activity to guide treatment decisions earlier and more precisely. 

Surgery and implanted devices can also be very effective, but they're not the right option for every patient.  

That's where noninvasive brain stimulation, like TMS or tDCS, is especially promising. Because these approaches target specific areas of the brain without surgery, they generally don't produce the same whole-body side effects that medications can.  

While additional research is needed, I've also seen patients whose seizures were significantly reduced or eliminated entirely through noninvasive brain stimulation after other treatments hadn't worked. Our hope is to continue refining these approaches so more patients can benefit from safe, personalized therapies. 

Q: What are biomarkers, and why are they important in understanding the brain? 

A: One of the biggest modern challenges in using brain stimulation therapies is that we still don't have simple, precise ways to measure how the brain is working in real time. Before treatments like TMS or tDCS can be used most effectively, we first need to understand how the brain is functioning. 

Biomarkers are measurements that help us understand what's happening inside the brain and help us identify abnormalities. We gather this information using tools such as electroencephalography (EEG), which records the brain's electrical activity, and magnetoencephalography (MEG), which measures the magnetic fields produced by that activity.  

Q: Why is Mayo Clinic the right environment for this kind of research? 

A: Understanding how the brain works is incredibly complex, and solving these challenges requires expertise from many different fields. Neurologists, engineers, imaging specialists, computational neuroscientists, data scientists and many others all play an important role in developing new ways to diagnose and treat neurological disorders. 

One of Mayo Clinic's greatest strengths is that this kind of collaboration is part of how we work every day. Researchers and clinicians from different specialties work side by side, combining discoveries about how the brain functions with technologies that can measure and influence brain activity.  

Many institutions recognize the value of multidisciplinary research, but Mayo Clinic's integrated model makes collaboration especially seamless. Rather than working in separate silos, experts across departments are united by a shared goal of improving patient care.  

Q: How are new technologies, including noninvasive stimulation, advanced monitoring or computational modeling, being used or envisioned within BIONIC research? 

The BIONIC initiative is centered on advancing bioelectronic medicine, which uses technology to better understand, diagnose and treat disease. Traditionally, medicine has relied on medications and surgery, but bioelectronic medicine offers another way to care for patients by measuring and influencing the brain's electrical activity. 

In my research, we're using advanced brain monitoring tools, noninvasive brain stimulation and computational approaches with the goal of combining these technologies so we can develop more personalized treatments and, ultimately, help more patients become seizure-free with fewer side effects. 

Looking ahead, I'm especially excited about the role artificial intelligence (AI) can play. AI can help us bring together information from many different sources to better understand brain activity and guide more precise treatments.  

There are certainly challenges ahead, but I think the potential is extraordinary. By combining these new technologies with the collaborative environment fostered by BIONIC, we have an important opportunity to improve how we diagnose, monitor, and treat epilepsy and many other neurological disorders. 

The post How noninvasive brain stimulation could transform epilepsy care (VIDEO) appeared first on Mayo Clinic News Network.

Glioblastoma begins in glial cells, the brain's support cells. When these cells become cancerous, they can grow rapidly into surrounding tissue, damaging the healthy brain they were meant to protect. 

Watch: The Mayo Clinic Minute

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"It tends to be a tumor that also tends to grow and invade the brain," says Dr. Alfredo Quinones-Hinojosa, Mayo Clinic neurosurgeon. "Sometimes it can be slow and steady, but it tends to grow very fast." 

Despite significant advances in surgery, chemotherapy, immunotherapy and radiation therapy, glioblastoma remains one of the most challenging cancers to treat. Long-term survival is uncommon. 

"The median survival of patients with the best therapies tends to be between 12 and 14 months," says Dr. Quinones-Hinojosa. 

Although there is no cure for glioblastoma, treatment can help slow tumor growth, manage symptoms and maintain quality of life. Ongoing research continues to advance understanding of the disease and create new possibilities for patients. 

"Research is crucial to finding hope and healing in every corner of our operating room, in every corner of our laboratory," says Dr. Quinones-Hinojosa. "We are connecting research and hope, ultimately, through our patients." 

The post Mayo Clinic Minute: Treatment and research of glioblastoma (VIDEO) appeared first on Mayo Clinic News Network.