Issue link: https://viewer.e-digitaledition.com/i/41086
Internationally known for his work in childhood brain tumors and mitochon- drial disease, he has seen tremendous advances over the span of his 27-year career. In August, Akron Children's team began using a new 3T MRI, the most powerful magnet available for clinical use and a great aid in performing functional neurologic exams. "Today the diagnosis of brain tumors is much easier due to the sophistication of CT scans and MRIs," he explains. "When I first started, studies were very difficult, painful and invasive. Now, they are much better with results obtained in about an hour. Similarly, surgeries are safer. Mortality has dropped significantly, and radiation and chemotherapy techniques have improved. There is much more hope than ever before." The challenge today, according to Dr. Cohen, is quality of life. In the past, little thought was given to physi- cal, mental and emotional function following treatment. Now, years later, doctors are discovering that some brain tumor survivors struggle with daily activities, such as keeping up with peers in school, maintaining friendships and holding down jobs. As with epilepsy, brain tumor care requires ongoing management by a multidisciplinary team. "Twenty years ago, we didn't think about life after a brain tumor because many patients didn't survive," he says. "Today it's a new ballgame — one that requires intervention by a team of therapists, psychologists and neuro- psychologists to help survivors thrive." Tackling the Complexities of Mitochondrial Disease Dr. Cohen also specializes in mitochon- drial disease, which affects approximately 1 in 2,000 people, primarily children, but adult onset is becoming more common. Disorders are characterized by failure of the mitochondria, which are respon- sible for creating more than 90 percent of the cell energy needed to sustain life and support growth. Symptoms vary widely and may include loss of acquired John Duby, MD, is director of Developmental-Behavioral Pediatrics at Akron Children's and medical director of the Family Child Learning Center. In the past two years he has received the Ohio American Academy of Pediatrics Elizabeth Spencer Ruppert Pediatrician of the Year award and the Arnold P. Gold Foundation Award for Humanism in Medicine from the American Academy of Pediatrics. development, strokes, dementia, seizures, migraines, weakness and fatigue of all types of muscles, cardiac conduction defects, cardiomyopathy, non-alcoholic steatohepatitis (NASH), deterioration of the peripheral nervous system, retinitis pigmentosa, diabetes and more. Dr. Cohen encourages primary care physicians to consider mitochondrial disease as a possible diagnosis for patients with a complex set of symptoms that span organ systems. With research in its infancy, treatment is driven by symptoms, and he notes that exercise is proving vital to help patients manage their disease. "Even though they are sick, patients get stronger when they exercise," he says. "They can replicate and expand their number of mitochondria." Akron Children's is also one of four active test sites in the United States with fi ve patients in the trial for EPI 743, an experimental drug that may improve energy fl ow through the mitochondria. Treating Development and Behavior Disorders Akron Children's NeuroDevelopmental Science Center also offers help for children with conditions that affect cognitive and behavioral development. These include attention-defi cit/hyperac- tivity disorder (ADHD), autism, cerebral palsy, dyslexia, sleep disorders, spina bifi da, vision and hearing impairments, and more. Dr. John Duby is director of Developmental-Behavioral Pediatrics at MDNEWS.COM SEPTEMBER-OCTOBER 2011 MD NEWS Cleveland-Akron-Canton | 25 PHOTO © JOE SMITHBERGER PHOTOGRAPHY, NORTH CANTON