The Neuromuscular Diseases Division is directed by David Lacomis, MD. Other division members are Sasa Zivkovic, MD, Paula Clemens, MD, and Araya Puwanant, MD. Dr. Lacomis’ major clinical interests are myasthenia gravis, motor neuron diseases, and myopathies. Dr. Zivkovic specializes in peripheral neuropathies, neuromuscular diseases and ALS, including cognitive dysfunction in ALS. Dr. Clemens specializes in muscular dystrophies and other inherited neuromuscular disorders. Dr. Puwanant specializes in neuromuscular diseases, especially muscular dystrophies, myotonic disorders, and periodic paralysis.
Treatment Sites and Programs
The Division of Neuromuscular Disease provides inpatient care, electromyography and autonomic testing at UPMC Presbyterian and EMG testing in the UPMC Shadyside office (Drs. Puwanant and Zivkovic). Outpatient care, including the subspecialty ALS, Myopathy, and Neuropathy clinics, occurs in the Kaufmann Building. Division members provide clinical services in the Muscular Dystrophy Association Clinic and Amyotrophic Lateral Sclerosis multidisciplinary clinic.
The ALS multidisciplinary clinic is designed for people who require treatment from many specialists – neurologists (Drs. Lacomis and Zivkovic, and Puwanant), nurses, physical therapist, occupational therapist, respiratory therapist, social worker, and dietitian, for example. For these patients, the clinic offers the ability to receive many types of care in the same place and, in some cases, during the same visit. The clinic allows the specialists in a patient's care to confer and coordinate treatment, leading to decisions based on sound information and feedback. It also gives patients the opportunity to participate in clinical drug trials and other clinical research. The ALS Multidisciplinary Clinic has been designated an MDA-ALS Center by the Muscular Dystrophy Association in recognition for excellence in clinical and research services. MDA support staff are available at the clinic to answer questions. The Multidisciplinary Clinic is held monthly, usually on the second Friday of each month, in the Kaufmann Medical Building, Suite 810. The other specialty clinics are held weekly.
Dr. Lacomis is in charge of the neuromuscular pathology service.
Dr. Lacomis staffs a Botox Clinic on Thursday mornings in the Kaufmann Medical Building, Suite 810, for patients requiring EMG-guided botulinum therapy, especially for disorders of muscle tone affecting the arm or leg. Additional treatments for patients including botulinum therapy for dystonia and movement disorders are offered through the Movement Disorders Clinic.
Dr. Clemens has an active program in dystrophinopathy research that involves both basic and clinical research. Drs. Lacomis and Zivkovic are collaborating in numerous ALS studies involving biomarkers, neuroimaging, and stem cells. Ongoing ALS clinical trials include the use of R+ pramipexole. Dr. Lacomis is director of the University of Pittsburgh Center for ALS Research. Drs. Puwanant and Clemens are studying the use of rituximab in myasthenia gravis.