The INR has made a stunning discovery: that the neurological status of patients following stroke or brain injury, even years after the acute event, may rapidly improve following the use of an anti-TNF therapeutic.
Consultation following Stroke or Brain Injury at the INR
Patients who have experienced stroke or brain injury often have weakness or decreased sensation in one half of the body, cognitive or speech difficulties, or other neurological problems that can last for years. Consultation with an INR medical provider after hospital discharge is encouraged, even if the stroke or brain injury has occurred years before. Please call the INR in Florida at +1 (561) 353-9707 for further information.
Consultation and treatment are by appointment only. Phone or in-office consultations can be scheduled by calling the INR in Florida at +1 (561) 353-9707 for further information.
The INR welcomes referrals from neurologists, geriatricians, internists, family physicians, other health care providers, or family members of patients with selected neuroinflammatory disorders. Please note: INR medical providers utilize etanercept for a limited number of off-label indications. INR medical providers do not use etanercept for treating Parkinson’s disease, brain tumor, or carpal tunnel syndrome. Individual treatment recommendations are only made following a phone or in-office consultation, including history, physical examination, and review of imaging studies.
The INR welcomes telephone inquiries from physicians and family members. In particular, the INR encourages telephone inquiry and discussion with an INR medical provider for those patients referred from locations at a geographic distance from Boca Raton, Florida, prior to appointment scheduling. This is recommended especially for those patients who will be flying across country or from overseas for treatment at the INR, due to the special nature of the services provided at the INR, and the unique experience which the INR has performing anti-TNF treatment for neurological disorders.
Relevant Scientific Publications
**Indicates articles of particular interest
**1. Perispinal etanercept: a new therapeutic paradigm in neurology. Edward Tobinick MD. Expert Review of Neurotherapeutics. 2010 Jun;10(6):985-1002.
**2. Perispinal etanercept for neuroinflammatory disorders. Edward Tobinick MD. Drug Discovery Today. 2009 Feb;14(3-4):168-77.
3. Roh, M., et al., Etanercept, a widely used inhibitor of tumor necrosis factor-alpha (TNF-alpha), prevents retinal ganglion cell loss in a rat model of glaucoma. PLoS One, 2012. 7(7): p. e40065.
**4. Santello, M. and A. Volterra, TNFalpha in synaptic function: switching gears. Trends Neurosci, 2012. 35(10): p. 638-47.
5. Smith, C., et al., The neuroinflammatory response in humans after traumatic brain injury. Neuropathol Appl Neurobiol, 2012.
**6. Tobinick, E., Deciphering the physiology underlying the rapid clinical effects of perispinal etanercept in Alzheimer’s disease. Curr Alzheimer Res, 2012. 9(1): p. 99-109.
**7. Tobinick, E., et al., Selective TNF Inhibition for Chronic Stroke and Traumatic Brain Injury : An Observational Study Involving 629 Consecutive Patients Treated with Perispinal Etanercept. CNS Drugs, 2012. 26(12): p. 1051-70.
**8. Blaylock, R.L., Immunology primer for neurosurgeons and neurologists part 2: Innate brain immunity. Surg Neurol Int, 2013. 4: p. 118.
**9. Cheong, C.U., et al., Etanercept attenuates traumatic brain injury in rats by reducing brain TNF- alpha contents and by stimulating newly formed neurogenesis. Mediators Inflamm, 2013. 2013: p. 620837.
**10. Chio, C.C., et al., Etanercept attenuates traumatic brain injury in rats by reducing early microglial expression of tumor necrosis factor-alpha. BMC Neurosci, 2013. 14(1): p. 33.
11. Efrati, S., et al., Hyperbaric oxygen induces late neuroplasticity in post stroke patients–randomized, prospective trial. PLoS One, 2013. 8(1): p. e53716.
12. Iwatsuki, K., et al., Targeting anti-inflammatory treatment can ameliorate injury-induced neuropathic pain. PLoS One, 2013. 8(2): p. e57721.
**13. Johnson, V.E., et al., Inflammation and white matter degeneration persist for years after a single traumatic brain injury. Brain, 2013. 136(Pt 1): p. 28-42.
**14. King, M.D., C.H. Alleyne, Jr., and K.M. Dhandapani, TNF-alpha receptor antagonist, R-7050, improves neurological outcomes following intracerebral hemorrhage in mice. Neurosci Lett, 2013. 542: p. 92-6.
15. Kumar, A., et al., Traumatic brain injury in aged animals increases lesion size and chronically alters microglial/macrophage classical and alternative activation states. Neurobiol Aging, 2013. 34(5): p. 1397-411.
**16. Lei, B., et al., Tumor necrosis factor alpha antagonism improves neurological recovery in murine intracerebral hemorrhage. J Neuroinflammation, 2013. 10(1): p. 103.
17. Petzold, A. and A. Girbes, Pain management in neurocritical care. Neurocrit Care, 2013. 19(2): p. 232-56.
18. Starke, R.M., et al., Tumor Necrosis Factor-alpha Modulates Cerebral Aneurysm Formation and Rupture. Translational Stroke Research, 2013. 10.1007/s12975-013-0287-9.
**19. Waters, R.J., et al., Cytokine gene polymorphisms and outcome after traumatic brain injury. J Neurotrauma, 2013. 30(20): p. 1710-6.
**20. Works, M.G., J.B. Koenig, and R.M. Sapolsky, Soluble TNF receptor 1-secreting ex vivo-derived dendritic cells reduce injury after stroke. J Cereb Blood Flow Metab, 2013.
The INR’s scientific findings have been published in multiple, peer-reviewed medical journals, including Expert Review of Neurotherapeutics, CNS Drugs, BMC Neurology, Current Alzheimer Research, Clinical Therapeutics, Drug Discovery Today, and Current Medical Research and Opinion. INR publications, findings, and research have advanced the science of neurology, dementia, and spine medicine, and have been cited and discussed by physicians and scientists from academic centers around the world. There have been hundreds of scientific citations to INR publications, including in Nature Clinical Practice Neurology and F1000 Biology.
Edward Tobinick, MD, founder of the INR, has presented his scientific findings regarding the effects of etanercept for neurological disorders at multiple U.S. and international medical and scientific conferences, including the Karolinska Institute in Sweden; the 2008 Drug Repositioning Summit in Boston; the International Conference on Alzheimer’s Diseasein Chicago; the 7th Annual Alzheimer’s Drug Discovery Conference in New York; the 2008 Best Practices in the Continuum of Care: Advances in Alzheimer’s Disease Management conference at the University of Arkansas Medical Sciences in Little Rock, Arkansas; and, in 2009, the 3rd International Restauracion Neurologica Conference in Havana, Cuba, the World Pharmaceutical Congress in Philadelphia and the 5th Modern Drug Discovery Conference in San Diego. Dr. Tobinick has performed collaborative research with scientists from Stanford University School of Medicine and additional academic centers.
The following are selected publications that have cited scientific publications of Edward Tobinick MD, Founder of the INR®, in 2012:
1. Belarbi, K., et al., TNF-alpha protein synthesis inhibitor restores neuronal function and reverses cognitive deficits induced by chronic neuroinflammation. J Neuroinflammation, 2012. 9: p. 23.
2. Bomfim, T.R., et al., An anti-diabetes agent protects the mouse brain from defective insulin signaling caused by Alzheimer’s disease- associated Abeta oligomers. J Clin Invest, 2012. 122(4): p. 1339-53.
3. Butchart, J. and C. Holmes, Systemic and central immunity in Alzheimer’s disease: therapeutic implications. CNS Neurosci Ther, 2012. 18(1): p. 64-76.
4. Cereda, C., et al., The Role of TNF-alpha in ALS: New Hypostheses for Future Therapeutic Approaches, in Amyotrophic Lateral Sclerosis, M.H. Maurer, Editor. 2012, InTech. p. 413-436.
5. Clark, I., et al., Tumor necrosis factor-induced cerebral insulin resistance in Alzheimer’s disease links numerous treatment rationales. Pharmacol Rev, 2012. 64(4): p. 1004-26.
6. Dhawan, G. and C.K. Combs, Inhibition of Src kinase activity attenuates amyloid associated microgliosis in a murine model of Alzheimer’s disease. J Neuroinflammation, 2012. 9: p. 117.
7. Drent, M., E.E. Lower, and J. De Vries, Sarcoidosis-associated fatigue. Eur Respir J, 2012. 40(1): p. 255-63.
8. Ferraccioli, G., et al., Rheumatoid Arthritis and Alzheimer Disease: Possible Cellular and Molecular Links. Gerontology and Geriatric, 2012. 1(1).
9. Gabbita, S.P., et al., Early intervention with a small molecule inhibitor for tumor necrosis factor-alpha prevents cognitive deficits in a triple transgenic mouse model of Alzheimer’s disease. J Neuroinflammation, 2012. 9: p. 99.
10. Gruber, H.E., et al., Genome-wide analysis of pain-, nerve- and neurotrophin -related gene expression in the degenerating human annulus. Mol Pain, 2012. 8(1): p. 63.
11. Hojlund, J., et al., Effect of head rotation on cerebral blood velocity in the prone position. Anesthesiol Res Pract, 2012. 2012: p. 647258.
12. Ingles-Esteve, J., et al., Inhibition of specific NF-kappaB activity contributes to the tumor suppressor function of 14-3-3sigma in breast cancer. PLoS One, 2012. 7(5): p. e38347.
13. Jiang, T., J.T. Yu, and L. Tan, Novel disease-modifying therapies for Alzheimer’s disease. J Alzheimers Dis, 2012. 31(3): p. 475-92.
14. Krishnadas, R. and J. Cavanagh, Depression: an inflammatory illness? J Neurol Neurosurg Psychiatry, 2012. 83(5): p. 495-502.
15. Landoni, V.I., et al., Shiga toxin 1 induces on lipopolysaccharide-treated astrocytes the release of tumor necrosis factor-alpha that alter brain-like endothelium integrity. PLoS Pathog, 2012. 8(3): p. e1002632.
16. Lauterbach, E.C., Psychotropic drug effects on gene transcriptomics relevant to Alzheimer disease. Alzheimer Dis Assoc Disord, 2012. 26(1): p. 1-7.
17. Lima, A. and F. Antunes, Intervention of Physical Medicine and Rehabilitation in Failed Back Surgery Syndrome. Journal of Regional Anaesthesia and Pain Management, 2012. 68: p. 29-30.
18. Maccioni, R.B., et al., In Search of Therapeutic Solutions for Alzheimer’s Disease, in When Things Go Wrong–Diseases and Disorders of the Human Brain, T. Mantamadiotis, Editor. 2012, InTech. p. 125-.
19. Matias-Guiu, J.A. and R. Garcia-Ramos, Primary progressive aphasia: from syndrome to disease. Neurologia, 2012.
20. Montgomery, S.L. and W.J. Bowers, Tumor Necrosis Factor-alpha and the Roles it Plays in Homeostatic and Degenerative Processes Within the Central Nervous System. Journal of Neuroimmune Pharmacology, 2012. 7(1): p. 42-59.
21. Ooi, L., et al., New drugs under development for Alzheimer’s disease, in Advances in Alzheimer’s Disease Management, S. Gauthier and P. Rosa-Neto, Editors. 2012. p. 58-67.
22. Ramesh, V., et al., Disrupted sleep without sleep curtailment induces sleepiness and cognitive dysfunction via the tumor necrosis factor-alpha pathway. J Neuroinflammation, 2012. 9.
23. Santello, M. and A. Volterra, TNF-alpha in synaptic function: switching gears. Trends Neurosci, 2012. 35(10): p. 638-47.
24. Singh, P.L., et al., Current therapeutic strategies for inflammation following traumatic spinal cord injury. Neural Regeneration Research, 2012. 7(23): p. 1812-1821.
25. Steele, M.L. and S.R. Robinson, Reactive astrocytes give neurons less support: implications for Alzheimer’s disease. Neurobiol Aging, 2012. 33(2): p. 423 e1-13.
26. Stringer, M.D., et al., The vertebral venous plexuses: the internal veins are muscular and external veins have valves. Clin Anat, 2012. 25(5): p. 609-18.
27. Tweedie, D., et al., Tumor necrosis factor-alpha synthesis inhibitor 3,6′-dithiothalidomide attenuates markers of inflammation, Alzheimer pathology and behavioral deficits in animal models of neuroinflammation and Alzheimer’s disease. J Neuroinflammation, 2012. 9: p. 106.
28. Wilcock, D.M., Neuroinflammation in the aging down syndrome brain; lessons from Alzheimer’s disease. Curr Gerontol Geriatr Res, 2012. 2012: p. 170276.
29. Woodward, M.C., Drug treatments in development for Alzheimer’s disease. Journal of Pharmacy Practice and Research, 2012. 42(1): p. 58-65.
30. Yoshiyama, Y., V.M. Lee, and J.Q. Trojanowski, Therapeutic strategies for tau mediated neurodegeneration. J Neurol Neurosurg Psychiatry, 2012.
The INR’s scientific publications have been cited and discussed in scientific publications from academic centers around the world, including the following publications in 2010 and 2011:
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