Kenneth M. Heilman MD, FAAN
James E. Rooks Jr. Distinguished Professor
Director, Center for Neuropsychological Studies & Memory Disorders Clinics
Department of Neurology
PO Box 100236
Gainesville
November 9, 2009
In the past hundred years, medicine as made great advances in the diagnosis and treatment of many diseases, but there are still many diseases of the brain that are not treatable. Of all the diseases to afflict humans, none are more devastating than those that impair the brain, which is the seat of the mind.
Advances in medicine are made by creative thinkers and Dr. Schmahmann, Professor of Neurology at Harvard, is one of the world’s most creative thinkers. Many people have acquired and developmental disorders of an old structure in the back of the brain called the cerebellum. Up to the time that Dr. Schmahmann performed his neurobehavioral research most people considered the cerebellum primarily important in mediating motor behaviors such as coordination. However, through a series of brilliant papers, Dr. Schmahmann has demonstrated that the cerebellum does indeed play a critical role in many cognitive behaviors and that damage to this portion of the brain causes both motor and cognitive (thinking) deficits. Understanding is the first step in repairing.
The brain’s anatomic connectivity constrains the types of behaviors that can be mediated and many behavioral disorders, both acquired and developmental are caused by disconnections between areas of the brain. Dr. Schmahmann has and continues to perform extensive research in anatomy. His book with Dr. Pandya, Fiber Pathways of the Brain (Oxford University Press) is probably the most important anatomic treatise in the last three decades. The publication of this book, together with the new technique of MRI diffusion tensor imaging, might very well induce a ‘paradigmatic shift’ in our understanding of neurobehavioral disorders and their treatments.
The best means of predicting the future is to examine the past. Based on Dr. Schmahmann’s important research advances, if provided with adequate support I believe he will not only continue to make important research contributions to the understanding of cerebellar diseases and disconnection syndromes, but that we will see even greater paradigmatic shifts in diagnosis and treatment.
Sincerely,
Kenneth M. Heilman M.D.
