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Faculty Spotlight: Noreen Bukhari-Parlakturk, MD, PhD

Tuesday, August 14, 2018
N Bukhari Parlakturk

For Noreen Bukhari-Parlakturk, MD, PhD, neurology is a study in contrasts. The logical organization of neuroanatomy makes the unusual pathologies of many movement disorders seem all the more striking. As a clinician, Bukhari-Parlakturk is often able to effectively treat symptoms of movement disorders, even as her research highlights the need to develop disease-modifying therapies for these conditions. In this week’s Faculty Spotlight interview, Bukhari-Parlakturk explores these paradoxes, discusses her time as a Movement Disorders Fellow, and talks about how a current treatment for depression may help people with dystonia.

What are your current responsibilities within the Neurology Department? What does your typical day look like?
My current responsibilities are providing clinical care to movement disorders patients, advancing research in dystonia, mentoring students and being mentored. My work varies on a day-to-day basis. In a typical week, I spend a day in clinic treating patients, another day conducting clinical research on patients, and yet another day teaching medical students or meeting with my research mentor to discuss ideas, or engaging with other movement providers about fascinating cases in the clinic. I really enjoy all aspects of my work. It's a privilege to have patients trust you with their medical care and it gives me great satisfaction when I can improve the quality of their lives. My patients' experience with a disease also helps me develop better research questions to advance the field. Working with a great research mentor and research team, I am constantly motivated to elevate the science and push the boundaries of possibilities in clinical research.

How and when did you first get interested in neurology?
The seed for my interest in neurology came from my neuroscience research. I became interested in neuroscience research during my undergraduate. As a former trekkie, I consider the nervous system to be the last uncharted frontier in medicine. In fact, my motto during my doctoral years was "saving the world, one neuron at a time." As I was transitioning back to clinical years, I spent some time shadowing on the neurology rotation and really enjoyed connecting the dots between basic neuroscience and clinical neurology. Neurology is really unique among other medical professions in that it has both a very logical way of thinking and can be very bizarre. Our neuroanatomy is so logically organized that once you understand it, you have so much insight in treating vascular and neuromuscular diseases for example. But at the same time, there's some very bizarre pathologies such as in our movement disorders patients that can occur when things go wrong in the brain. It's this mix of logical with bizarre sprinkled over it that hooked me to neurology.

How did you get interested in movement disorders? What do you enjoy most about your work?
I became interested in movements disorders from a few different perspectives. During residency, we had weekly morning rounds with our Movement Division Chief and he would show us videos of his clinic patients. I always found his patient cases with their unusual phenomenologies fascinating. There are also no disease modifying therapies for any of the movement disorders and as a researcher, advancing disease mechanism and developing clinical therapies is my lifelong goal. So from both a clinical and scientific perspective, movement disorders allowed me to fully apply my professional skills and nurture my curiosity in the field. In my work, I really enjoy helping improve the quality of my patients' lives. It's ironic because I am so interested in developing disease-modifying therapies but I have come to appreciate the pivotal role that symptomatic treatments play in changing the quality of patients' lives. We had a Parkinson's patient go from being wheelchair bound to walking with support as a result of symptomatic medications and physical therapy during my fellowship. It was a really gratifying experience. It's these stories and the resilience of my patients that motivates me to keep chipping at the boundaries of clinical and scientific knowledge. It's the reason I switched from doing basic science to clinical research.

In addition to your clinical work, you’re also conducting research on dystonia. Would you briefly describe your current project(s) and how that research will further our ability to treat the condition?
I am very excited about my research on dystonia! As you know, dystonia is an involuntary condition where patients develop intermittent muscle contractions that leads to abnormal postures. Writer's cramp is a fascinating condition where subjects develop dystonia in their hand only during the task of handwriting. Based on the work of Nicole Calakos and other pioneers in this field, we know that dystonia is due to an imbalance of brain plasticity mechanisms. In my research, I will be applying a non-invasive brain stimulation therapy called transmagnetic stimulation (TMS) to restore imbalance in the dystonia brain network. This study has significant value because TMS is an FDA-approved therapy for treatment of depression. If we can demonstrate therapeutic benefit in dystonia patients, we can provide a readily available symptomatic therapy for dystonia patients. Furthermore, findings from my research can also provide mechanistic insight on a disease pathway that is not well understood. Finally, on a broader level, TMS thus far has been applied to change human brain cortical activity. In this line of work, I am proposing to use TMS to make network-level changes which can be used as a new paradigm for non-invasive brain stimulation therapy. The research study will begin enrolling writer's cramp patients in mid-August. I would greatly appreciate if house staff and faculty can make referrals for any interested writer's cramp patients to me!

You recently completed our fellowship program in Parkinson’s and Movement disorders. What’s one experience from that program that stands out as especially helpful or memorable?

As you know during my fellowship, two of the faculty in the division were promoted to other institutions. In order to care for their patients during the transition year, some of the other faculty in the Neurology Department as well as our mid-level providers pitched in and saw some of our patients. I really appreciated the teamwork they displayed. In addition, my division faculty (Burton Scott, Jeffrey Cooney and Nicole Calakos) wore multiple hats to keep things functioning in our division. It was difficult at times but it made me value their commitment to our group as a whole. Now as we begin a new academic year with three new faculty and a new Division Chief, I am excited about the next chapter for the Movement Division and the contribution we can make to the department and the institution.

What other passions or hobbies do you have outside of the Department?

My husband and I enjoy giving back to the community. When I moved to the local area, we volunteered at the Ronald McDonald house, and helped the local refugee communities. I still like to help out when I can but my time has become more limited. I also enjoy reading and creative writing such as poems and short stories. My writing pieces are usually inspired by stories of my patients and my work.

French riviera

In this photo, Bukhari-Parlakturk enjoys the French Riviera with her husband.