Michael Geschwind, MD, PhD – UCSF Site Principal Investigator

Can you briefly describe your medical background?

My path to medicine was not direct. After college when deciding between a career as a PhD neuroscientist, going into government service/politics or getting an MD, I decided to try out government and politics first. I took the US State Department Foreign Service exam and began working in a Congressional office on Capitol Hill.  I soon realized I did not like working directly in politics and took a position a researcher in an economic environmental consulting firm doing projects for the U.S. Environmental Protection Agency (EPA).  After a few years, I began volunteering after work at a medical clinic for the indigent and homeless in DC. This rekindled my interest in medicine and medical research, so I went to get my MD and PhD (in neuroscience) at the Albert Einstein College of Medicine in The Bronx, NY.  After completing my internal medicine internship at UCLA, my neurology residency at The Johns Hopkins Hospital, my fellowship in neurobehavior at UCSF Memory and Aging Center, I became faculty at UCSF around 2002. While in my residency I found that I preferred clinical research (with patients) to working in the laboratory at the bench, which led to my academic career in clinical research.

Why are you driven to pursue CADASIL research?

A neurology colleague who was a friend and medical school classmate was directing the first CADASIL treatment trial (sponsored by Esai using donepezil (Aricept®) and invited UCSF to be a site. I had been following several patients with adult-onset brain white matter diseases (leukoencephalopathies), including CADASIL and was excited to participate. Over the years, I have been referred many patients adult onset white matter diseases, including not only CADASIL but also many in whom we identified known as well as novel genetic disorders.

What is one idea you have for CADASIL community outreach?

We really depend on patients with or at-risk for CADASIL and their families, as well as participants in this study, spreading the word about this important study for the CADASIL community. It’s important to tell friends and families about this study, convincing people to participate or at least find out more information.

What is a CADASIL question you have been asked that you feel is important for the CADASIL community to know?

Why should I participate? Answer: Right now, there are scientists and pharma companies interested in, or currently, developing potential treatments for CADASIL. To design optimal clinical trials in the United States, however, we need information on the natural progression of CADASIL from the presymptomatic through the early to moderate symptomatic stages. Our study is the first one to be doing this in the United States. This information will facilitate determining if a future intervention has a beneficial effect on stopping or slowing CADASIL progression.

For more information on Dr. Geschwind and UCSF, visit the site page in the main menu: https://cadasil-consortium.org/sites/ucsf/