Understanding the brain and movement

Joseph Jankovic, M.D., professor of neurology at Baylor College of Medicine, is internationally regarded for his unwavering dedication to his patients and his extraordinary productivity in research. As such, it is with some irony that his legacy as a pioneer turning the tide against many neurological disorders at BCM was conceived almost on blind faith.

Fresh out of medical school and just married, Jankovic had not interviewed with a BCM representative, much less visited Houston, when he accepted an internship at the college. But upon hearing a former roommate's testimonial about his own experience at BCM, Jankovic was sold. Since then, legions of patients with Parkinson's disease and hyperkinetic movement disorders have reaped the dividends of Jankovic's decision to come to the Texas Medical Center. But the story of how Jankovic wound up at BCM confronting some of the most daunting human diseases began well before medical school, half a world away.

Neurogenesis

At 17, Jankovic came alone to the United States from what was then Czechoslovakia and was eventually "adopted" by distant relatives in Phoenix, Arizona. Within four years he completed high school and college and was joined by his parents and half-brother who also finally escaped the grips of communism. While a student at the University of Arizona College of Medicine, he began to narrow his focus down to what would ultimately be his calling in life.

"My friends were sons of doctors, so I was always interested in medicine and the sciences," he said. "I was driven toward the neurosciences and eventually decided to pursue neurology because I was interested in the functions of the brain."

During his last year of medical school, he was accepted for a clerkship at the world renowned Neurological Institute of New York at the Columbia University Medical Center. He so impressed his professors with his knowledge, clinical skills and sheer enthusiasm that by the end of the clerkship he was offered a neurology residency position there. After his internship at BCM, he and his wife moved to New York to start his neurology residency at Columbia.

Baylor, past and present

BCM was undergoing rapid growth under the leadership of renowned heart surgeon Michael E. DeBakey, M.D., when Jankovic joined the college's faculty in 1977. With a broad scope of medical cases, diagnostic facilities, and emerging technology, it provided the ideal setting for Jankovic's practice and research. He started the Parkinson's Disease Center and Movement Disorder Clinic shortly after his arrival, serving as its director from the outset.

Over time, a growing number of patients were referred to the clinic, which quickly garnered distinction for treating devastating movement and degenerative neurological disorders. Jankovic and his team handled not only Parkinson's patients but also patients with hyperkinetic movement disorders characterized by tics and involuntary movements, such as tremors, Tourette's syndrome, dystonia, and Huntington's disease.

Before long, the center's patient population grew large enough to facilitate investigator-initiated studies. Many clinical trials under Jankovic's watch have resulted in innovative ways of coping with otherwise untreatable diseases. Early studies resulted in novel approaches that are now standard medications and procedures. They include the first therapeutic use of botulinum toxin (or Botox) to control involuntary spasms and movements. Indeed, he and his team conducted the first double-blind controlled study of botulinum toxin in patients with blepharospasm and other facial spasms which eventually led to the FDA's approval of it for therapeutic uses in 1989.

"I learned very early that in order for me to establish myself as a clinical researcher, I would have to build a large population of patients, which was my focus initially," said Jankovic. "Since we were treating large numbers of patients, we were able to conduct clinical trials very efficiently."

Today, the clinic has a database of over 22,000 patients and a team that includes four full-time faculty members and several fellows. It also incorporates a basic science laboratory headed by Weidong Le, M.D., Ph.D., associate professor of neurology at BCM.

Jankovic soon became internationally recognized for his innovative clinical and basic research. In recognition of his many achievements, he was elected as the president of the international Movement Disorders Society in 1994. With over 600 published articles and numerous studies conducted in association with his team of dedicated physician-scientists and research staff, the center has been recognized by the National Parkinson's Foundation as its Center of Excellence since 1992 and was selected by the Huntington's Disease Society of America as the HDSA Center of Excellence in 2001.

"All members of our team over the years have helped us stay on the cutting edge of neurology and become leaders in Parkinson's research," Jankovic said. "None of our accomplishments would be possible without the support of my team and my family."

All in the family

Although Jankovic's passion for medicine and science did not carry over to his three children, other interests have. A lifelong movie buff, Jankovic has witnessed two of his sons pursue careers in the film industry, giving rise to a number of lively dinnertime discussions over the years.

"I have other passions, like a passion for classical music and tennis, which I share with my sons," he said.

Jankovic enjoys not only familial support (his wife, Cathy, works as a media producer at the center) but also widespread respect among his peers, other leaders in the medical and scientific communities, and dignitaries from all over the world. In addition to a litany of awards over his career and continuous invitations to serve as a guest lecturer, Jankovic remains closely associated with various study networks, support groups, and scientific foundations. He currently serves on the scientific advisory boards of the Tourette Syndrome Association and Michael J. Fox Foundation for Parkinson's Research, among others.

"Being invited to various institutions as a named lecturer is an honor, and I always appreciate it, but to me the greatest honor is to be able to serve my patients," Jankovic said. "I consider it a privilege to treat all of them – from janitors to heads of state."

Jankovic views his patients not as subjects with a disease but as human beings, even relatives. He explains to each patient his guiding principle: he does not prescribe any treatment regimen that he would not recommend to members of his own family. In return, Jankovic has been invited to many a wedding, bar mitzvah, and graduation by those he has treated over the years.

"At the end of the day, I always ask myself, 'What is it that I have enjoyed the most during the day?' and clearly it's always the interactions I have with my patients," Jankovic said. "I try to maintain a positive outlook for them in spite of the adversity of the neurodegenerative diseases many of them face."