Washington University School of Medicine

Robert Naismith, MD

TITLES
Assistant Professor of Neurology. 2003-present
Neurology Clerkship Director. 2002-present

CLINICAL SPECIALTIES
Dr. Naismith is trained in the multidisciplinary care of those with MS. This includes use of disease modifying therapies, symptom management, and rehabilitation. He sees and treats those with the demyelinating disease called Neuromyelitis Optica (NMO) or Devic's Disease, transverse myelitis, and optic neuritis. He also treats other autoimmune diseases of the central nervous system. In addition, the MS center is involved with clinical trials to discover new treatments for MS and related diseases.

RESEARCH FOCUS
Dr. Naismith is NIH-funded to work on imaging in MS and NMO. Specifically, this includes clinical and qualitative imaging of the optic nerve, brain, and spinal cord. Diffusion Tensor Imaging (DTI) is a primary focus, particularly how it correlates with function, predicts disability, and serves as a surrogate of pathology. Optical coherence tomography and visual evoked potentials are additional areas of study. Clinical MRI measures include T1 hypointensities, T2 hyperintensities, and gadolinium-enhanced lesions.
Additional areas of expertise include clinical trials, clinical outcome measures, epidemiology, and biostatistics.

Medical Training

EDUCATION
Fellowship in Multiple Sclerosis. Mentor is Dr. Anne Cross. Washington University. 2003-2004
Neurology Residency. Washington Unviersity. Residency Director was Dr. David Clifford. 2000-2003
Medicine Residency. Barnes Jewish Hospital. Residency Director was Dr. Daniel Goodenberger. 1998-2000
Medical Degree. Case Western Reserve University. 1994-1998
Bachelor of Science in Chemistry. Case Western Reserve University. 1990-1994

Selected Publications

A. Peer reviewed manuscripts.

Naismith RT, Piccio LP, Tutlam NT, Lauber J, Trinkaus K, Parks BJ, Song SK, Cross AH. Rituximab add-on therapy for breakthrough relapsing multiple sclerosis: a 52-week phase II trial. Submitted.

Naismith RT, Tutlam NT, Shepherd J, Trinkaus K, Cross AH, Song SK. Increased radial diffusivity in remote optic neuritis discriminates clinical visual outcomes. Submitted.

Naismith RT, Xu J, Tutlam NT, Scully P, Snyder A, Trinkaus K, Song SK, Cross AH. Increased diffusivity in acute multiple sclerosis lesions predicts risk for progression to a persistent black hole. Submitted.

Klawiter E, Cross AH, Naismith RT. MS medication efficacy in the modern era: is the new 66% just the old 33%? Neurology 2009;73:984-990..

Piccio L, Naismith RT, Trinkaus K, Klein RS, Parks BJ, Lyons JA, Cross AH. Changes in B and T lymphocytes and chemokines with rituximab treatment in multiple sclerosis. Accepted at Archives of Neurology.

Newland PK, Naismith RT, Ullione M, Madsen R. The impact of pain and other symptoms on quality of life in women with relapsing-remitting multiple sclerosis. Accepted at Journal of Neuroscience Nursing.

Naismith RT, Tutlam NT, Xu J, Shepherd JB, Klawiter EC, Song SK, Cross AH. Optical coherence tomography is less sensitive than visual evoked potentials in optic neuritis. Neurology 2009;73:53-58.

Klawiter EC, Alvarez E, Xu J, Paciorkowski A, Zhu L, Cross AH, Naismith RT. NMO IgG detected in CSF in seronegative neuromyelitis optica. Neurology 2009;72:1101-1102.

Naismith RT, Tutlam NT, Xu J, Klawiter EC, Shepherd J, Trinkaus K, Song SK, Cross AH. Optical coherence tomography differentiates neuromyelitis optica from multiple sclerosis. Neurology 2009;72:1077-1082.

Naismith RT, Tutlam NT, Weihl CC, Shepherd J, Cross AH. Acute and bilateral blindness due to optic neuropathy associated with copper deficiency. Arch Neurol 2009;66(8):1025-1027.

Naismith RT, Xu J, Benzinger T, Shimony J, Shpherd J, Trinkaus K, Cross AH, Song SK. Disability in optic neuritis correlates with diffusion tensor derived directional diffusivities. Neurology 2009;72:589-594.
Xu J, Sun SW, Naismith RT, Snyder AZ, Cross AH, Song SK. Assessing optic nerve pathology with diffusion MRI: from mouse to humans. NMR in Biomedicine 2008;21(9):928-940..

Piccio L, Buonsanti C, Cella M, Tassi I, Schmidt RE, Fenoglio C, Rinker J, Naismith RT, Panina-Bordignon P, Passini N, Galimberti D, Scarpini E, Colonna M, Cross AH. Identification of soluble TREM-2 in cerebrospinal fluid and its association with multiple sclerosis and CNS inflammation. Brain 2008; 131(10).

Rinker JR, Trinkaus K, Naismith RT, Cross AH. Higher IgG index found in African-Americans versus Caucasians with multiple sclerosis. Neurology 2007;69:68-72.

Naismith RT, Trinkaus K, Cross AH. Phenotype and prognosis of African-Americans with multiple sclerosis: a retrospective chart review. Multiple Sclerosis 2006:12(6):775-81.

D Simpson, L Estanislao, S Evans, L Li, K Marcus, M Truffa, J McArthur, B Lucey, R Naismith, I Guerrero, J Mendez, J Lonergan, Y Landau, M Harris, J Montaner, J Gathe, C Mayberry, and D Clifford. HIV-Associated Neuromuscular Weakness Syndrome. AIDS 2004; 18(10); 1403-12.

Sayre LM, Naismith RT, Bada MA, Li WS, Klein MB, Tennant MT. Trans-2-phenylcyclopropylamine is a substrate and inactivator of horseradish peroxidase. Biochem-Biophys-Acta 1996 Sept 5 1296(2); 250-6.

B. Invited Publications.

Benzinger TLS, Cross A, Xu J, Naismith RT, Sun SW,Song SK. Directional diffusivity as a magnetic resonance biomarker in demyelinating disease. Proc. SPIE 2007;6759(67590O):1-10.

Naismith RT, Cross AH. Magnetic Resonance Imaging in Multiple Sclerosis. In Continuum: Multiple Sclerosis. Editors Naismith RT and Cross AH. Maryland, USA. Lippincott Williams & Wilkins. November 2007.

Naismith RT, Cross AH. Magnetic Resonance Imaging in Multiple Sclerosis. In Continuum: Multiple Sclerosis. Editors Naismith RT and Cross AH. Maryland, USA. Lippincott Williams & Wilkins. Anticipated in 2007.

Naismith RT, Cross AH. Black Holes and MS: Trying to Connect the Pixels. Arch Neurol 2005; 62(11):1666-8.
Rinker JR, Naismith RT, Cross AH. Is MS an Autoimmune Disease? In Stuart Cook's Handbook of Multiple Sclerosis 4th edition.

Naismith RT and Cross AH. Does the hepatitis B vaccine cause MS? Neurology 2004;63(5)772-3.

Ford AL and Naismith RT. Depression and Brain Dysfunction: Depression and Multiple Sclerosis. London, UK: Taylor & Francis, 2006.
RT Naismith and AH Cross. Year in Neurology 2004: Neuro-Immunology Section. Editor: Edward Faught. London, UK: CRC Press, 2004.

Naismith RT, Cross AH. Multiple Sclerosis: novel treatments and therapeutic directions. Neuroscience News 2001; 4(4-5):48-57.

C. Abstracts.

Naismith RT, Xu J, Tutlam NT, Cross AH, Song SK.. Increased radial diffusivity in remote optic neuritis discriminates clinical visual outcomes. ECTRIMS Dusseldorf 2009.

Naismith RT, Xu J, Tutlam NT, Trinkaus K, Song SK, Cross AH. Increased Diffusivity in Acute MS Lesions Predicts Risk for Black Hole Progression. ECTRIMS Dusseldort 2009.

Qian Peiqing, Cross AH, Naismith RT. Assessment of Pain in Neuromyelitis Optica. ACTRIMS Atlanta 2009.

Naismith RT, Xu J, Tutlam NT, Trinkaus K, Song SK, Cross AH. Diffusion Tensor imaging predicts severe tissue injury in acute MS lesions. Platform Presentation. ACTRIMS Atlanta 2009.

Klawiter E, Trinkaus K, Liang HF, Shu-Wei S, Budde M, Naismith RT, Schmidt R, Song SK, Cross AH, Benzinger T. Axial and radial diffusivity as MR biomarkers of axonal and myelin injury in ex-vivo multiple scleorsis cervical spinal cords. AAN Seattle 2009.

Xu J, Klawiter EC, Benzinger TLS, Naismith RT, Song SK, Cross AH. Directional diffusivities in human spinal cord correlate with functional outcome. ISMRM 2009. Honolulu.

Xu J, Klawiter EC, Naismith RT, Benzinger TLS, Cross AH, Song SK. Assessment of spinal cord injury via diffusion MRI. Keystone Symposia on MS, Sante Fe, AZ, 2009.

Klawiter E, Trinkaus K, Hsiao-Fang L, Shu-Wei S, Budde M, Naismith R, Schmidt R, Cross A, Song SK, Benzinger T. Axial and radial diffusivity as MR biomarkers of axonal and myelin injury in ex-vivo multiple sclerosis cervical spinal cords. AAN 2009. Seattle.

Cross AH, Piccio L, Klein RS, Parks BJ, Lyons JA, Trinkaus KT, Naismith RT. B cell depletion in MS patients using Rituximab (antiCD20) Keystone 2009, Santa Fe.

Naismith RT, Xu J, Tutlam NT, Cross AH, Song SK. Diffusion tensor imaging detects clinical and structural alterations in optic neuritis. ACTRIMS 2008, Montreal.

Naismith RT, Trinkaus K, Fairbairn M, Lauber J, Piccio L, Cross AH. Rituximab as add-on therapy for breakthrough disease: clinical effects over 24 weeks. ACTRIMS 2008 Montreal.

Cross AH, Naismith RT, Trinkaus K, Parks BJ, Piccio L. Alterations in CSF chemokine patter following B cell depletion with rituximab in relapsing MS patients. ACTRIMS 2008 Montreal.

Naismith RT, Xu J, Snyder A, Benzinger T, Shimony J, Trinkaus K, Cross AH, Song SK. Axial diffusivity in acute and isolated optic neuritis. ISMRM 2008 Toronto.

Xu J, Naismith RT, Benzinger TL, Sun P, Priatna A, Cross AH, Song SK. Dynamic directional diffusivity alterations in acute transverse myelitis. ISMRM 2008 Toronto.

Xu J, Naismith RT, Priatna A, Cross AH, Song SK. FLAIR diffusion with inner volume optic nerve imaging. ISMRM 2008 Toronto.

Xu J, Naismith RT, Trinkaus KM, Cross AH, Song SK. Towards accurate in vivo diffusion measurement in human optic nerve. ISMRM 2007 Berlin.

Xu J, Snyder AZ, Foster G, Naismith RT, Cross AH, Song SK. Optic nerve injury increases water diffusivity. ISMRM 2006.

Zazulia AR, Naismith RT, Clifford DC, Goldberg MP. Bioterrorism preparedness in the neurology curriculum. AAN 2002.

Naismith RT, Yamamoto BK. The effect of methamphetamine on extracellular GABA in the substantia nigra. Case Western Reserve University Irwin H Lepow Student Research Day. 1995.