The focus of OMRF’s Multiple Sclerosis Center of Excellence is to provide optimal medical care while advancing the understanding of MS—a disease of the central nervous system. Multiple sclerosis is an autoimmune disease of the brain and spinal cord caused by inflammation and degeneration. Inflammation causes damage to myelin, the protective covering that surrounds nerve cells. When this covering is damaged, nerve impulses are slowed and sometimes totally blocked. Degeneration can cause nerve cells to die prematurely. This combination of effects causes a variety of symptoms, including problems with vision, tremors, paralysis, painful spasms, imbalance, and cognitive changes.
From an MS clinical research perspective, we are interested in the visual system, cognition, balance and ambulation in MS.
The effects of MS in the brain commonly involve information processing in the visual system. The field of neuro-ophthalmology deals with problems with vision such as information coming from the eyes to the brain (called the afferent system) and the brain control of eyes positioning and movement (called the efferent system). Damage to the nerve pathways in the afferent system causes decrease or loss of vision, or blind spots in the visual fields. Damage to the efferent system creates misalignment of the eyes causes double vision or tracking abnormalities. Through clinical trials, we hope to determine if evaluating certain measurements in the eye can give us insight into degenerative processes in the brain and use those measurements as markers of disease progression.
One area of research we are pioneering is the effect of MS on balance. The delay of messages from the brain to the body can cause overcorrection causing patients to fall. It can alter normal gait, making it impossible to walk independently. We want to design objective ways to monitor changes and how the disease progression can impact patients’ function and safety. This will help identify the problems in a timely manner and assist us in intervening accordingly.
In addition to working with patients to address MS-related motor skills difficulties, sensory issues, cognition, and coordination, the Center participates in clinical trials to evaluate new medications directed at treating the disease.
We also work with scientists in the lab exploring basic science aspects of MS such as genetics and immunology. By learning more about the origins and behaviors of the disease, we hope to be able to slow or stop progression in current patients and prevent MS in others.
Multiple sclerosis poses many scientific challenges that cover the spectrum from molecular research to clinical outcomes. A hindrance to all type of research and clinical interventions is the relative lack of objective quantifiable measures of disease progression. These “disease markers” are yet to be identified and validated and may include autoantibodies, cytokines, MRI parameters, anatomical neuronal evaluation, and disability measures.
A clinical research interest of our center is the use of computerized systems to evaluate gait and balance. This approach identifies changes before they are apparent on regular physical examinations and can be used to accurately monitor progression. Another is the use of optical coherence tomography to measure potential neuronal loss in the retina as an indicator of a corresponding process in the brain that is secondary to MS-induced inflammation and/or neurodegeneration.
B.S., Colegio San Carlos, Bogotá, Colombia, 1980
M.D. Universidad Militar Nueva Granada, Bogotá, Colombia, 1985
Ophthalmology Residency, Universidad Militar Nueva Granada, Bogotá, Colombia
Neuro-Ophthalmology Fellowship, University of Texas, Galveston, TX
Neurology Residency, University of Oklahoma, Oklahoma City, OK
Honors and Awards
1990 Hospital Militar Central Resident’s Best Research Project: “Chlamydial Iga Antibodies In Tears Of Humans With Follicular Conjunctivitis”
2000 American Medical Association, Physician’s Recognition Award
2008 Volunteer Hall of Fame, Health Professionals / Research category, NMSS
2010 Honorary Chairman, MS Walk OKC, NMSS
2017 Labe Scheinberg Award in Neurorehabilitation, Consortium of Multiple Sclerosis Centers
2018 Hope Award in Outstanding Community and Humanitarian Services, NMSS
Member, Board of Trustees, National Multiple Sclerosis Society, Oklahoma Chapter, 2001 – present
Board Member, MS Bridge, 2003 – present
Vice Chairman, Clinical Action Committee, National Multiple Sclerosis Society, Oklahoma Chapter, 2005 – 2006
Chairman, Clinical Action Committee, National Multiple Sclerosis Society, Oklahoma Chapter, 2007 – present
Member, National Council of Clinical Action Committee Chairs, National Clinical Advisory Board, National Multiple Sclerosis Society, 2008 – present
Reviewer, International Journal of MS Care, 2006 – present
Reviewer, Neurology, 2000 – present
Reviewer, Ocular Therapeutics Handbook – Sudden Visual Loss chapter, Editor: Nicky R. Holdeman, 1995
American Academy of Neurology
American Academy of Ophthalmology
American Medical Association
North American Neuro-Ophthalmology Society
Multiple Sclerosis Section
Neuro-Ophthalmology / Neuro-Otology Section AAN
Oklahoma State Medical Association
Oklahoma County Medical Society
Joined OMRF Scientific Staff in 2011
Farrell JW 3rd, Bemben DA, Black CD, Larson DJ, Pardo G, Fjeldstad-Pardo C, Larson RD. Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis. Int J Environ Res Public Health 16, 2019 September, PMID: 31533224, PMCID: PMC6765940
Jog NR, McClain MT, Heinlen LD, Gross T, Towner R, Guthridge JM, Axtell RC, Pardo G, Harley JB, James JA. Epstein Barr virus nuclear antigen 1 (EBNA-1) peptides recognized by adult multiple sclerosis patient sera induce neurologic symptoms in a murine model. J Autoimmun:102332, 2019 September, PMID: 31515129
Freitas EDS, Frederiksen C, Miller RM, Heishman A, Anderson M, Pardo G, Fjeldstad C, Bemben DA, Bemben MG. Acute and Chronic Effects of Whole-Body Vibration on Balance, Postural Stability, and Mobility in Women With Multiple Sclerosis. Dose Response 16:1559325818816577, 2018 December, PMID: 30627068, PMCID: PMC6311586
Fjeldstad-Pardo C, Thiessen A, Pardo G. Telerehabilitation in multiple sclerosis: Results of a randomized feasibility and efficacy pilot study. International Journal of Telerehabilitation. 10(2): 55-64. Fall 2018. PMID: 30588276 PMCID: PMC6296802
Pardo G, Jones D. The sequence of disease-modifying therapies in relapsing multiple sclerosis: safety and immunologic considerations. Journal of Neurology. 264(12): 2351-2374. December 2017 (Epub September 6, 2017). PMID: 28879412 PMCID: PMC5688209
McCroskery P, Selmaj K, Fernandez O, Grimaldi LM, Silber E, Pardo G, Freedman M, Zhang Y, Xu L, Cadavid D, Mellion M. Safety and tolerability of opicinumab in relapsing multiple sclerosis: the Phase 2b SYNERGY Trial. Neurology Apr 2017, 88 (16 Supplement) P5369
Schubert RD, Hu Y, Kumar G, Szeto S, Abraham P, Winderl J, Guthridge JM, Pardo G, Dunn J, Steinman L, Axtell R. IFN-β treatment requires B cells for efficacy in neuroautoimmunity. The Journal of Immunology. 194(5): 2110-2116. March 2015. PMID: 25646307 PMCID: PMC4340715
Fjeldstad C, Fjeldstad A, Weir J, Pardo G. Association of vitamin D deficiency with RNFL thickness in MS individuals without history of optic neuritis. Multiple Sclerosis and Related Disorders. 3(4): 489-493. 2014. PMID: 25877061
Fjeldstad C, Bemben M, Pardo G. Reduced retinal nerve fiber layer and macular thickness in patients with multiple sclerosis with no history of optic neuritis identified by the use of spectral domain high-definition optical coherence tomography. Journal of Clinical Neuroscience. 18(11): 1469-1472. November 2011. PMID: 21917458
Multiple Sclerosis Center of Excellence
Arthritis & Clinical Immunology Research Program, MS 50
Oklahoma Medical Research Foundation
825 N.E. 13th Street
Oklahoma City, OK 73104
Phone: (405) 271-6242
Fax: (405) 271-2887
Cecilie Fjeldstad, Ph.D.
Clinical Research Scientist
RN Case Manager
Nurse Case Manager
Bobbette Miller, DPT, NCS