When it comes to helping people with complex neuromuscular diseases, Adam Comer, MD, is all-in. His roles as a physician, principal investigator and graduate medical education leader have implications for patients today and in the future. A graduate of IU School of Medicine, Comer completed his neurology residency and an electromyography (EMG) fellowship at IU. His research interests include myotonic dystrophy and neuromuscular ultrasound. As an assistant professor of clinical neurology, Comer is currently conducting industry-sponsored clinical trials in adult patients with myotonic dystrophy type 1. Additionally, he serves as a clinical trial investigator or sub-investigator on multiple neuromuscular research studies. A recipient of the Indiana University Trustees’ Teaching Award, Comer is associate program director of the IU School of Medicine Adult Neurology Residency Program.
How did you become involved in clinical research at IU School of Medicine? I’ve been fortunate to have Dr. Laurie Gutmann (chair, Department of Neurology) as my mentor, and she pointed me toward research in myotonic dystrophy. It’s a disorder that is interesting from a scientific standpoint. I'm passionate about research and treatment for all neuromuscular diseases, but myotonic dystrophy is one in particular that I think we're close to having some therapies that can really do some good for these patients.
What do you find most rewarding about being a physician-scientist?
Myotonic dystrophy and other neuromuscular diseases are devastating disorders that affect people physically, cognitively and emotionally. These are conditions that have existed for thousands of years and today, we're finally able to offer therapies that target the root problem, which is toxic RNA. It’s exciting to be among the first physician-scientists to see this come to fruition and to be able to offer patients a therapy that will hopefully help them. And because it’s a genetic disorder, the work we do can impact their children and families too, and for me that’s very humbling.
Do you have other research interests?
I’ve applied for grants to help fund my other clinical research interest—neuromuscular ultrasound. In the past 10 or 15 years ultrasound has become a very useful tool in neuromuscular medicine, specifically as a complement to EMG, or nerve conduction studies. EMG tells us a lot about how nerves and muscles function, but it can’t tell us why there’s dysfunction. With ultrasound we can identify lesions—tumors or cysts that may be compressing the nerve, or a neuroma—that offer the insight to inform treatment.
There's also the potential to use muscle ultrasound to identify biomarkers. We have some pilot and feasibility studies underway that use muscle ultrasound to look at fasciculations (involuntary muscle fiber twitches) in Lou Gehrig's disease (ALS) and to look at muscle echogenicity, or the brightness of the muscle. In both cases, we can identify biomarkers for use in determining how a patient’s condition changes over time, after the introduction of therapy, for example.
What impact will physician-scientists have on patient care in the future?
It’s absolutely vital that we have future physicians who want to do research. We recently started a resident research track as part of the neurology residency program. So far we have two residents who are interested in research. I also work with several medical students and some undergraduate students on research projects. Our hope is to give learners the tools to hit the ground running once they graduate.