Naomi Gerber's guest appearances

Naomi Gerber

RUSK Insights on Rehabilitation Medicine

John Dodson

William Barr

Joel Stein

Robert Gordon

Aaron Johnson

Douglas Smith

Antonio Stecco

Tayyaba Ahmed

Pablo Celnik

Estelle Gallo

JR Rizzo

Jeff Heckman

Mitchell Elkind

Heather Milton

David Biderman

OwlTail

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  Listeners to Part 1 of Dr. Gerber’s presentation will recall that she talked about fatigue in the context of proteomics, performance, and perception. In Part 2, she began by asking how do we separate central fatigue from depression? It is a difficult question and may be why the biosignatures are so important. From a clinical perspective, sad and despairing feelings, anhedonia, really is the hallmark of depression. It’s not the hallmark of central fatigue, which is a different pathway. Many important factors here originate in the liver. We need to be attentive to the way we measure the specifics of both peripheral and central fatigue. We have objective measures that are quantitative and we have self-reports. Both are needed, along with observer-recorded reports to obtain a full picture of what we mean by fatigue. A perfect fatigue instrument has not been found yet. She described the fatigue severity scale and indicated some of its deficiencies. She also described the kinds of procedures undertaken in her laboratory to obtain a fuller understanding of fatigue. She indicated who can be considered fatigued. It’s usually women, individuals who are less active, who are obese or overweight, who are smokers with more than moderate alcohol intake, often complaining of depressed symptomology, and they are anxious. In her view, metabolic issues are under appreciated by our specialty. 

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  Listeners to Part 1 of Dr. Gerber’s presentation will recall that she talked about fatigue in the context of proteomics, performance, and perception. In Part 2, she began by asking how do we separate central fatigue from depression? It is a difficult question and may be why the biosignatures are so important. From a clinical perspective, sad and despairing feelings, anhedonia, really is the hallmark of depression. It’s not the hallmark of central fatigue, which is a different pathway. Many important factors here originate in the liver. We need to be attentive to the way we measure the specifics of both peripheral and central fatigue. We have objective measures that are quantitative and we have self-reports. Both are needed, along with observer-recorded reports to obtain a full picture of what we mean by fatigue. A perfect fatigue instrument has not been found yet. She described the fatigue severity scale and indicated some of its deficiencies. She also described the kinds of procedures undertaken in her laboratory to obtain a fuller understanding of fatigue. She indicated who can be considered fatigued. It’s usually women, individuals who are less active, who are obese or overweight, who are smokers with more than moderate alcohol intake, often complaining of depressed symptomology, and they are anxious. In her view, metabolic issues are under appreciated by our specialty.

Dr. Naomi Gerber, Part 2

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  In Part 1 of her presentation, Dr. Gerber’s aim is to decipher fatigue in the context of proteomics, performance, and perception. She wants to describe the construct that is beginning to be shaped to enable us to understand fatigue better and indicate how it is effectively measured both objectively and subjectively. She mentioned that the term biosignature is a more robust term than biomarker because it represents multiple domain measures to help us understand complex ideas, such as fatigue. When talking about fatigue, it is necessary for individuals to report what they are experiencing. Expectation plays a role in what a person is trying to accomplish. In order to treat fatigue effectively, it is necessary to know the parameters. Her presentation included the topics of cancer fatigue and liver fatigue, noting that if we do not study the liver better, an important concept in the rehabilitation world, we are not going to conquer this problem. She made a distinction between pathological and non-pathological (normal) fatigue and how to treat these conditions. She also discussed peripheral and central fatigue. There is confusion in the domain culture about these kinds of fatigue and an effort is underway to identify a biosignature that gives a mix of objective measures linked to perception. A portion of the tryptophan pathway is critical for understanding fatigue, both peripheral and central.

Dr. Naomi Gerber serves as the Director of Research for the Department of Medicine at Inova Fairfax Hospital in Virginia and the Outcomes Program at the Beatty Center for Integrated Research. After graduating from Tufts University School of Medicine, Dr. Gerber completed two residencies in internal medicine and rehabilitation medicine and a fellowship in rheumatology. She served as the Chief of the Rehabilitation Medicine Department at the Clinical Center, National Institutes of Health in Bethesda, Maryland and was instrumental in helping to develop the sub-specialty of rehabilitative rheumatology. In 2006, Dr. Gerber joined the faculty of George Mason University in the Health Administration and Policy Department and is co-director of the Laboratory for the Study and Simulation of Human Movement.  In Part 1 of her presentation, Dr. Gerber’s aim is to decipher fatigue in the context of proteomics, performance, and perception. She wants to describe the construct that is beginning to be shaped to enable us to understand fatigue better and indicate how it is effectively measured both objectively and subjectively. She mentioned that the term biosignature is a more robust term than biomarker because it represents multiple domain measures to help us understand complex ideas, such as fatigue. When talking about fatigue, it is necessary for individuals to report what they are experiencing. Expectation plays a role in what a person is trying to accomplish. In order to treat fatigue effectively, it is necessary to know the parameters. Her presentation included the topics of cancer fatigue and liver fatigue, noting that if we do not study the liver better, an important concept in the rehabilitation world, we are not going to conquer this problem. She made a distinction between pathological and non-pathological (normal) fatigue and how to treat these conditions. She also discussed peripheral and central fatigue. There is confusion in the domain culture about these kinds of fatigue and an effort is underway to identify a biosignature that gives a mix of objective measures linked to perception. A portion of the tryptophan pathway is critical for understanding fatigue, both peripheral and central.

Dr. Naomi Gerber, Part 1