For Dr. Jeffrey Lahrmann, a Connecticut native who recently joined The Hartford HealthCare Ayer Neuroscience Institute at Charlotte Hungerford Hospital (CHH), medicine has been an interest since he was quite young.
Having grown up with several practicing physicians in his family, he says, “Medicine was very much discussed at the dinner table.” As a student, he enjoyed science, and by high school, he was confident that he wanted to pursue medicine as a career. He attended the University of Connecticut on a pre-med track for his undergraduate studies, majoring in molecular and cell biology with a focus in genetics.
Today, as a practicing neurologist, he and his fellow team members at the Ayer Neuroscience Institute offer state-of- the-art care for patients with diseases and disorders of the brain, spinal cord, and nervous system. Using the most sophisticated technology, the neurologists of the institute are able to diagnose and treat a variety of neurologic conditions.
Dr. Lahrmann specializes particularly in movement disorders, which refer to diseases that impair a person’s ability to control movement. Examples include Parkinson’s disease, Restless Legs Syndrome, Huntington’s disease, tremors, ataxia (a degenerative disease that causes difficulty with coordination of voluntary movements), and dystonia (which causes sustained spasms or muscle contraction of different body parts).
And what does he enjoy about this particular subspecialty? For one thing, he says, it affords him the opportunity to establish long-term relationships with patients in a purely outpatient setting. He also finds the ability to positively impact a patient’s life in just a single office visit to be very gratifying.
The major challenge in the treatment of movement disorders, he notes, is being able to provide patients the needed access to all the treatment options available. Optimizing medication regimens is also key to successful patient outcomes. Having a comprehensive care team that specializes in these disorders and their treatments – like the neuroscience institute at Charlotte Hungerford – minimizes those challenges, he says.
Following His Path
While Dr. Lahrmann spent the first two decades of his life in the Nutmeg State, his studies took him on a circuitous path before eventually leading him home. He attended medical school at St. George’s University, Grenada, West Indies, then completed an internship in Internal Medicine at Ascension St. John Hospital and Medical Center, Grosse Pointe, Michigan.
Although he took a research-oriented neuroscience and behavioral science course during college, it wasn’t until about halfway through medical school that he became interested in neurology as a subspecialty. It was then that he took another neuroscience course which focused more on its clinical applications.
His desire to pursue neurology was confirmed when he was able to complete multiple clinical rotations in neurology during his third and fourth years of medical school. This exposure to various subspecialties within neurology made him appreciate the breadth of practice options that existed within the field.
His interests became more focused as he progressed through his education and training. It was during his first year of neurology residency that he decided to pursue movement disorders as his subspecialty within neurology.
Dr. Lahrmann, who was born and raised in Mansfield before moving to Glastonbury as a teenager, did a three-year residency in neurology at Drexel University College of Medicine in Philadelphia. In 2020, he completed his one-year fellowship in movement disorders at the University of Connecticut Health Center in Farmington.
After his fellowship, he chose to take a position at Hartford HealthCare’s Chase Family Movement Disorder Center in Vernon – not only because he loved Connecticut and had family in the area but because of the unique approach to patient care that the movement disorder centers advocate.
A Comprehensive Approach
Hartford HealthCare’s movement disorder centers offer comprehensive care for patients. There are multiple resources available in one location – from the neurologists and physician assistants to rehabilitation services specific to movement disorders, physical and occupational therapists, imaging services (MRI, CT scan), neuro-psychiatric evaluation for cognitive and memory issues, and integrative medicine services such as massage and acupuncture. Social workers are available to assist patients. Patients may also participate in patient and family support groups or even exercise and yoga classes at the centers.
Dr. Lahrmann points out the importance of housing services in one location, especially for patients who have difficulty with movement. He states, “For patients who have enough access to those resources, we find that they not only feel better, but we also noticed that the progression of their disease is slower.”
Currently, there are three movement disorder center locations – in Vernon, Mystic, and Cheshire. Two existing office locations in Torrington and Stamford are slated to become movement disorder centers in the future. Dr. Lahrmann is thrilled to be involved in the expansion of the centers so that resources and services are accessible to more patients and closer to their homes. Previously, patients would have to travel long distances to see him in Vernon.
The professionals from the various disciplines within the centers regularly communicate with each other about individual patients’ needs, goals, and progress. Care is very integrated. This communication extends to between the centers as well. So, it is relatively easy for a patient to move their care from one center to another if they need to do so. Dr. Lahrmann explains, “We don’t just pay lip service to disease management. This is a real example of comprehensive disease management.”
If a patient is hospitalized, whether related to a movement disorder or something else, the care team receives an alert in the electronic medical record. Although Dr. Lahrmann and the other neurologists from the centers do not provide direct care to patients in the hospital setting, they are available to answer questions and provide guidance to the hospital care team about a patient’s movement disorder care plan.
Dr. Lahrmann explains that there have been significant advances in all aspects of treatments for movement disorders.
He says neurologists have grown to appreciate the real value of physical therapy and targeted exercise or strength training designed for a specific movement disorder in improving a patient’s functional ability and their quality of life. Although it takes commitment on the patient’s part, this is a relatively easy, noninvasive therapy and is combined with other therapy options.
Medications have been a mainstay of treatment for movement disorders for years. Specifically for Parkinson’s disease, the focus has been on the role that dopamine, one of several neurochemicals normally present in our brain and nervous system, plays in the disease.
Many of the available medications work by replenishing or improving existing dopamine activity in the body. There have been advances in creating new formulations of these existing medications. For instance, some are now available in long-acting formulations so that patients do not need to take as many pills, nor as frequently, as before. There are also more “as-needed rescue medications” available for patients.
“We’re now even exploring the idea that there are non-dopaminergic medications that can help patients,” Dr. Lahrmann says.
Another therapy available for movement disorders is injection of Botulinum toxin, which most people know as “Botox.” This is mainly used for dystonia, facial spasms, tremors, sustained involuntary muscle contractions, or spasticity. When a small amount of Botulinum toxin is injected into a muscle, it blocks nerve signals that tell your muscles to contract. The effects of the injections are temporary, usually lasting for a few months, but these effects can last longer for some patients.
Deep brain stimulation, which is primarily used as a treatment option for Essential Tremor (ET) or Parkinson’s disease, was first approved by the Food and Drug Administration (FDA) in 2002. It requires a surgical procedure, sometimes involving two stages, to implant electrodes in the brain. These electrodes are then programmed to interrupt abnormal brain activity. The concept is similar to the way in which a pacemaker works for the heart.
Other advances in care have made it possible for neurologists to better alter the strength and direction of the stimulation signal in the brain, and to monitor the patient’s brain activity during stimulation in order to get the desired effect, while avoiding unwanted effects. When patients come to the office, Dr. Lahrmann can make adjustments in the strength or direction of a programmed signal and can observe the effects on the patient’s symptoms in real time. So unlike changing the dose of a medication, where it may take days to weeks to notice a change in symptom control or adverse effects of the medicine, he and the patient know the results before the patient even leaves the appointment.
Dr. Lahrmann is currently welcoming new patients, with appointments available on Tuesdays and Wednesdays at the Torrington location. He is also excited to be able to continue caring for patients he first met at the Vernon location during his fellowship, on Mondays, Thursdays, and Fridays.
Apart from enjoying a career that allows him to do what he loves, he is delighted to be living in his home state, saying he loves New England for its four seasons and for all the opportunities for outdoor activities it provides. He played tennis competitively as a child and enjoys hitting the courts to this day. He also enjoys snowboarding and cycling.
Currently, when he isn’t working, Dr. Lahrmann and his fiancée are planning their wedding and enjoying caring for Tillie, the eight-month-old, 55-pound, Bernedoodle puppy – a cross between a bernese mountain dog and a poodle – that they recently adopted.
Margaret M. Burke, Pharm.D., BCPPS, is a freelance medical writer with more than 25 years of clinical pharmacy experience, including board certification as a pediatric pharmacotherapy specialist. She lives in Manchester.