Dr. Naomi Gerber, Part 1

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.