Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2014; 15: 473–474
OBITUARY
Theodore Leon ‘Ted’ Munsat MD (1930–2013)
BENJAMIN RIX BROOKS & MICHAEL SWASH
In 2014 there are many physicians and scientists involved in ALS research, but in the last quarter of the 20th century this field was only just opening. Ted Munsat, who passed away at his home in Waltham, Massachusetts on 22 November 2013, aged 83 years, surrounded by his family, was a driving force among the early enthusiasts for ALS research. He was born in Portland, Maine but his family soon moved on to Rutland, Vermont, a state he thereafter regarded with special affection. He graduated from Rutland High School, studied chemistry at the University of Michigan and graduated MD from the University of Vermont in 1957. He interned at Mount Sinai Hospital in New York City, before completing a neurology residency with J. Houston Merritt at Columbia-Presbyterian Medical Center. He then moved to UCLA where he worked with Augustus S. Rose, developing expertise in the then innovative techniques of histochemical studies of skeletal muscle biopsies. After service in the US Navy he returned to UCLA before serving from 1970 as Professor of Neurology and Director of the University of Southern California Muscular Dystrophy Clinic, working with Carl Pearson, himself the author with Derek Denny-Brown of a well-regarded text on muscle pathology. In 1975 he took a sabbatical year in Newcastle, working with John Walton and Walter Bradley, a period that proved crucial to his future career. He returned to the US as Chairman and Professor of Neurology at the Tufts-New England Medical Center in Boston, a position he retained until 1982. From that time he focussed his attention on ALS research and treatment. His early work on ALS involved measuring clinical deficit by a combination of quantitative strength (force) testing of muscles and functional tests, was codified in the ‘Tufts Quantitative Neurological Assessment’. Such endeavors, embracing the work of others, led to the 1986 International Workshop on Neurologic Quantitation in Talloires, France that helped spur national efforts to establish quantitative
normative databases in the United States, England, Germany, Ireland, France and Italy. Clinical trials in ALS before and since have struggled with the notion of an emphasis on strength as the ‘sine qua non’ of ALS, largely because of secondary adaptive changes within the neuromuscular system in the disease. Interested as he was in evolving appropriate clinical trial methodologies in order to be able to assess new therapies for ALS, he quickly realized that diagnosis itself was not as simple as most neurologists believed. He convened an International Workshop in 1990 at El Escorial, near Madrid, to produce consensus agreement on diagnosis, a process that soon assumed epic proportions as various fixed beliefs were taken apart in discussions that continued late into the night over several days (1). In propelling his enthusiasm for ALS research, with a number of others, he founded the Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis from the World Federation of Neurology Research Group on Neuromuscular Diseases. The World Federation of Neurology established the Research Group on Motor Neuron Diseases with Ted Munsat as its first Chairman. The activities of this spearhead, together with its pivotal 1994 Airlie House Workshop on Therapeutic Trials, leading in 1995 to international guidelines on clinical trials, led
Correspondence: Benjamin Rix Brooks, Charlotte, North Carolina USA Michael Swash, London, UK. E-mail: [email protected] ISSN 2167-8421 print/ISSN 2167-9223 online © 2014 Informa Healthcare DOI: 10.3109/21678421.2014.909492
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to a controversial International Workshop on Therapeutic Trials in ALS, in Talloires, France, at which riluzole and other newer treatments were evaluated. This research group proved a pivotal vehicle in fostering collaboration between US and European research groups. By promoting international clinical trials it greatly facilitated clinical trial methodology in ALS. Although in 1998 the El Escorial criteria were modified at another consensus conference, these issues continue to exercise the minds of ALS physicians, especially in relation to the vexed question of early diagnosis. Ted Munsat had experience of the organization of teaching in neurology, at national level, as Chairman of the AAN’s Continuing Education Committee, setting up the beginnings of the complex organization of courses at the annual congress that is so familiar today. He served as President of the AAN from 1989 to 1991 (2). He was a cofounder of the successful newspaper-style AAN publication CONTINUUM, which he saw as having a major educational function concerning developments in neurology. His diplomatic skills were much admired. He used these skills later in his career by travelling to countries in which facilities and personnel for neurological diagnosis and care were poorly developed, acting as a neurological ambassador for the WFN (3). This required the organization of seminar-style teaching sessions, advising on the structure of future postgraduate training and assessing clinical facilities in these countries, a role for which he remains revered in
no less than 42 countries in Eastern Europe, Asia, the Middle East, North Africa, central Africa and South America. This, perhaps his greatest legacy, was recognized recently by Marco Medina, Dean of the National Autonomous University of Honduras (4). Ted Munsat had friends in many countries, all of whom felt they could rely on him whenever necessary, knowing that his principal interest was always in fostering good research in ALS, especially research directed to the long-term goal of finding its cause and cure. He was the recipient of many honours, including the AB Baker Award for Education of the AAN, the Sheila Essey Award for ALS research, and lifetime achievement award of the WFN Research Committee on Neuromuscular Diseases. He was honoured by the University of Marseilles with the degree of MD honoris causa. Outside neurology he was an active man, sailing, working with his maple trees, and making furniture. He is survived by his wife Carla, their daughter and son and six grandchildren. References 1. Brooks BR and World Federation of Neurology sub-Committee on Motor Neuron Diseases. El Escorial World Federation of Neurology criteria for diagnosis of amyotrophic lateral sclerosis. J Neurol Sci. 1994;124:965–1085. 2. Rowland LP. Theodore L Munsat MD; President AAN 1987– 1989. Neurology. 1987;37:548. 3. Munsat TL, Aarli J, Medina M, Birbeck G, Weiss A. International issues; educational programs in neurology. Neurology. 2009;72:46–9. 4. Medina MT. In memoriam of Professor Theodore L Munsat (1930–2013): his outstanding legacy with the WFN. J Neurol Sci. doi: 10.1016/j.jns.2014.01.031.
Copyright of Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
OBITUARY
Theodore Leon ‘Ted’ Munsat MD (1930–2013)
BENJAMIN RIX BROOKS & MICHAEL SWASH
In 2014 there are many physicians and scientists involved in ALS research, but in the last quarter of the 20th century this field was only just opening. Ted Munsat, who passed away at his home in Waltham, Massachusetts on 22 November 2013, aged 83 years, surrounded by his family, was a driving force among the early enthusiasts for ALS research. He was born in Portland, Maine but his family soon moved on to Rutland, Vermont, a state he thereafter regarded with special affection. He graduated from Rutland High School, studied chemistry at the University of Michigan and graduated MD from the University of Vermont in 1957. He interned at Mount Sinai Hospital in New York City, before completing a neurology residency with J. Houston Merritt at Columbia-Presbyterian Medical Center. He then moved to UCLA where he worked with Augustus S. Rose, developing expertise in the then innovative techniques of histochemical studies of skeletal muscle biopsies. After service in the US Navy he returned to UCLA before serving from 1970 as Professor of Neurology and Director of the University of Southern California Muscular Dystrophy Clinic, working with Carl Pearson, himself the author with Derek Denny-Brown of a well-regarded text on muscle pathology. In 1975 he took a sabbatical year in Newcastle, working with John Walton and Walter Bradley, a period that proved crucial to his future career. He returned to the US as Chairman and Professor of Neurology at the Tufts-New England Medical Center in Boston, a position he retained until 1982. From that time he focussed his attention on ALS research and treatment. His early work on ALS involved measuring clinical deficit by a combination of quantitative strength (force) testing of muscles and functional tests, was codified in the ‘Tufts Quantitative Neurological Assessment’. Such endeavors, embracing the work of others, led to the 1986 International Workshop on Neurologic Quantitation in Talloires, France that helped spur national efforts to establish quantitative
normative databases in the United States, England, Germany, Ireland, France and Italy. Clinical trials in ALS before and since have struggled with the notion of an emphasis on strength as the ‘sine qua non’ of ALS, largely because of secondary adaptive changes within the neuromuscular system in the disease. Interested as he was in evolving appropriate clinical trial methodologies in order to be able to assess new therapies for ALS, he quickly realized that diagnosis itself was not as simple as most neurologists believed. He convened an International Workshop in 1990 at El Escorial, near Madrid, to produce consensus agreement on diagnosis, a process that soon assumed epic proportions as various fixed beliefs were taken apart in discussions that continued late into the night over several days (1). In propelling his enthusiasm for ALS research, with a number of others, he founded the Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis from the World Federation of Neurology Research Group on Neuromuscular Diseases. The World Federation of Neurology established the Research Group on Motor Neuron Diseases with Ted Munsat as its first Chairman. The activities of this spearhead, together with its pivotal 1994 Airlie House Workshop on Therapeutic Trials, leading in 1995 to international guidelines on clinical trials, led
Correspondence: Benjamin Rix Brooks, Charlotte, North Carolina USA Michael Swash, London, UK. E-mail: [email protected] ISSN 2167-8421 print/ISSN 2167-9223 online © 2014 Informa Healthcare DOI: 10.3109/21678421.2014.909492
474
B. R. Brooks & M. Swash
to a controversial International Workshop on Therapeutic Trials in ALS, in Talloires, France, at which riluzole and other newer treatments were evaluated. This research group proved a pivotal vehicle in fostering collaboration between US and European research groups. By promoting international clinical trials it greatly facilitated clinical trial methodology in ALS. Although in 1998 the El Escorial criteria were modified at another consensus conference, these issues continue to exercise the minds of ALS physicians, especially in relation to the vexed question of early diagnosis. Ted Munsat had experience of the organization of teaching in neurology, at national level, as Chairman of the AAN’s Continuing Education Committee, setting up the beginnings of the complex organization of courses at the annual congress that is so familiar today. He served as President of the AAN from 1989 to 1991 (2). He was a cofounder of the successful newspaper-style AAN publication CONTINUUM, which he saw as having a major educational function concerning developments in neurology. His diplomatic skills were much admired. He used these skills later in his career by travelling to countries in which facilities and personnel for neurological diagnosis and care were poorly developed, acting as a neurological ambassador for the WFN (3). This required the organization of seminar-style teaching sessions, advising on the structure of future postgraduate training and assessing clinical facilities in these countries, a role for which he remains revered in
no less than 42 countries in Eastern Europe, Asia, the Middle East, North Africa, central Africa and South America. This, perhaps his greatest legacy, was recognized recently by Marco Medina, Dean of the National Autonomous University of Honduras (4). Ted Munsat had friends in many countries, all of whom felt they could rely on him whenever necessary, knowing that his principal interest was always in fostering good research in ALS, especially research directed to the long-term goal of finding its cause and cure. He was the recipient of many honours, including the AB Baker Award for Education of the AAN, the Sheila Essey Award for ALS research, and lifetime achievement award of the WFN Research Committee on Neuromuscular Diseases. He was honoured by the University of Marseilles with the degree of MD honoris causa. Outside neurology he was an active man, sailing, working with his maple trees, and making furniture. He is survived by his wife Carla, their daughter and son and six grandchildren. References 1. Brooks BR and World Federation of Neurology sub-Committee on Motor Neuron Diseases. El Escorial World Federation of Neurology criteria for diagnosis of amyotrophic lateral sclerosis. J Neurol Sci. 1994;124:965–1085. 2. Rowland LP. Theodore L Munsat MD; President AAN 1987– 1989. Neurology. 1987;37:548. 3. Munsat TL, Aarli J, Medina M, Birbeck G, Weiss A. International issues; educational programs in neurology. Neurology. 2009;72:46–9. 4. Medina MT. In memoriam of Professor Theodore L Munsat (1930–2013): his outstanding legacy with the WFN. J Neurol Sci. doi: 10.1016/j.jns.2014.01.031.
Copyright of Amyotrophic Lateral Sclerosis & Frontotemporal Degeneration is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
