About the Institute

The Institute of Neurological Recovery (INR®) is pleased to provide this introduction to its pioneering medical concepts, research, and treatment programs. INR designates a group of separate medical practices that utilize innovative, patented, off-label medical treatments developed by Edward Tobinick M.D.  These treatment methods are designed to target a number of neuroinflammatory conditions with unmet medical need. In addition, the INR has an active physician training program.


Appointments at the INR

Consultation and treatment with an INR physician is by appointment only.  Appointments can be scheduled by calling the INR at (310) 824-6199, Monday through Friday, 8 AM to 5 PM.


Referrals to the INR

The INR welcomes referrals from neurologists, geriatricians, internists, family physicians, other health care providers, or family members of patients with selected neuroinflammatory disorders.  Individual treatment recommendations are only made following physician evaluation, including history, physical examination, and review of imaging studies.

The INR welcomes telephone inquiries from physicians and family members. In particular, the INR encourages telephone inquiry and discussion with an INR physician for those patients referred from locations at a geographic distance from Los Angeles prior to appointment scheduling. This is recommended especially for those patients who will be flying across country or from overseas for treatment at the INR, due to the special nature of the services provided at the INR, and the unique experience which the INR has performing anti-TNF treatment for neurological disorders.


Selected INR Scientific Publications

1. Edward Tobinick M.D., Rapid improvement of chronic stroke deficits after perispinal etanercept: three consecutive cases. CNS Drugs, 2011. 25(2): p. 145-155.

2. Edward Tobinick M.D.., Perispinal etanercept: a new therapeutic paradigm in neurology. Expert Review of Neurotherapeutics, 2010. 10(6): p. 985-1002.

3. Tobinick, E.L., K. Chen, and X. Chen, Rapid intracerebroventricular delivery of Cu-DOTA-etanercept after peripheral administration demonstrated by PET imaging. BMC Res Notes, 2009. 2: p. 28.

4. Edward Tobinick M.D., The value of drug repositioning in the current pharmaceutical market. Drug News Perspect, 2009.22(2): p. 119-25.

5. Edward Tobinick M.D.., Perispinal etanercept for neuroinflammatory disorders. Drug Discov Today, 2009. 14(3-4): p. 168-77.

6. Edward Tobinick M.D.., Tumour necrosis factor modulation for treatment of Alzheimer’s disease: rationale and current evidence.CNS Drugs, 2009. 23(9): p. 713-25.

7. Tobinick, E.L. and H. Gross, Rapid cognitive improvement in Alzheimer’s disease following perispinal etanercept administration. J Neuroinflammation, 2008. 5: p. 2.

8. Tobinick, E.L. and H. Gross, Rapid improvement in verbal fluency and aphasia following perispinal etanercept in Alzheimer’s disease. BMC Neurol, 2008. 8: p. 27.

9. Edward Tobinick M.D., Perispinal etanercept produces rapid improvement in primary progressive aphasia: identification of a novel, rapidly reversible TNF-mediated pathophysiologic mechanism. Medscape J Med, 2008. 10(6): p. 135.

10. Edward Tobinick M.D., Perispinal etanercept for treatment of Alzheimer’s disease. Curr Alzheimer Res, 2007. 4(5): p. 550-2.

11.  Edward Tobinick M.D. , The cerebrospinal venous system: anatomy, physiology, and clinical implications. MedGenMed, 2006.8(1): p. 53.

12. Edward Tobinick M.D., et al., TNF-alpha modulation for treatment of Alzheimer’s disease: a 6-month pilot study. MedGenMed, 2006. 8(2): p. 25.

13. Edward Tobinick M.D., Spinal delivery of p38: TNF-alpha inhibitors. PLoS Med, 2006. 3(11): p. e511.

14. Tobinick, E. and S. Davoodifar, Efficacy of etanercept delivered by perispinal administration for chronic back and/or neck disc-related pain: a study of clinical observations in 143 patients. Curr Med Res Opin, 2004. 20(7): p. 1075-85.

15. Tobinick, E.L. and S. Britschgi-Davoodifar, Perispinal TNF-alpha inhibition for discogenic pain. Swiss Med Wkly, 2003.133(11-12): p. 170-7.

16. Edward Tobinick M.D., Targeted etanercept for treatment-refractory pain due to bone metastasis: two case reports. Clin Ther, 2003. 25(8): p. 2279-88.


INR Scientific Background

The INR’s scientific findings have been published in multiple, peer-reviewed medical journals, including Expert Review of Neurotherapeutics, CNS Drugs, BMC Neurology, Current Alzheimer ResearchClinical TherapeuticsDrug Discovery Today, and Current Medical Research and Opinion. INR publications, findings, and research have advanced the science of neurology, dementia, and spine medicine, and have been cited and discussed by physicians and scientists from academic centers around the world. There have been hundreds of scientific citations to INR publications, including in Nature Clinical Practice Neurology and F1000 Biology.

Edward Tobinick, MD, founder of the INR, has presented his scientific findings regarding the effects of etanercept for neurological disorders at multiple U.S. and international medical and scientific conferences, including the Karolinska Institute in Sweden; the 2008 Drug Repositioning Summit in Boston; the International Conference on Alzheimer’s Diseasein Chicago; the 7th Annual Alzheimer’s Drug Discovery Conference in New York; the 2008 Best Practices in the Continuum of Care: Advances in Alzheimer’s Disease Management conference at the University of Arkansas Medical Sciences in Little Rock, Arkansas; and, in 2009, the 3rd International Restauracion Neurologica Conference in Havana, Cuba, the World Pharmaceutical Congress in Philadelphia and the 5th Modern Drug Discovery Conference in San Diego. Dr. Tobinick has performed collaborative research with scientists from Stanford University School of Medicine and additional academic centers.


2010-2011 Scientific Publications citing INR publications

Dr. Tobinick’s scientific publications have been cited and discussed in scientific publications from academic centers around the world, including the following publications in 2010 and 2011:

  • Aderinwale, O.G., H.W. Ernst, and S.A. Mousa, Current therapies and new strategies for the management of Alzheimer’s disease. Am J Alzheimers Dis Other Demen, 2010. 25: (5): p. 414-24.
  • Bassi, E. and C. De Filippi, Beneficial neurological effects observed in a patient with psoriasis treated with etanercept. Am J Clin Dermatol, 2010. 11 Suppl 1: p. 44-5.
  • Boettger, M.K., et al., Spinal tumor necrosis factor alpha neutralization reduces peripheral inflammation and hyperalgesia and suppresses autonomic responses in experimental arthritis: a role for spinal tumor necrosis factor alpha during induction and maintenance of peripheral inflammation. Arthritis Rheum, 2010. 62(5): p. 1308-18.
  • Buchhave, P., et al., Soluble TNF receptors are associated with Abeta metabolism and conversion to dementia in subjects with mild cognitive impairment. Neurobiol Aging, 2010. 31(11): p. 1877-84.
  • Candore, G., et al., Inflammation, cytokines, immune response, apolipoprotein E, cholesterol, and oxidative stress in Alzheimer disease: therapeutic implications. Rejuvenation Res, 2010. 13(2-3): p. 301-13.
  • Chavant, F., et al., Imipramine, in part through tumor necrosis factor alpha inhibition, prevents cognitive decline and beta-amyloid accumulation in a mouse model of Alzheimer’s disease. J Pharmacol Exp Ther, 2010. 332(2): p. 505-14.
  • Chez, M.G. and N. Guido-Estrada, Immune therapy in autism: historical experience and future directions with immunomodulatory therapy. Neurotherapeutics, 2010. 7(3): p. 293-301.
  • Clark, I.A., L.M. Alleva, and B. Vissel, The roles of TNF in brain dysfunction and disease. Pharmacol Ther, 2010.128(3): p. 519-48.
  • Colton, C.A. and D.M. Wilcock, Assessing activation states in microglia. CNS Neurol Disord Drug Targets, 2010.9(2): p. 174-91.
  • Dumont, T.M., D.W. Stockwell, and M.A. Horgan, Venous air embolism: an unusual complication of atlantoaxial arthrodesis: case report. Spine (Phila Pa 1976), 2010. 35(22): p. E1238-40.
  • Duro, D., et al., Validation studies of the Portuguese experimental version of the Montreal Cognitive Assessment (MoCA): confirmatory factor analysis. J Neurol, 2010. 257(5): p. 728-34.
  • Elfferich, M.D., et al., Everyday cognitive failure in sarcoidosis: the prevalence and the effect of anti-TNF-alpha treatment. Respiration, 2010. 80(3): p. 212-9.
  • Esposito, E. and S. Cuzzocrea, Anti-TNF therapy in the injured spinal cord. Trends Pharmacol Sci. 2011 Feb;32(2):107-15.
  • Frankola KA, Greig NH, Luo W, Tweedie D. Targeting TNF-Alpha to Elucidate and Ameliorate Neuroinflammation in Neurodegenerative Diseases. CNS Neurol Disord Drug Targets. 2011 Feb 2. [Epub ahead of print] PMID: 21288189
  • Furst, D.E., et al., Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2009. Ann Rheum Dis, 2010. 69 Suppl 1: p. i2-29.
  • Galimberti D, Scarpini E. Alzheimer’s Disease: From Pathogenesis to Disease-Modifying Approaches. CNS & Neurological Disorders – Drug Targets March 2011. 10(2):163-174.
  • Geis, C., et al., Evoked pain behavior and spinal glia activation is dependent on tumor necrosis factor receptor 1 and 2 in a mouse model of bone cancer pain. Neuroscience, 2010. 169(1): p. 463-74.
  • Gu, X., et al., Intraperitoneal injection of thalidomide attenuates bone cancer pain and decreases spinal tumor necrosis factor-alpha expression in a mouse model. Mol Pain, 2010. 6: p. 64.
  • He, M.X., et al., Association between interleukin-6 gene promoter -572C/G polymorphism and the risk of sporadic Alzheimer’s disease. Neurol Sci, 2010. 31(2): p. 165-8.
  • Huang, H., et al., TNF{alpha} is required for late BRB breakdown in diabetic retinopathy and its inhibition prevents leukostasis and protects vessels and neurons from apoptosis. Invest Ophthalmol Vis Sci, 2011 Jan 6.
  • Landoni, V.I., et al., Shiga toxin 1-induced inflammatory response in lipopolysaccharide-sensitized astrocytes is mediated by endogenous tumor necrosis factor alpha. Infect Immun, 2010. 78(3): p. 1193-201.
  • Lanni, C., et al., The expanding universe of neurotrophic factors: therapeutic potential in aging and age-associated disorders. Curr Pharm Des, 2010. 16(6): p. 698-717.
  • Liu, Z.P., et al., Identifying dysfunctional crosstalk of pathways in various regions of Alzheimer’s disease brains. BMC Syst Biol, 2010. 4 Suppl 2: p. S11.
  • McIntyre, R.S., et al., Brain volume abnormalities and neurocognitive deficits in diabetes mellitus: points of pathophysiological commonality with mood disorders? Adv Ther, 2010. 27(2): p. 63-80.
  • McNaull, B.B., et al., Inflammation and anti-inflammatory strategies for Alzheimer’s disease–a mini-review. Gerontology, 2010. 56(1): p. 3-14.
  • Menza M, Dobkin RD, Marin H, Mark MH, Gara M, Bienfait K, Dicke A, Kusnekov A. The role of inflammatory cytokines in cognition and other non-motor symptoms of Parkinson’s disease. Psychosomatics. 2010 Nov;51(6):474-9.
  • Merino, A., et al., Drug profiling: knowing where it hits. Drug Discov Today, 2010. 15(17-18): p. 749-56.
  • Money, T.T., et al., Treating schizophrenia: novel targets for the cholinergic system. CNS Neurol Disord Drug Targets, 2010. 9(2): p. 241-56.
  • Munoz, L. and A.J. Ammit, Targeting p38 MAPK pathway for the treatment of Alzheimer’s disease. Neuropharmacology, 2010. 58(3): p. 561-8.
  • Nicolae, C. and B.R. Olsen, Unexpected matrix diseases and novel therapeutic strategies. Cell Tissue Res, 2010.339(1): p. 155-65.
  • Oldreive, C.E. and G.H. Doherty, Effects of tumour necrosis factor-alpha on developing cerebellar granule and Purkinje neurons in vitro. J Mol Neurosci, 2010. 42(1): p. 44-52.
  • Pan, S.Y., et al., New perspectives on innovative drug discovery: an overview. J Pharm Pharm Sci, 2010. 13(3): p. 450-71.
  • Potter, P.E., Investigational medications for treatment of patients with Alzheimer disease. J Am Osteopath Assoc, 2010.110(9 Suppl 8): p. S27-36.
  • Ramanan, S., et al., Role of PPARs in Radiation-Induced Brain Injury. PPAR Res, 2010. 2010: p. 234975.
  • Seigers, R. and J.E. Fardell, Neurobiological basis of chemotherapy-induced cognitive impairment: a review of rodent research. Neurosci Biobehav Rev, 2011. 35(3): p. 729-41.
  • Simen AA, Bordner KA, Martin MP, et. al., Cognitive dysfunction with aging and the role of inflammation. Therapeutic Advances in Chronic Disease, 2011. Published online before print February 15, 2011, doi:10.1177/2040622311399145.
  • Sinclair, S.M., et al., Attenuation of Inflammatory Events in Human Intervertebral Disc Cells with a Tumor Necrosis Factor Antagonist. Spine (Phila Pa 1976), 2011 Jan 6.
  • Tamayo AC, Guajardo-Rosas J. Cervical epidural injections for radicular pain. Techniques in Regional Anesthesia and Pain Management. Volume 14, Issue 3, July 2010, Pages 106-112.
  • Vinukonda, G., et al., Neuroprotection in a rabbit model of intraventricular haemorrhage by cyclooxygenase-2, prostanoid receptor-1 or tumour necrosis factor-alpha inhibition. Brain, 2010. 133(Pt 8): p. 2264-80.
  • Wang, M.J., et al., Glycogen synthase kinase-3beta inactivation inhibits tumor necrosis factor-alpha production in microglia by modulating nuclear factor kappaB and MLK3/JNK signaling cascades. J Neuroinflammation, 2010. 7: p. 99.