Women’s Neurology Specialist Mary Angela O’Neal, MD, Joins UPMC Department of Neurology

Mary Angela O’Neal, MD, is a neurologist specializing in women’s neurology and functional neurologic disorders. She joined the UPMC Department of Neurology in late 2025 after more than a decade at Brigham and Women’s Hospital and Harvard Medical School (and before that in private practice), where she developed clinical programs, national educational initiatives, and one of only two women’s neurology fellowships in the United States. At UPMC, she serves as director of women’s neurology education and director of the Functional Neurologic Disorders program, with a focus on expanding clinical programs, strengthening multidisciplinary care, and advancing education across specialties.

Q: What led You to Join UPMC?

A: My clinical and academic work has centered on two areas, women’s neurology and functional neurologic disorders. Those are both areas where, in many institutions, there is not an established structure or there are only isolated efforts rather than coordinated programs. What stood out to me at UPMC was that both of those areas already existed in a meaningful way going back a number of years.

That is not common. In most places, I would have been starting from the ground up, which is a different kind of work. I have done that before, and it is valuable, but it also means spending a significant amount of time creating infrastructure before you can begin to expand it. Here, the infrastructure is already present. That allows the work to focus on growth, integration, and refinement.

The other factor is the ability to work across specialties. The kind of work I do does not sit within neurology alone. It requires collaboration with maternal-fetal medicine, psychiatry, cardiology, sleep medicine, and others. That kind of multidisciplinary environment is already part of how care is organized here, which makes it possible to do this kind of work in a more complete fashion.

Q: How did Your Prior Work Shape Your Approach to Building Programs in Women’s Neurology?

A: Much of my career has involved building programs that did not previously exist in a formalized way. At Mass General Brigham, I developed a women’s neurology fellowship, and that required defining what the field actually encompasses in a practical sense. Women’s neurology is not a single disease category. It is a framework that cuts across multiple neurologic conditions and requires integration with other areas of medicine.

Building that fellowship meant identifying the clinical areas that span pregnancy and neurologic disease, menopause and brain health, migraine, epilepsy, autoimmune disease as examples– and then determining how those intersect with other specialties. It also meant developing curriculum, identifying faculty across disciplines, and creating a structure that trainees could move through in a coherent way.

In parallel, I was involved in national educational efforts, including directing courses and contributing to curriculum development through professional organizations. That work reinforced that there is a significant gap between what is known in the field and what is routinely applied in clinical practice. A major part of my approach has been closing that gap through education, which is directly tied to clinical care.

That experience carries over directly into what I am doing at UPMC. The focus is not only on expanding clinical services, but on building the educational structure that allows those services to be understood and sustained.

Q: How do You Define Women’s Neurology in Terms of Clinical Care?

A: Women’s neurology is best understood as an approach to neurologic care that accounts for how sex and gender influence disease across the lifespan. It is not a separate category of disorders. It applies to conditions that neurologists already treat, but it changes how those conditions are evaluated and managed.

For example, migraines are more prevalent in women, and hormonal factors play a role in how the disease presents and evolves. Epilepsy occurs equally in men and women, but management is different in the context of pregnancy, contraception, menopause and long-term medication effects. Stroke risk is influenced by factors such as pregnancy-related conditions, hormonal therapy, and midlife vascular changes.

If those factors are not incorporated into clinical decision making, the care is incomplete. The issue is not that neurologists are unaware of these conditions. It is that the connections between them are not always systematically addressed. Women’s neurology brings those connections into a more structured framework.

Q: What Are Your Priorities for Expanding Women’s Neurology at UPMC?

A: I have three main areas that my attention is focused on. Those are education, clinical program development, and outreach.

On the education side, my role includes directing women’s neurology education and strengthening the fellowship program. That involves expanding the curriculum, increasing faculty participation, and creating educational opportunities that go beyond what you traditionally have in subspecialty training. That includes courses for neurologists as well as for primary care providers and other specialties.

Clinically, we are working to expand services and to build more coordinated care pathways for patients. That includes strengthening referral networks and making it easier for patients to access appropriate care at different stages in their lives. It also involves working with other departments to ensure that neurologic considerations are integrated into care models that already exist.

Outreach is also an important component. There are many patients and providers who are not aware that these services exist or how to access them. Part of the work is making those connections more visible and more accessible across the region.

Q: What Is the Rationale Behind Developing a Midlife Women’s Brain Health Program?

A: One of the things that is interesting about neurology is that we often see patients for the first time after something has already happened to them. A patient has already had a stroke. A patient is already having cognitive concerns. A patient is already dealing with a neurologic complication that might have been building for years. In women’s neurology, especially when you think about midlife and the menopausal transition, there is an opportunity to be more proactive.

What we are trying to do is think more deliberately about women in midlife as a population in whom there are identifiable neurologic and vascular risks that often are not pulled together in one place. A woman may have a history of preeclampsia or eclampsia, which we know is associated with a higher risk of stroke and cardiovascular disease decades later. She may also have hypertension, diabetes, migraine with aura, sleep apnea, or new cognitive complaints that are tied to sleep disruption, mood, or the menopausal transition itself. Those things are often considered separately, but they belong in the same conversation if you are thinking seriously about long-term brain health.

That is what makes this different. The goal is not simply to create another clinic around menopause or another clinic around cognition. The goal is to look at women in midlife through a neurologic lens and ask what we can identify earlier, what we can modify, and what we can do before a major neurologic event occurs. We have already been meeting with colleagues in menopause care, and we are bringing in sleep and cognitive specialists as well, because this only works if the program is built in a coordinated way. We counsel patients about these issues all the time in routine practice, but that is not the same thing as building a program that is actually designed around prevention and long-term brain health. That is what we are trying to do here globally in terms of women’s neurology.

Learn More

To refer a patient to the Women’s Neurology program at UPMC, please call 412-802-6642.