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Signature Program in Brain and
Behavioral Illness
The Signature Program in Brain and Behavioral Illnesses is a leading
center for comprehensive, state-of-the-art research and training in the
diagnosis and treatment of neurologic and behavioral health disorders.
The program represents a diverse array of basic, clinical and computational
research, with four relatively distinct subgroups:
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Stroke and Cerebrovascular Disorders Research Subgroup
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Schizophrenia and Behavioral Health Research Subgroup
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Addiction Research Subgroup
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Neuro-developmental Disorders Research Subgroup
Key activities within these subgroups cover the spectrum of translational
processes from bench to bedside to community and population, as exemplified
by work investigating prenatal ethanol exposure. This program obtained
a
COBRE grant in 2001 that has been recently renewed. The COBRE, as a career
development grant for junior faculty, has successfully mentored several
new
faculty members into NIH-funded investigators. Our Career Development
Core
will exploit the success of this program. This program has secured a new
NIAAA-funded T32 training grant entitled “Alcohol Research Training
in
Neurosciences” that supports students and fellows.
The vision of this Research Program is to form a “Neuroscience
Institute” that becomes the leading center in the Southwestern and
Rocky Mountain states for comprehensive state-of-the-art clinical care,
research and training in the diagnosis and treatment of neurologic and
behavioral health disorders.
Neuroscience Program Structure
Currently, there is no centralized organization to support, coordinate or
advocate for neuroscience (NS) programs. The SOM NS community is composed
of a relatively large number of investigators principally located in the
Departments of Neurosciences, Neurology, Neurosurgery and Psychiatry, with
participation by smaller numbers of faculty in Radiology, Cell Biology and
Physiology, Biochemistry, Pediatrics, OB/GYN, Orthopedics, and Family
and
Community Medicine. Perhaps to a greater degree than the other three
signature programs, the NS research community extends well beyond the SOM to
include, most notably, the Department of Psychology and the MIND Institute,
as well as collaborators in Pharmacy, Chemistry, Computer Science,
Electrical and Computer Engineering, the UNM-MIND Center, the Center on
Alcoholism, Substance Abuse and Addictions (CASAA), and the Center for
High Technology Materials.
While an extremely diverse array of basic, clinical and computational
research exists in the broader NS community, programmatic research activities
have emerged in four relatively distinct “disease-oriented”
areas within, but not limited to, SOM investigators. Each program area
has a sufficient number of investigators to have either attained, or be
competitive for NIH center-level funding. Each area has secondary programs,
some with potential for developing program-project level support as well.
Further, each area either has, or has the potential to pursue, NIH-funded
training grants.
Program Strengths and 5 Year Goals
A. Stroke and Cerebrovascular Disorders Research Program
The current strength in this area is stroke and trauma research in the BRaIN
imaging center and the Center for Stroke Research and Treatment (CSTR)
conducted by investigators in the departments of Neurology, Neurosciences,
and Neurosurgery. The BRaIN center, directed by Dr. Okada, is focused on the
molecular mechanisms of brain injury in cerebrovascular diseases and is
supported by a recently renewed five-year NCRR COBRE grant, along with four
NINDS RO1 grants and American Heart Association funding. The CSTR, co-directed
by Drs. Rosenberg and Yonas, consists of the clinical enterprise, clinical
stroke studies, studies in the intensive care setting, and advanced resources
for clinical neuroimaging. The recent arrival of Dr. Yonas to lead the
new Department of Neurosurgery has added considerable strength and research
capabilities in these areas. As the only level-one neurotrauma center
for the state of New Mexico, a large population base that requires aggressive
and complex care is available for involvement in clinical studies directed
at improving outcome through a better understanding of disease mechanisms.
In addition to stroke and trauma related programs, a Multiple Sclerosis
Treatment and Research Center directed by Dr. Ford is conducts clinical
studies to advance new treatments for MS. This work is complemented by
RO1-funded research of the mechanisms of demyelinating diseases conducted
by Dr. Bizzozero (Cell Biology and Physiology).
Goals for the Next Five Years
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Establish a comprehensive Stroke Center at the UNM Hospital. The
goal is to recruit a team of stroke neurologists, interventional radiologists
and vascular oriented surgeons capable of providing state of the art
care while exploring new approaches guided by close interaction with
experimentally focused neuroscientists. The goal is also to develop
a team of neurotrauma-focused physicians and scientists that can minimize
the sequelae of the large clinical population of cranial and spinal
cord injured patients cared for at UNM.
-
Recruit an epileptologist to direct the Comprehensive Epilepsy Center
(CEC). In addition, a neurosurgeon trained in epilepsy surgery is
needed to provide the crucial surgical support to the center. The
CEC is the only resource in New Mexico for comprehensive epilepsy
care, including video monitoring and epilepsy surgery.
-
Enhance clinical services in the areas of stroke, neurotrauma, spine,
pediatrics, movement disorders, pain and oncology, making the Neuroscience
ICU (soon to be expanded to 24 dedicated neuroscience focused beds)
and other neurology service units the premier center for the treatment
of neurological diseases in the region.
-
Develop novel clinical monitoring systems for severely injured patients
that will make the expanded neuroscience ICU (24 dedicated beds in
the new hospital pavilion) as site for clinical research for better
understanding the disease process and for monitoring the response
to innovative therapies.
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Secure a NINDS training grant on basic and clinical functional neuroimaging.
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Take a leadership role in securing the acquisition of a cyclotron,
and PET and SPECT imaging to enhance our neuroimaging research capabilities.
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Secure an NINDS P-30 or P-50 center grant to extend the BRaIN Imaging
research program at the end of the current five-year COBRE grant.
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Lay the foundation for creating future centers for the care of patients
with movement disorders and brain cancers. Each of the proposed centers
will have expertise for the care of children and adults.
B. Schizophrenia / Behavioral Health Research Program
The lead topic and principal strength in this program area has been the
clinical trials program for the treatment of schizophrenia and, more recently,
clinical neuroimaging research, led by Dr. Lauriello. The Clinical Trials
Program includes multi-center pharmaceutical trials, investigator-initiated
single and multi-center studies and NIH-funded multi-center trials (e.g.
Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and
Relapse Prevention in Schizophrenia. The clinical imaging includes NIH-
and VA-funded research on schizophrenia being
conducted at both the MIND Institute and the VA Medical Center. In addition
to these two areas, there is NIMH- and MIND Institute-funded research
on
postmortem changes in synaptic proteins in schizophrenic patients as well
as
the development of several animal models that mimic elements of the
neuropathology associated with schizophrenia. These projects are directed
by
Dr. Perrone-Bizzozero.
Goals for the Next Five Years
-
Secure the pending NCRR COBRE infrastructure grant on schizophrenia,
which will help sustain the functional neuroimaging research emphasis
of
Psychiatry and Psychology investigators working with the MIND Institute.
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Increase the communication and coordination of investigators working
in schizophrenia research.
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Develop a blueprint for services and outcomes research in psychiatric
illnesses, partnering with the state and UNM prevention centers and
the
work of the outcomes group headed by Dr. Helitzer.
-
Increase the number of RO1 level grants in the Psychiatry, Psychology
and Neurosciences in schizophrenia. Pilot project funding will be
required to achieve this objective.
-
Establish a NIMH-sponsored training grant to support graduate and
postdoctoral student training in schizophrenia and other behavioral
health disorders.
-
Develop a program on Post-traumatic Stress Disorder (PTSD) encompassing
existing VA-funded functional neuroimaging research coupled with basic
research on the long-term consequences of stress on brain function.
New faculty hires and pilot project funding will be required
in this area.
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Lay the foundation to develop research programs on affective disorders,
aging and child psychiatry. Recurring funds to support the targeted
hire of additional clinical and basic research investigators and pilot
project funding will be required to sustain these efforts.
C. Addiction Research Program
The strengths in this area lie in prevention, outreach and treatment
research programs at UNM’s Category III Center for Alcoholism, Substance
Abuse and Addictions (CASAA) along with treatment and clinical research
programs in the Department of Psychiatry. The lead research topic in this
area has been the behavioral and pharmacologic treatment of alcoholism,
including a NIDA U10 Clinical Trials Network Node grant, research on 12-step
programs, studies of mechanisms of behavioral change; DWI prevention,
and development of assessment technology. In addition, several other investigators
are funded to conduct basic research and functional neuroimaging research
on the neural circuits implicated in the reinforcing effects of drugs
of abuse.
Goals for the Next Five Years
-
Hire a new director of CASAA with the mission of building cross-campus
interactions and broadening the multidisciplinary scope of substance
abuse research and treatment at UNM.
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Establish more effective integration of research collaborations between
the Departments of Psychiatry, Psychology, Neurosciences, the VA Hospital,
The MIND Institute, CASAA and the substance abuse cessation programs
directed by Dr. Sally Davis.
-
Hire new investigators in the treatment of substance abuse disorders
with an emphasis on investigators trained in functional neuroimaging
research. Recurring funds to support the targeted hire of additional
clinical and basic research investigators in this area and sufficient
start-up funding to sustain these investigators for up to three years
after hiring is required. Strengthen the clinical trials program on
medications for treating addiction.
-
Support for new basic research on the neural mechanisms and consequences
of addiction. Acquire NIAAA and/or NIDA grants to support the training
of graduate, postdoctoral and resident trainees in addiction research.
D. Neurodevelopmental Disorders Research Program
The strengths of this area lie in the number of basic, clinical and epidemiological
investigators studying prenatal ethanol exposure supported by number of
RO1, UO1, R21, RO3 and T32 grants on Fetal Alcohol Spectrum Disorder (FASD),
primarily in the basic sciences (led by Dr. Savage) and epidemiological
/ prevention research (led by Dr. Phil May, Sociology). Further, there
is considerable potential to develop at least program-project level research
on prenatal exposure to nicotine, heavy metals and stress, given the overlapping
interests with fetal alcohol investigators and that these are high-impact
health issues in New Mexico.
Goals for the Next Five Years
-
Increase the number of NIAAA-funded RO1-level grants, particularly
clinical FASD research involving neurobehavioral assessment, functional
neuroimaging (MEG and/or high density EEG) and diagnostic markers
for maternal drinking and adverse neurobehavioral outcomes in offspring.
If this objective is achieved in the next two to three years, it will
be possible to resubmit a more competitive P-50 center application
to the NIAAA. The most critical resource to achieve this goal will
be pilot project funding to investigators that will allow the generation
of
preliminary data to enable the submission of competitive NIAAA RO1
grants.
-
Acquire high density EEG imaging capabilities to complement existing
MEG capabilities.
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Secure RO1 level funding for multidisciplinary studies on the neurodevelopmental
effects of nicotine (from NIDA), heavy metals (from NIEHS) and stress
(from NIMH). These areas will require pilot project funding also.
However, the targeted hiring and coordination of basic, clinical and
epidemiologic investigators will also be required to bring these programs
to program-project level organizations.
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Establish more effective research collaborations with other UNM
programs, namely, CASAA, UNM’s NIEHS center, and psychiatry/psychology
investigators conducting PTSD research. Further, all of these research
areas would benefit from interactions with the Center for Development
and Disability and Dr. Sally Davis’ outreach and prevention
programs.
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