There are currently at Duke University Medical Center (DUMC) several ongoing programs, groups or seminars that focus on translational research aspects in neuroscience and are relevant to the perinatal period. These include the Multidisciplinary Neuroprotection Laboratories (under the direction of Dr. David Warner in Neuroanesthesiology and Dr. Daniel Laskowitz, Neurology); and the Neonatal/Perinatal Research Institute (NPRI) (headed by Ronald Goldberg, M.D.,Chief of Neonatology and James McNamara, M.D., Chair, Department of Neuroscience).
Multidisciplinary Neuroprotection Laboratories
One core resource, which has served as a fertile training ground for clinician-scientists is the Multidisciplinary Neuroprotection Laboratories (MNL). The mission of this multidisciplinary program is to perform translational research in acute brain injury of various forms, including stroke, head injury and hypoxia. The MNL is supported by a number of the program faculty, and is designed to use molecular biology, and pharmacological techniques to investigate basic mechanisms of acute brain injury, and the potential for novel strategies for pharmacological intervention. There are currently multiple clinically relevant animal models being performed in the MNL, including global and focal ischemia, closed head injury, subarachnoid hemorrhage, prenatal hypoxia, and cardiopulmonary bypass-induced brain injury Vanucci model for hypoxic ischemic injury. In addition, many of these models, such as global and focal ischemia, subarachnoid hemorrhage, and closed head injury, have been adapted from the rat to the mouse, which allows for the exploitation of transgenic technology to dissect the molecular mechanisms of brain injury under biologically relevant conditions.
The MNL is devoted to fostering interactions between basic and clinical neuroscientists studying acute brain injury, providing a structured training environment for the physician-scientist. In many cases, trainees will be exposed to both preclinical and clinical trials of therapeutics for acute brain injury, and will also be exposed to the basic science disciplines, which support these endeavors.
Proposed Training
Since the goal of this training program is to provide opportunity for translational neuroscience research on clinically relevant topics, the primary trainee will be an MD clinician. There are many potential trainees with no prior research experience but with a sincere interest in exploring a topic in depth, and for these trainees research is a novel enterprise for which there must be adequate preparation and a patient, willing mentor and laboratory setting. Since most of the research training will be provided by the faculty mentor then the choice of mentor becomes critical, and the PI will need to remain critically aware of the ongoing work and lab atmosphere for proper placement. Likewise, the approval process for new mentors to be added to the training program will include a review of previous trainees in that research setting, particularly clinicians, to ensure that the atmosphere is optimal for this focused type of trainee. All trainees will be required to have a minimum of 40 hours of research per week, severely limiting any concurrent clinical obligations, and are expected to have a full-time research position and the commensurate level of effort.
There is a minimum of three levels of training to be provided, to ensure that all trainees are well equipped to function in an academic medical center environment. The first level will be a common set of Core Courses for all of the trainees. The goal of this set of Core Courses is to ensure that all trainees have a minimum of expertise and realistic expectations about the combination of clinical practice and research, which can be performed simultaneously. The second level will be in-depth training provided by the selected mentor, in terms of either laboratory or clinical research efforts. Most of the training will be provided at this level with an in-depth exposure to the selected topic or research. The third level will be involvement in additional conferences and research groups, depending upon the interests of the trainee, as described above
A rich environment for such enhanced interaction and discussion, though such conference attendance should not be too intrusive as to interfere with the primary research goal. The fourth level is novel and depends upon the interests of the trainee. However, since the target trainee population is primarily composed of MD clinicians who will likely pursue a combines research and clinical career, it is important that the trainee gain some initial expertise in the design, interpretation and execution of clinical studies, while pursuing the main research project. Therefore, for many of the trainees a companion clinical study will be encouraged, of their choice or selected for them, and one of the clinical research mentors will be asked to assist the trainee in the design and implementation of even a small scale clinical study.
Curriculum:
Genomic Research Program
Core Courses will be required for fellows in this program
Additional Neuroscience didactic Curriculum
(i) Neuroprotection Research Conference - Faculty presents 1-2 hour weekly
didactic teaching program
(ii) Perinatal Neuroprotection Research Conference - Weekly presentation of
pertinent topics and/or research progress.
To refer a patient,
24 hours a day:
Ask for the neonatologist on call at:
1-800-MED-DUKE (1-800-633-3853)
or dial the pager directly at: (919) 970-1714.
Phone (919) 668-1592
Fax (919) 681-6065
