Global Research Endeavors to Advance Treatment of Neurological Disorders in Africa (GREAT Neurology)

全球研究致力于推进非洲神经系统疾病的治疗（GREAT Neurology）

• 批准号: 10238395
• 负责人: GRETCHEN L. BIRBECK
• 金额: $ 44.78万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-01 至 2029-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10238395
• 关键词: 2019-nCoV; Acute; Adult; Africa; African; Aging; Award; Caring; Cerebral Malaria; Cerebrovascular Disorders; Cessation of life; Child; Chronic; Clinic; Collaborations; Communities; Disease; Environment; HIV; HIV Infections; HIV therapy; Hemorrhage; Impaired cognition; Infection; Inflammation; Inflammatory; Infrastructure; Injury; Investigation; Ischemia; Laboratories; Malaria; Malawi; Mentorship; Metabolic; Monitor; Morbidity - disease rate; Nervous system structure; Neurologic; Neurological outcome; Neurology; Neuropathy; Parasites; Population; Prevention; Process; Prospective cohort study; Randomized Controlled Trials; Reporting; Research; Research Activity; Research Infrastructure; Research Personnel; Resources; Risk Factors; Role; Rural; Scholarship; Scientist; Seizures; Severe Acute Respiratory Syndrome; Stroke; Structure; Thrombosis; Work; Zambia; antipyretic; antiretroviral therapy; clinical investigation; co-infection; epidemiology study; imaging study; nervous system disorder; neuroAIDS; neuroimaging; neuroinflammation; novel; premature; programs; psychiatric symptom; study population

The burden of neurological disorders disproportionately impacts resource-limited tropical settings resulting in grossly insufficient capacity for care provision or research. This global research program aims to advance our understanding of common neurological disorders in the African context to inform the local prevention and treatment of these conditions while also elucidating pathophysiological processes more broadly relevant. This will be accomplished through the continuation of Dr. Birbeck's neuro-HIV and cerebral malaria investigations plus support and mentorship for young clinician scientists engaged in a broad range of research endeavors. Research activities include-- • Cerebral malaria: In a prospective cohort study of children with CNS malaria, we will examine the role of neuroinflammation in structural injury and neurologic morbidity with laboratory assessments of acute inflammation, serial neuroimaging, and long term neurological outcomes. The novel study population will include children in a randomized controlled trial (RCT) of aggressive antipyretics as well as a more representative non-RCT population. The effects of co-infection with SARS-CoV-2 on parasite clearance, inflammatory factors associated with malarial death and neurologic sequelae and structural injuries including ischemia, bleeding, and thromboses will be ascertained. • Neuro-HIV: Given the widespread availability of HIV therapies, the next challenge in neuro-HIV care in Africa includes noncommunicable disorders associated with chronic low grade inflammation. Utilizing our network of rural and urban HIV clinics, we will study HIV-associated accelerated aging of the nervous system. Given its highly inflammatory state, SARS-CoV-2 could potentially contribute to this burden. Among children, we have recently reported high rates of subclinical cerebrovascular disease (CVD) despite long-standing, effectively treated HIV. We will pursue further imaging studies including in HIV uninfected but exposed children and community controls to identify risk factors for CVD, examine the metabolic impact of antiretroviral therapies and assess the relationship between premature CVD and infection with SARS-Co-V2. Among adults with HIV, SARS-Co-V2 infection will be evaluated for its possible role in accelerated aging in a 5-year prospective cohort study monitoring for cognitive impairment, psychiatric symptoms, strokes, neuropathies and seizures. This research will be undertaken in Zambia and Malawi where Dr. Birbeck has worked for over 25 years. This research program award will also provide infrastructure, mentorship and a vibrant environment for scholarship and trainee engagement with both US and African academics.

神经系统疾病的负担不成比例地影响资源有限的热带地区，导致 提供护理或研究的能力严重不足。这项全球研究计划旨在推进我们的发展。 了解非洲常见的神经系统疾病，为当地的预防和治疗提供信息 治疗这些病症的同时还阐明了更广泛相关的病理生理过程。 将通过继续伯贝克博士的神经艾滋病毒和脑疟疾研究来完成 加上对从事广泛研究工作的年轻临床科学家的支持和指导。 研究活动包括—— • 脑型疟疾：在一项针对中枢神经系统疟疾儿童的前瞻性队列研究中，我们将研究脑型疟疾的作用 通过实验室评估急性结构损伤和神经系统发病率中的神经炎症 炎症、系列神经影像学和长期神经学结果。 将包括儿童参加一项积极退烧药的随机对照试验（RCT）以及更多 代表性非 RCT 人群同时感染 SARS-CoV-2 对寄生虫的影响。 清除率、与疟疾死亡相关的炎症因子以及神经系统后遗症和结构 将确定包括缺血、出血和血栓在内的损伤。 • 神经艾滋病毒：鉴于艾滋病毒疗法的广泛应用，神经艾滋病毒护理的下一个挑战 非洲包括与慢性低度炎症相关的非传染性疾病。 我们的农村和城市艾滋病毒诊所网络，我们将研究与艾滋病毒相关的加速老龄化 鉴于其高度炎症状态，SARS-CoV-2 可能会导致这种情况。 在儿童中，我们最近报告亚临床脑血管疾病的发病率很高。 (CVD) 尽管长期有效治疗艾滋病毒，我们仍将进行进一步的影像学研究，包括 未感染艾滋病毒但暴露的儿童和社区控制，以确定 CVD 的危险因素，检查 抗逆转录病毒治疗的代谢影响并评估过早 CVD 之间的关系 SARS-Co-V2 感染成人中，将评估 SARS-Co-V2 感染的情况。 一项为期 5 年的前瞻性队列研究监测认知功能在加速衰老中的可能作用 损伤、精神症状、中风、神经病和癫痫发作。 这项研究将在赞比亚和马拉维进行，Birbeck 博士已在这两个国家工作了超过 25 年。 研究项目奖还将提供基础设施、指导和充满活力的奖学金环境 以及学员与美国和非洲学者的接触。