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: 10397647
• 负责人: GRETCHEN L. BIRBECK
• 金额: $ 52.19万
• 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/10397647
• 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; SARS-CoV-2 infection; Scholarship; Scientist; Seizures; Stroke; 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.

神经系统疾病的伯恩（Burnen）不成比例地影响资源有限的热带环境，导致 严重不足的护理提供或研究能力。该全球研究计划旨在推动我们的 在非洲情况下了解常见神经系统疾病，以告知当地的预防和 处理这些条件，同时还阐明了更广泛相关的病理生理过程。这 将通过Birbeck博士的Neuro-HIV和脑疟疾调查来实现 再加上对年轻临床科学家的支持和心态，从事各种研究。 研究活动包括 - •脑疟疾：在对CNS疟疾儿童的前瞻性队列研究中，我们将检查该作用 急性评估的结构损伤和神经系统发病率的神经炎症 炎症，串行神经影像和长期神经系统结果。新的研究人群 将包括儿童参加侵略性抗热管的随机对照试验（RCT） 代表性的非RCT人群。与SARS-COV-2共同感染对寄生虫的影响 清除率，与疟疾死亡和神经系统后遗症有关的炎症因子和结构 将确定包括缺血，出血和血栓形成在内的伤害。 •Neuro-HIV：鉴于艾滋病毒疗法的宽度可用性，这是神经HIV护理中的下一个挑战 非洲包括与慢性低年级炎症有关的非通信疾病。利用 我们的农村和城市艾滋病毒诊所网络，我们将研究与HIV相关的加速衰老 神经系统。鉴于其高度炎症状态，SARS-COV-2有可能为此做出贡献 负担。在儿童中，我们最近报道了亚临床脑血管疾病的高率 （CVD）策略长期以来有效治疗的艾滋病毒。我们将进行进一步的成像研究，包括 未感染但暴露的儿童和社区控制以识别CVD的危险因素，检查 抗逆转录病毒疗法的代谢影响和评估过早CVD之间的关系 和SARS-CO-V2感染。在患有艾滋病毒的成年人中，将评估SARS-CO-V2感染 在认知的5年前瞻性队列研究监测中，可能作用在加速衰老中 障碍，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，伯贝克博士在那里工作了25年以上。 研究计划奖还将为科学提供基础设施，指导和充满活力的环境 以及与美国和非洲学者的培训者互动。