University of Rochester Medical Center (URMC) neurologist Gretchen Birbeck, M.D., M.P.H., has received a $4.3 million award from the National Institutes of Neurological Disorders and Stroke (NINDS) to continue her research in sub-Saharan Africa on the neurological problems that arise in people recovering from malaria, HIV, and other infectious diseases, including COVID.
The NINDS Research Program Award, which uses the R35 funding mechanism, is given to investigators whose record of research achievement demonstrates an ability to make major contributions to the field of neuroscience. The eight-year award is intended to provide recipients the freedom to embark on ambitious, creative, and longer-term research projects, without the constraints of specific aims.
Birbeck has spent the last 25 years working in Zambia and Malawi in collaboration with local government ministries, medical schools, hospitals, and other U.S.-affiliated neuroscientists to identify the mechanisms of common neurological disorders and improve care through evidence-based interventions and clinical trials. Her research has focused on evaluating outcomes of cerebral malaria and other brain infections in children, and the neurological symptoms that arise from chronic HIV infection and treatments. These diseases – which are prevalent in sub-Saharan Africa – have broad effects on cognitive, behavioral, quality-of-life, and economic outcomes.
Birbeck will initially focus on two research projects:
- Nearly one-third of cerebral malaria survivors develop epilepsy or other neurological conditions soon after recovery. Previous research by Birbeck has demonstrated that improved seizure control and management of aggressive fever caused by malaria could provide the key to decreasing the risk of brain injury and developing epilepsy. Birbeck and her team 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. Researchers will also investigate the effects of co-infection with COVID on children who have recovered from malaria.
- Given the widespread availability of HIV therapies, the next challenge in neuro-HIV care in Africa includes disorders associated with chronic low grade inflammation brought about by the virus and the toxicity of long-term use treatments such antiretroviral drugs. Specifically, studies have shown high rates of cerebrovascular disease in children with HIV, despite long-standing effective treatment of the virus. Utilizing a network of rural and urban HIV clinics, the team will study HIV-associated accelerated aging of the nervous system. Given its highly inflammatory state, the researchers will examine whether COVID could potentially contribute to this burden in children. The team will also see if COVID infection in adults with HIV contributes to cognitive impairment, psychiatric symptoms, strokes, neuropathies, and/or seizures.
The projects involve researchers, clinicians, and students and trainees from URMC, the University of Zambia’s University Teaching Hospitals, Queen Elizabeth Central Hospital in Malawi, the University of Malawi College of Medicine, the Centre for Infectious Disease Research in Zambia, and a consortium of rural hospitals in Zambia led by Chikankata Hospital. The research program award will also help provide the infrastructure, mentorship and an environment for scholarship and training for both U.S. and African academics.