Segunda, 22 de Janeiro de 2018
Idioma: Português / English
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Brain Institute ("InsCer")

Institutes


Bridging the "bench" to the "bedside" through development and application of innovative technologies for prognosis and treatment of neurological diseases.

Promoting better teaching, better understanding of disorders and, ultimately, better care of neurological patients



A trans-disciplinary approach to...:

 

The InsCer and the model of a Trans-disciplinary Approach to Knowledge

"Multi-disciplinarity" is an over-used term. Any activity involving more than one area of knowledge can be considered as multi-disciplinary, but that does not necessarily mean a real partnership in the approach to knowledge. Clearly, a large number of areas must come into play to generate new medical knowledge. More specifically, a lot has been advanced in modern Medicine through developments in imaging which, in turn, depended upon an interaction of biology, physics, pharmacology, chemistry and informatics. Furthermore, good patient care is dependent not only upon medical knowledge, but also on correct and timely information about medical advances and the hope these generate.

Along these lines, the InsCer will solidly establish a trans-disciplinary approach to knowledge, bridging the enormous needs of clinical and basic neuroscience with the problem-solving abilities provided by radio-chemistry, pharmacology, physics and informatics on the one hand, and with human sciences like journalism, philosophy, psychology and linguistics on the other. It is hoped that trans-disciplinary research, based on these interactions, will lead to fruitful advances in all these areas and eventually help people. Furthermore, this trans-disciplinary perspective is bound to be highly beneficial to the education of students from a large array of areas of knowledge. It is certainly hard to conceive any approach that would suit best the approximation of InsCer to a major university as PUCRS.

 

Patient care

InsCer will develop a stepwise approach to patient care, which will be organized in 3 progressive and incremental steps.

In phase I, high resolution imaging will be offered to help with diagnosis and treatment plan of patients with medical problems in general, with an emphasis on neurological, behavioral and oncological problems. Clinical neuroimaging will benefit from the combination of state of the art equipment, highly trained neuroimagers and online collaboration with centers of excellence in neuroimaging around the world. An innovative approach will be to organize reports of neuroimaging exams in patients presenting more complex clinical scenarios after in-house discussion between neuroimagers and clinical neurologists specialized in the different types of neurological diseases. In fact, this would constitute a post-processing imaging team, responsible to make the best out of the acquired images and streamline diagnosis and treatment plan. This will lead to more clinically-guided reports which may help better the referring physicians.

Phase II will add the capabilities of diagnosis and treatment counseling at-a-distance. The information technology branch of the InsCer will work in close collaboration with neuroimagers and neurologists to provide the means for a program of TeleNeurology. This will allow consultations between referring doctors in the community and specialists of the InsCer to discuss any facet of a clinical situation, from a second opinion on imaging exams to a broad discussion of complex clinical scenarios.

Finally, phase III will incorporate patient care in the Institute, through the organization of specific outpatient clinics targeted at sensitive neurological problems. These will be linked with capabilities to build a database where each patient will both be benefited by the clinical approach of the InsCer specialists, whereas at the same time will contribute data to foster development in knowledge through research. Furthermore, patients will benefit from a number of ongoing studies related to neurological diseases and will have the opportunity to engage in specific clinical research protocols that may bring further relief to their problems.

 

Research: A two-way path

A cornerstone of the InsCer will be to combine patient care and research, in a way that new knowledge will help patients and, on the other hand, patients will contribute to the generation of new knowledge. The trans-disciplinary approach will bring together researchers from several disciplines and this is going to be an asset, complemented by the high level of technology involved. Thus, this blend of trained and dedicated personnel with up to date technology will be the hallmark of the research produced at InsCer.

Such crafted research will span a number of fields and shall both consolidate areas of excellence at PUCRS whereas, at the same time, may become a major drive to the development of new research groups. In particular, interactive partnerships will be established with productive groups such as the Memory Center, the Epilepsy Program, the Cellular Signaling and Cell Therapy Laboratories, as well as with clinical research groups of excellence in neurodevelopmental and cognitive sciences. The logistics and capabilities for the development of basic neuroscience will be almost unparalleled, with the incorporation of the laboratories for cellular signaling, epilepsy and cell therapy in the same environment where micro-PET capabilities will be available. Furthermore, the latter will also provide the means for basic pharmacological research, a necessary step to the development of new pharmaceutical agents.

Certainly, the availability of a cyclotron will allow the development of new radio-ligands, to target specific clinical questions, in partnership with groups at Pharmacy / Radiopharmaceutical unit and Chemistry / Organic synthesis. In a sense, this is a very good example of translational research, in which clinical questions are posed through patient care and attempts to answer such questions engage basic scientists in developing new ways to address the problem. It is more than likely those solid developments in areas such as the biology of aging, early detection and prevention of Alzheimer's disease pathology, epilepsy, autism and genetic brain disorders - to mention just a few - will benefit from the developments of new radio-ligands to probe specific aspects of their pathogenesis.

In addition, InsCer will be a catalyst of a great deal of clinical research in which imaging features prominently. These studies will involve both clinical trials and projects addressing specific clinical questions in epilepsy, cognitive and movement disorders, vascular and neuro-immunologic diseases, both in children and in adults. The capabilities of the Institute will allow the establishment of national and international partnerships for this research, boosting the development of knowledge and specialized personnel.

Finally, the mission of becoming a major research center with a view to improve patient care will necessarily foster the collaboration between InsCer and the community. As detailed below, the Institute will attempt to turn medical research into something incorporated and followed by the general public. In other words, the distance between "Academia" and "Public" will diminish as InsCer provides continuous update to the community in regard to the advances being made by research at the Institute.

 

Teaching

As indicated below, the InsCer will operate through a trans-disciplinary approach to knowledge. This will offer unique educational opportunities in all the 'disciplines' involved. Undergraduate students from Medicine, Biology, Chemistry, Pharmacy, Physics, as well as computer and human sciences will profit from the many 'facets' of InsCer. Particularly, neuroscience teaching, clinical and basic, will be greatly refined. Research projects will approximate the Institute to many Graduate Courses at PUCRS, opening new lines of investigation. Furthermore, an Office for Continuing Education, in connection with the University, will allow practitioners to update knowledge in the many disciplines involved for.

 

Interaction with the Community: a pro-active approach of the "home of neuroscience"

InsCer will have a bold approach toward the community. The constant flow of information regarding potential treatments for neurological diseases demands a novel approach between specialists and the public. The time is long gone for the traditional scenario in which patients need to struggle to get objective views regarding what comes up in the media, particularly in connection with the hope and applicability of new treatments. Thus, InsCer hopes to inaugurate a trans-disciplinary collaboration with specialized journalists from PUCRS to monitor whatever appears in the media regarding neurological diseases and, pro-actively, feed-back society on the relevance and applicability of the announced advances.

Furthermore, InsCer will work to build a reputation as the 'Home of Neuroscience' in the south of Brazil. The Institute will be open to the community, which will be invited for a number of educational activities regarding functioning of the brain and neurological diseases. More specifically, we are planning regular public sessions in which lay persons will come and openly discuss with specialists their doubts and concerns regarding the way the brain functions and how to prevent neurological diseases. We at InsCer believe that with the current widespread access to information and with the aging of the population, such direct interaction will be crucial for the well-being of the society. In these sessions, ideas for projects with societal relevance - raised by society - will be carefully considered.

 

Vision for the future

In the next decade, InsCer should become a major national and international center for clinical and applied neurological research, excellence in teaching and should develop the ability to translate research into better patient information and care.

 

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