October 28, 2016—(BRONX, NY) — The National Institutes of Health (NIH) offers career development grants to young researchers—usually senior postdoctoral fellows or early-career faculty members. These grants, known as K awards, enable recipients to conduct independent research and eventually compete for major grant support. Ten Einstein researchers have recently received K awards in federal fiscal year 2016.
Three Einstein researchers have received K grants for research aimed at improving mobility and cognition in older people. Gait abnormalities can be diagnosed in more than one-third of older adults who do not reside in supportive housing, and they increase the risk for falls and for hospitalization and death. Cognitive decline also increases falling risk.
Pierfilippo De Sanctis, Ph.D.Reducing Falls in the Elderly—The NIH has awarded Pierfilippo De Sanctis, Ph.D., $646,149 over five years to determine how the central nervous system contributes to age-related declines in mobility. Insights into age-related impairments in both gait and cognition can lead to better strategies for reducing the risk of falls and improving mobility. Dr. De Sanctis will use a novel EEG-based technique called Mobile Brain-Body Imaging (MOBI) during active walking on a treadmill to examine the link between gait, cognition and falls in aging. The system uses 3-D infrared camera technology to monitor gait, posture, stride length and foot-falls, while simultaneously recording high-density electrophysiology. Dr. De Sanctis is research assistant professor of pediatrics and in the Saul R. Korey Department of Neurology.
Helena Blumen, Ph.D.Improving Gait and Cognition with Motor Imagery—Envisioning motor actions without physically doing them has proved an effective rehabilitative tool in studies involving Parkinson’s disease patients and stroke survivors. The NIH has awarded Helena Blumen, Ph.D., $522,180 over four years to study the effectiveness of an “imagined gait” protocol (visualizing walking as well as walking while talking) for helping relatively healthy older adults improve their gait and cognition. Dr. Blumen predicts that imagined gait will help these individuals because it engages and strengthens neural systems that are similar to those used during actual walking and cognition. The research is the first to test the use of motor imagery to improve gait and cognition in older adults, and the results will help in designing full-scale randomized controlled trials. Dr. Blumen is assistant professor of medicine and in the Saul R. Korey Department of Neurology.
Jeannette Mahoney, Ph.D.Integrating Sensory Inputs in Older Adults—Multisensory integration (MSI) pertains to the nervous system’s ability to process concurrent information generated by the senses. Intact MSI is vital for normal functioning in everyday life. But researchers don’t fully understand how MSI relates to cognitive and motor function. The NIH has awarded Jeannette Mahoney, Ph.D., a five-year, $652,725 grant to study how older adults integrate visual and somatosensory information, looking particularly at how this integration influences balance and other motor outcomes. Her findings could lead to interventions that prevent loss of mobility, falls and disability in older people. Dr. Mahoney is assistant professor in the Saul R. Korey Department of Neurology.
Two of the grants focus on other elements of aging.
Britta Will, Ph.D.Stem Cells in Aging—Adult stem cells help repair tissues throughout life but also contribute to aging and aging-related disorders. Little is known about how stem cell function is established, maintained and, ultimately, compromised. The NIH has awarded Britta Will, Ph.D., a five-year, $622,500 grant to study the molecular mechanisms that regulate the renewal and differentiation of hematopoietic stem cells, which give rise to all other blood cells. By revealing potentially reversible processes that underlie stem cell aging, this research could yield treatments for hematopoietic stem cell disorders such as cytopenia and leukemia that affect the elderly. Dr. Will is assistant professor of medicine and of cell biology.
Sofiya Milman, M.D.Genetics and Healthy Aging—Sofiya Milman, M.D., studies centenarians and family members who are generally free of age-related diseases. She hypothesizes that unique genetic variants protect against age-related diseases and lead to long lives. The NIH has awarded Dr. Milman $691,200 over four years to study the role that growth hormone/insulin-like growth factor-1 (GH/IGF-1) plays in longevity. She will expand on evidence suggesting that gene variants code for proteins that improve health and extend survival by weakening GH/IGF-1 signaling. Her research may lead to drugs that mimic the effects of life-extending proteins. Dr. Milman is assistant professor of medicine at Einstein and attending physician, endocrinology, Montefiore.
Two of the K grants pertain to migraine—a common, painful and disabling headache that mainly affects women.
Jelena Pavlovic, M.D., Ph.D.Hormonal Fluctuations and Migraine—Migraine has long been linked to sex hormones, whose levels change significantly over the course of women’s reproductive lifespans. Lack of information regarding well-characterized menstrual cycles and the hormonal changes that accompany menopause in women with migraine has hindered efforts to study how changes in sex hormones (either separately or together) affect migraine occurrence. The NIH has awarded Jelena M. Pavlovic, M.D., Ph.D., a five-year, $918,176 grant to study how hormone fluctuations affect migraine symptoms during the menstrual cycle and across the transition to menopause. Dr. Pavlovic will use data from the Study of Women’s Health Across the Nation (SWAN), which has followed more than 3,000 women for 20 years as they transitioned from pre- or early perimenopause to post-menopause. For a subset of more than 800 of the women, SWAN has mapped daily hormone levels and daily headache symptom data for one menstrual cycle each year for up to 10 years. Ideally, this data will reveal how daily hormonal fluctuations affect migraine occurrence over the course of the menstrual cycle and over the menopausal transition. Dr. Pavlovic’s findings may lead to more effective and appropriately timed hormonal treatment for women who suffer from migraines. She is assistant professor in the Saul R. Korey Department of Neurology at Einstein and attending physician, neurology, Montefiore.
Elizabeth Seng, Ph.D.Adhering to Migraine Treatment—Effective treatment can handle migraines, but patients generally do a poor job of adhering to migraine management strategies. Part of the problem is that people with migraine must conduct preventive management (to reduce migraine frequency) as well as acute management (to reduce the symptoms of a migraine attack). The NIH has awarded Elizabeth Seng, Ph.D., $965,385 over five years to examine psychological factors that affect how well migraine patients comply with treatment strategies. She will identify those people who have the most difficulty sticking with those strategies and determine when it’s hardest for them to do so. This project will also develop a mobile “headache diary app” that takes symptom and migraine-management strategy information from patients and sends them notifications (e.g., how many medications they’ve taken over the past week) to aid their in-the-moment treatment decisions. Dr. Seng is research assistant professor in the Saul R. Korey Department of Neurology.
Three of the K grants involve infectious disease research.
Qibin Qi, Ph.D.HIV and Cardiovascular Disease—Now that antiretroviral therapies are enabling people infected with HIV to achieve normal life spans, cardiovascular disease (CVD) has become a major cause of illness and death for this population. The NIH has awarded Qibin Qi, Ph.D., a four-year, $637,387 grant to identify biomarkers that may help in predicting and preventing CVD in people with HIV. He will examine plasma levels of metabolites among 495 men and women (338 of whom are HIV-positive) who do not have carotid artery plaque at the start of the study. He will look for associations between genes, metabolites, HIV infection and development of carotid artery plaque. This research may lead to personalized antiretroviral therapies and other interventions aimed at preventing CVD among people infected with HIV. Dr. Qi is assistant professor of epidemiology & population health.
Uriel Felsen, M.D.HIV Testing in the Emergency Department—Testing for HIV is crucial for preventing and treating HIV infection. Hospital emergency departments (EDs) can play key roles in identifying people who don’t know they are HIV-positive. The NIH has awarded Uriel Felsen, M.D., a five-year, $920,029 grant to study ways to improve the outcomes associated with expanded HIV testing strategies in EDs. He will (1) identify what helps and what hinders efforts to implement expanded HIV testing in the ED; (2) use those findings to improve an existing ED-based HIV testing strategy; (3) test the outcomes achieved by using this new strategy; and (4) develop a generalizable plan for developing and evaluating an ED-based HIV testing strategy. Ultimately, this intervention may identify more people with previously undiagnosed HIV—an outcome that can save lives and help prevent new infections. Dr. Felsen is assistant professor of medicine at Einstein and attending physician, infectious diseases, Montefiore.
Brianna Norton, D.O., M.P.H.Treating Hepatitis C—The overwhelming majority of Americans infected by hepatitis C (HCV) are people who inject drugs. Recently developed HCV medications are highly effective and could potentially end the HCV epidemic, but few people who inject drugs ever initiate such life-saving treatments. These individuals urgently need innovative strategies to connect them with HCV care and treatment—ideally in the primary-care settings they already use. The NIH has awarded Brianna Norton, D.O., M.P.H., a five-year, $922,215 grant to test a primary-care-based HCV Group Evaluation and Treatment UPtake (HCV GET-UP) intervention. During group clinical visits, patients will receive HCV specific medical evaluations, education about HCV through peer and provider support, and help in developing self-management skills. If effective, this innovative care intervention could reduce deaths from HCV and also reduce person-to-person HCV transmission. Dr. Norton is assistant professor of medicine at Einstein and attending physician, infectious diseases, Montefiore and director of Montefiore’s Comprehensive Health Care Center.