BICOEE Brain Imaging Center of Economic Excellence

Why Create a Brain Imaging Ceoter of Economic Excellence (BICOEE)?

One of the last remaining frontiers in science and medicine is to understand how the human brain works, both in health and disease. Central to this exploding area of science are new non-invasive tools for imaging the brain. The main area of rapid development in this area involves magnetic resonance imaging, or MRI. Given the great increase in the ability to research and investigate the living human brain, there is widespread expectation that intervention technologies to improve the function of the damaged or even the normal brain will become possible. The State of South Carolina is both an ideal testing ground and a needy recipient for many of these technologies. For example, in the context of technology to repair the damaged brain, South Carolina has the highest incidence of brain damage due to stroke of any state in the USA. Similarly, when we consider brain-related technologies for defense and law-enforcement, South Carolina is also optimally positioned. With the Department of Defense Polygraph Institute located in our state, we are ideally placed to foster technology related to the detection of deception.

Building on Our Present Strengths:
Both universities have considerable portions of the expertise that is necessary to compete at a national and international level. If we look to the concentrations of expertise, the overall levels of funded research and the consequent industry spin-offs in a city such as Boston, it is clear that neither USC nor MUSC can compete, nor could either institution realistically aspire to the level of critical mass needed to create such a center. However, working together and with modest help from the SC Lottery Endowment we can realistically aspire to this level of excellence in the area of neuroimaging.

MUSC:

Leaders back in 1994 saw the need for expertise in the area of brain imaging and recruited a core of researchers to MUSC. This group is particularly well-known for the advances they have made in combining functional brain imaging with non-invasive brain stimulation, largely using a technology called transcranial magnetic stimulation (TMS). This group has been a world leader in combining TMS with functional brain imaging, particularly functional magnetic resonance imaging (fMRI). When this group began their pioneering work, this technology was obscure, and most thought that the vision of stimulating with TMS inside an MRI scanner was impossible. The group has now succeeded in refining this technique, and continues to lead the world with several new advances yearly. In 2000, the MUSC Board of Trustees granted this group center status, and it is now known as the Center for Advanced Imaging Research (CAIR). The use of TMS as a neuroscience tool, and a potential treatment is now mainstream, with review articles featuring this group in Nature and Science within the past year.

In conjunction with the imaging group, MUSC also created a clinical translational Brain Stimulation Laboratory (BSL), housed within the department of psychiatry but with strong ties to the other clinical neuroscience groups on campus (neurology, neurosurgery, basic neuroscience). The BSL has been a world leader in developing the potential clinical applications of the stimulation technologies. They have pioneered studies of TMS and vagus nerve stimulation (VNS) in the treatment of depression. They are actively investigating deep brain stimulation (DBS) for the treatment of Parkinson's Disease. Finally, they are also investigating whether TMS can improve normal or sleep-deprived cognitive performance. Although the CAIR and the BSL are administratively separated, there is active exchange of ideas and collaborations. MUSC is unique in the world in having both of these groups on the same campus. This model allows for circuit-based ideas about how the brain works to flow directly from the scanner (CAIR) to the bedside (BSL), and back, in a fluid and fertile model.

In 1999, the group realized that it needed a better infrastructure to build on these advances. MUSC wisely invested in purchasing and creating a state of the art 3 Tesla MRI scanner. This facility is architecturally designed to enable simultaneous stimulation and imaging, and should allow this group to begin also looking at the pharmacological effects of stimulation, using advanced MR spectroscopy. Other major research universities, with promises of endowed chairs, heavily recruited the group. In order to counter the strong offers, the MUSC administration in 2000 promised an endowed chair to the group, which has not yet been realized.

Over the past few years these two groups have continued to forge new ground, with over 20 manuscripts, 6 patents or invention disclosures, and over 6 million dollars in research grants. The group is a magnet for talented scientists from around the world, as well as enabling some of South Carolina's best and brightest talent to remain in SC (e.g., Dr. Mark George (native Columbia), Dr. Donna Roberts (native Georgetown)).

However, MUSC has no graduate programs in cognitive neuroscience, computer science and informatics, or physics and engineering. This group has now 'outgrown' the MUSC environment and needs desperately to collaborate in order to gain access to personnel with training in these areas, in order to carry out the world-class research they have pioneered. This next phase of research, where they refine and apply some of the techniques they have pioneered, promises to bring in large industry and defense department dollars.

USC:

At USC there are world-class programs in cognitive neuroscience, computer science, and engineering and public health. A number of clusters of brain science researchers have risen to national visibility. In order to increase the caliber and amount of research in these clusters, the natural synergies within the different departments at USC need to be exploited. The opportunities for huge research growth in the area of neuroscience was recently underscored in the Report of the USC Strategic Directions and Initiatives Committee, a report endorsed by the entire administration as well as the Board of Directors. Major developments continue to occur in this area, with, for example, the recent recruitment of two world leaders in Behavioral Neuroscience - Professors Rosemary Booze and Charles Mactutus. These two researchers have brought enormous stature to the Neuroscience group at USC, as well as multimillion dollar grant funding. The research potential of this group is just beginning to be tapped, with, for example, a $10.5 million proposal submitted to the NCRR for a Center of Biomedical Research Excellence (COBRE) Award. The COBRE program is specifically designed to allow states such as South Carolina that are relatively under funded by federal agencies to receive a bootstrapping grant to rapidly propel them to prominence in a specific area. We are confident in all aspects of our proposal with the possible exception of our expertise in brain imaging. The creation of the BICOEE would all but assure us of success if we have to resubmit this proposal.

A large number of the neuroscience projects at USC are strong in every area except brain imaging - all groups need to extend their research into functional MRI. Once we can create the BICOEE, in addition to stimulating current research areas at USC, the catalytic effect of an area of common overlap - brain imaging - will lead to an explosion of collaborative ventures. This means that the creation of a BICOEE not only will lead to synergistic increases in research collaboration between USC and MUSC, but will also energize collaborations within USC. The imaging expertise at MUSC that the BICOEE would bring to bear would ensure that technical and conceptual excellence was maintained in all our imaging research. In essence, within the context of the BICOEE, USC would gain an imaging center complete with extensive expertise (from MUSC), short-circuiting the usual long learning time to acquire experience with these technologies, and the credibility, pilot data and track record that grant reviewers require before awarding large sums.

An example of the dire need for brain imaging infrastructure and expertise at USC is illustrated by the success of the cognitive neuroscience group in the area of recording brain activity using another technology - High Density Electroencephalogram - Evoked Response Potential (EEG-ERP). In 1998, the cognitive neuroscience group received funding from the National Science Foundation to equip a laboratory for High Density EEG-ERP research. This facility, headed by Dr. Richards, has rapidly become a well-funded and highly productive center for understanding the electrical activity of the brain in adults and children. This facility has faculty supported by the National Polygraph Institute at Fort Jackson, SC, and have performed studies on the brain's electrical responses. They do not have access to a group skilled in brain imaging. However, electrical systems such as HD-EEG/ERP are naturally complementary to brain scanning methods such as MRI because the strengths of one neatly complement the weaknesses of the other. Although the USC group are at the cutting edge of HD-EEG/ERP research, it is becoming very obvious that the future of this area lies in relating results from this technique to structure and function as elucidated by MRI. The creation of the BICOEE will turn the USC-MUSC cluster into a world leader in this area.