PRESIDENT'S COLUMN

Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.

April 2022

For the Love of Science

While COVID struck all of us professionally in indelible ways, arguably those who are scientists have endured some of the most devastating career setbacks of all. Among the American Academy of Neurology’s 641 researcher members, there were those whose trials were terminated due to inability to maintain cell lines or care for animal subjects, deployment to clinical duties, or restricted use of research facilities. The pandemic also dissuaded clinical trial enrollment or discouraged existing enrollees’ continued participation. Personnel losses from faculty furloughs, departures of clinical research coordinators, and other key laboratory employees stressed an already precarious infrastructure. The pressures were so great, in some cases, that a wave of researchers left academics entirely to go to industry or private practice. Along with the Great Resignation came unprecedented supply chain shortages which further crippled research at the cost of additional expense and time.

But throughout it all, many persevered, and despite the obstacles, some have succeeded in bringing their exciting—and all-the-more precious—science to our Annual Meeting in Seattle this month. Here are the stories of three scientists who prevailed.

The closure of several research facilities in the Philippines during lockdowns and establishment of social distancing limited face-to-face interactions of researchers, a challenge Adrian Espiritu, MD, MSc (cand.), currently a multiple sclerosis fellow at the University of Toronto, and his colleagues were ultimately able to address by video-teleconferencing. The pandemic also added to a financial burden on research project expenses, on top of the preexisting problem of inadequate research funding in the Philippines, which they were able to overcome thanks to generous research grants from the Philippine Neurological Association and the Philippine General Hospital. Furthermore, the pandemic imposed intrinsic changes to institutional logistic procedures, research processes including protocol development, ethical review applications, participant recruitment, data collection and analysis, and manuscript writing, all of which took considerably longer to accomplish than usual. Personally, Dr. Espiritu had to shuffle several important tasks such as preparing for the specialty board examinations and completing coursework for his master’s degree, all while juggling clinical responsibilities.

Despite those obstacles, Dr. Espiritu conducted a nationwide, multicenter, respective cohort study with his colleagues that incorporated people who had COVID-19 admitted to 37 hospitals across several regions of the Philippines. The study found that new-onset neurologic symptoms independently increased the risk of mortality, respiratory failure, and ICU admissions among COVID-19 patients. His work is being recognized in Seattle with the bestowal of the esteemed Bruce S. Schoenberg International Award in Neuroepidemiology. The pandemic made existing disparities in resources needed to accomplish research wider and more apparent, especially in developing countries like the Philippines, said Dr. Espiritu, who plans to continue his work by setting up an MS clinic and research center when he returns to the Philippines.

Another of those scientists is Shibani Mukerji, MD, PhD, assistant professor of neurology at Harvard, who will be exhibiting her abstract demonstrating the correlation of blood-brain disruption with proinflammatory cytokines and chemokines in patients with COVID-19. Although her MGH lab had existing institutional review board protocols and deep relationships with the microbiology and infectious diseases department members which helped buffer her work initially, she suffered from isolation and struggled to return her lab’s work to HIV, her research focus, in 2021. Further compounding her dilemma was the lack of childcare for her elementary school-aged daughter during the pandemic. This compounded her exhaustion as it meant she often needed to work weekends, late nights, and early mornings to stay afloat. Lack of face-to-face communication with colleagues was particularly difficult as she wrote her first R01 grant and tried to set up an independent lab. She partly attributes her ultimate success to a professional coach—hired from funds set aside by her institution for well-being—who helped her craft her career agenda, develop action plans, and improve her efficiency.

The pandemic also presented multiple logistical challenges to UCSF pediatric neurologist and researcher Alex Fay, MD, PhD, when families of patients were unable or unwilling to risk travel with their children. Dr. Fay—who divides his time between caring for people with neuromuscular disorders and cerebral palsy, performing clinical trials, and laboratory collaborations focused on neurogenetics and preclinical development of therapeutics—had brought children to UCSF from four continents before the pandemic to take part in a trial of a novel therapeutic, RT001, in treating infantile neuroaxonal dystrophy (a devastating degenerative disorder that results in psychomotor regression and death, usually by age 10). By deploying telehealth, training local physicians to perform clinical assessments, and reviewing those visits live or recorded, the study was able to be completed and the abstract was accepted by the AAN to be exhibited at the Annual Meeting.

Dr. Mukerji, reflecting on the impact of COVID-19 on young researchers like herself, said, “Professionally, I anticipate the full brunt of the burdens faced by myself, my colleagues, and other junior faculty as part of the pandemic will only be understood in hindsight. I hope that as the field of neurology tries to return to a semblance of normalcy, it will recognize career choices made or not made by junior faculty.”

This year’s Presidential Lecture, "Post-COVID Challenges to Scientific Research,” held on Sunday, April 3, will delve more deeply into the threat to scientific research created by the COVID-19 pandemic. Nina F. Schor, MD, PhD, FAAN; Merit E. Cudkowicz, MD, MSC; and Brenda Banwell, MD, FAAN, will present the challenges and offer potential solutions to address them.

I am both thankful and delighted that so much new and thought-provoking neuroscience will be shared—in person, at last!—in Seattle. Below, I am pleased to share some comments from our neuroscience members about what they are looking forward to.

Orly Avitzur, MD, MBA, FAAN
President, AAN
oavitzur@aan.com
@OrlyA on Twitter

“The Great Neuro Reunion is the finest forum for sharing the endeavor of systematic observations and experiments. It highlights the brilliant minds of our most treasured neurologists and neuroscientists.”
—Marcelo Matiello, MD

“It shouldn't matter to see each other in person―scientists are used to communicating asynchronously, even over years, with each other’s data and writing. Terry Cascino and Ralph Sacco and Jim Stevens taught me, however, that there is nothing more rewarding as a product of research than a warm smile, the alert look of delight in a colleague’s eyes when you tell them something surprising, and even the lively tone of challenge and debate that neurologists are so much teased for by other specialties. I’m looking forward to enjoying all of these right brain benefits when I go to Seattle―because, after all, the right brain is the dominant hemisphere for this scientist.”
—A.M. Barrett, MD, FAAN

“It is invigorating to know that soon the large neuroscience family will reconnect again at the 2022 AAN Annual Meeting in Seattle. With the pandemic, the quote from Dickens ‘The pain of parting is nothing to the joy of meeting again’ certainly took a different dimension.”
—Fernando Testai, MD, PhD, FAAN

“It means a hoped-for return to normalcy, with a free and open exchange of ideas with people in the same room at the same time.”
—John Corboy, MD, FAAN