Tuesday, July 5, 2011

Days 22 & 23 - Building Strong Collaborations

Day 22

More EU Coordinated Research

This morning I met with Petra Pütz of the International Office of the BMBF, which coordinates major research projects among the EU. Even though they have put out a call for proposals on neurodegenerative diseases, they were unaware of CTE. However they did have many great recommendations for how I can get more people working on this and individuals to reach out to while I am here.

German Olympics

In the afternoon I took a train to Frankfurt to meet with Dr. Michael Vesper, Director General of the Germany Olympic Sports Confederation (DOSB), along with Olav Spahl, who is in charge of sports medicine. This was another meeting set up by former fellow Miriam Merckel – she really has pull in this country. The German Olympic Sports Confederation is a real leader in sports medicine, and Olav told me they provide annual training to over one thousand physios and take the lead with doctors in sports medicine as well. Olav said DOSB has yet to make an effort with concussions – their latest educational campaign was focused on sudden cardiac death, and they had dramatic improvements in athletes using free annual screenings. He was very enthusiastic that he could pull off a similar campaign on sports concussion, and was knowledgeable on this issue, and even asked „What would you do?“

He made an interesting point that is worth noting – he said the International Olympic Committee was one of the sponsors and co-signers of the Zurich Consensus Statement of 2008 that upgraded concussion guidelines and recommendations. That statement included the approval and promotion of the SCAT II, a Sideline Concussion Assessment Test, as a free and standard resource for assessment of concussion.

While it is widely used in the US, Olav told me it isn't used much in Germany... primarily because it hasn’t been translated into German!!! I guess the devil is always in the details.

Olav was kind enough to drive me to the train station, and his girlfriend is working at MIT, so I look forward to taking him to Dr. McKee’s VA CSTE Brain Bank in September during his next visit. Making the train with minutes to spare, I headed to Munich, home of Oktoberfest.

Day 23

Collaboration with the University of Munich

This is a big day. Before I left for the Fellowship, I was summoned to a meeting with Dr. Marty Shenton of Harvard Medical School. Dr. Shenton is our collaborator and a world renowned neuroimaging expert, and we conducted a pilot study with her to work toward developing diagnostic criteria for CTE. Her lab is like the Epcot Center, with post-doctorate imaging experts from around the world taking two year fellowships there to learn the latest techniques and bring them back to their home countries. One of those fellows is Dr. Inga Koerte of the University of Munich. Dr. Koerte and her team have taken an interest in TBI and CTE, and have started imaging soccer players. The meeting was held to inform me of this new collaboration, and to invite me to the University of Munich on my fellowship.

Fast forwarding to real time, this afternoon I was set up to meet with Dr. Koerte and the Dean of the medical school Prof. Dr. Reiser to discuss the collaboration. It turns out that the University of Munich also has one of the top neuropathologists and top brain bankers in the world, Prof. Dr. Hans Kretzschmar. At the last minute I was able to secure a meeting with Dr. Kretzschmar prior to meeting with Dr. Koerte, and traveled to the Munich suburbs to his lab. Dr. Kretzschmar has an impressive publication list, including many on TDP-43, one of our areas of interest, and also serves as coordinator of all German Brain Banks and BRAINNET II, a collaboration of brain banks across Europe, so he’s kind of a big deal.

One of my goals of this trip is to get other top researchers from around the world working on CTE. Dr. Kretzschmar seemed like the right person for the job, so when he welcomed me in I gave him my pitch. He asked challenging questions, but luckily my work with our team had me well prepared, and after he reviewed Dr. McKee’s images of CTE brains (her images are the best in the world), I think he was hooked. I feel strongly that we’ll be able to launch something there.

I then headed across campus to meet with the dean, Dr. Koerte, and her boss Professor Dr. Birgit Ertl-Wagner. This was a bit of a make it or break it moment. Dr. Koerte said the dean was interested in the subject by not necessarily sold that it was the right direction for his top imaging team. And the dean is a radiologist as well, so this is his area of expertise. Long story short, we nailed it and the dean said he’d like to join us for dinner, which I was told rarely happens.

Next I met with the full imaging team, including grad students, who were the German doppelgangers for our grad students at BU. I had to do a double take. Many of them were doing their dissertations on various aspects of intracranial pressure, including trauma. They showed me some of their pilot studies which included pictures and videos of blood flow and pressure around the brain, and even cerebrospinal fluid. I was blown away. They are conducting studies operating on the theory that with various diseases or traumas, blood flow may change. One theory was that the tissue of a concussed person actually permanently hardens with scar tissue, changing blood flow patterns. I’m excited for them to do more work in this area.

To end the evening we met up at the Augustine Beer Garden, which is simply the greatest invention in the world. It’s a giant park with dozens of tables covered by trees where you drink beer from giant mugs and eat various meats. As a joke I told them I wanted them all to dress in traditional Bavarian garb so I could have the authentic experience. When I arrived, half of them did it! Men in Leiderhosen, the women in the frilly dresses. Apparently people keep the outfits in the trunk of their car just in case a party breaks out. As I looked around, about ten percent of the place was just hanging out in their Bavarian uniforms. It was great.

The dean and the entire team came, including 3 of Dr. Ertly-Wagner's little girls. The oldest, in first grade, enjoyed practicing her English with me, but she had only gotten as far as, “My...name… ees…Sophie.” Too cute. The younger ones knew the international language of high fives and fist pounds, so we were good. I taught them pinkie swears and thumb wars.

The whole group was amazing hosts and I look forward to collaborating with them in the future.

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