Our ultimate goal is to develop translational neuroscience research at all levels. One goal of the CTN is to effectively translate new knowledge, mechanisms, and techniques generated by advances in basic science research into new approaches for prevention, diagnosis, and treatment of disease. We have been very successful in this T1 aim. A second goal (T2) is to improve access, coordinate systems of care, and help clinicians and patients make more informed choices, providing point-of-care decision support tools, and strengthening the patient physician relationship. Both goals are aimed at improving the health of our citizens. We currently support laboratory research (molecular, cellular, organ), pre-clinical research, are beginning to study medical and behavioral outcomes, and have solid experience in community based research and outreach.
Human Electrophysiology Core
We needed to be able to measure the effects of illness, lesion, drugs, etc. on different levels of the neuraxis in humans. Therefore, we established the capacity for recording the midlatency auditory P50 evoked potential, whose amplitude is a measure of level of arousal and thus assesses brainstem-thalamus processes (5). The use of paired auditory stimuli allows us to measure habituation to repetitive stimulation, or sensory gating, a process disturbed in a number of diseases (5). We also developed the capacity to measure reaction time (RT) using a Psychomotor Vigilance Task (6) to derive the prototypical measure of attention and thalamocortical processes (7). We developed the capacity to measure frontal lobe blood flow using near infrared spectroscopy, which provides an economical indicator for the use of more expensive methods such as PET. We have a clinical EEG machine with electrode cap, along with MatLab software. We established a satellite facility for spinal reflex testing in spinal cord injury and other patient populations.
Animal Electrophysiology Core
This Core includes the rodent equivalent of the human P50 potential, the midlatency auditory P13 evoked potential (8), allowing parallel human and animal studies. A separate room contains an animal reflex testing set-up to allow parallel studies on humans and animal with spinal cord injury and other motor disorders. We set up multiple patch-clamp rigs with immersion and interface chambers, and a full surgical facility is also part of this Core. We have expanded our capabilities to include voltage-sensitive dye and calcium imaging at high speed and at high resolution.
Image Analysis Core
This Core has a confocal microscope and morphometric analysis software, along with multizoom, and fluorescence microscopy capability, and a fully equipped and staffed histology laboratory for histochemical and immunocytochemical labeling.
Transcranial Magnetic Stimulation (TMS) Core
This Core allows testing of TMS on a number of conditions. As the equipment aged, we upgraded the human facility and used the older equipment to develop our capacity to use TMS on animals in the Animal Electrophysiology Core.
Molecular Biology Core
This Core includes a RT-PCR and multi-gene assay capacity, along with a state-of-the-art metabolic cage system.
The Core is based in the Pharmacology department under Dr. Fantegrossi’s direction. It includes chambers for assessing, in rats and mice, locomotion, conditioned place preference, and prepulse inhibition. A new Noldus EthoVision system was added for video tracking and activity measures, while a CatWalk system was purchased for gait analysis and detailed locomotion analyses.
This Core includes real-time teleconferencing and diagnostic quality imaging equipment for 20 rural hospitals and a central Mediasite facility. Weekly telemedicine conferences on perinatology allow our community of health care personnel, including physicians, nurses and therapists, to participate live, to gain continuing medical education (CME) credit, and to help develop therapeutic and other guidelines. The program is called Pediatric Physician Learning and Collaborative (Peds PLACE) program. Consultations follow the educational conferences and help form collaborative relationships, provide better care for rural and underserved populations, and lead to more organized transfers and referrals. A second program links 9 existing Emergency Department sites with 6 new ones in a program called Emergency Department Physician Learning and Collaborative Education (EDs PLACE).
The objective of a recent supplement is to enhance the Telemedicine Core Facility of the CTN, and create a Regional Core Facility among IDeA states that will reduce mortality as it has already done in our state. The Telemedicine Core Facility of the CTN is a shared resource that provides access to training, consultation, services, instruments, and technology for translational community-based research. The CTN remains one of the few COBREs designed to increase the number of clinician scientists to become independent researchers, with a focus on human subject research. We will facilitate the optimization of our community-based Telemedicine Core Facility, which has already decreased infant mortality across the state, to collaborate with the CTR in Oklahoma (OK) that will bring about a decrease in mortality in this adjacent IDeA state.
We propose, a) to develop training courses to optimize the implementation of our Peds PLACE and D-TRACE programs to decrease mortality from sub-optimal neonatal and emergency services with special emphasis on the health care delivery community, b) enhance communication and collaboration across regional IDeA states, initially, OK, but easily expandable to other regions and then nationally, c) provide the National IDeA Core Laboratory (NICL) with decreased mortality data to help implement the Core Facility across all IDeA states, and d) to help create, expand, and sustain this critical resource across IDeA states. The CTN Telemedicine Core Facility has decreased mortality in the state from 8.5/1,000 to 6.8/1,000 births, representing ~60 babies per year who will live instead of die. Every year from now on. We began in 2006, and significantly decreased mortality by 2010, and levels continue to decline.
We have also identified a program likely to decrease mortality from suboptimal emergency health coverage for underprivileged areas of the state. Non-trained public safety answering point (PSAP) operators do not provide enough medical priority dispatch system (MPDS) determinants on medical calls and risk delayed emergency service response time, jeopardizing patient safety. High mortality rates due to stroke, myocardial infarction, and trauma will be reduced statewide by adequately training rural dispatchers. Using a novel, phone app-based training program, PSAP personnel in underserved rural areas will provide better determinants, improve health care coverage, and decrease mortality.