Researchers receive $5 million to expand study of posttraumatic neurologic, mental health disorders

Led by Samuel McLean, MD, UNC School of Medicine researchers and collaborators received $5 million from the NIH and Department of Defense to expanding the AURORA Study, the most comprehensive longitudinal study of trauma survivors ever performed.

Researchers receive $5 million to expand study of posttraumatic neurologic, mental health disorders click to enlarge Sam McLean, MD

UNC School of Medicine researchers have been awarded an additional $5 million to support and expand the AURORA study from the National Institute of Mental Health and the U.S. Army Medical Research and Material Command, which is part of the U.S. Department of Defense. 

This funding builds on the initial $21-million NIH grant for AURORA, the purpose of which is to better understand, prevent, and treat adverse posttraumatic neurologic and mental health outcomes. Such conditions, including posttraumatic stress, depression, chronic regional and widespread pain, and traumatic brain injury symptoms, are common among civilian trauma survivors and the more than 2.6 million servicemen and women who have deployed to Iraq or Afghanistan since September 11, 2001.

McLean’s team has also received financial support support from two foundations – One Mind and Mayday. And the researchers have developed important partnerships with Mindstrong, a leading smartphone-based health company, and with Verily, the medical arm of Alphabet, which is Google’s parent company. 

The organizing principal investigator of the $5-million grant and AURORA is Samuel McLean, MD, professor of anesthesiology, emergency medicine, and psychiatry, and research vice chair in the department of anesthesiology. The study will utilize the efforts of 19 institutions and over 40 scientists, and will be led by McLean and three co-principal investigators at Harvard University. At UNC-Chapel Hill, Donglin Zeng, PhD, professor of biostatistics, is co-lead of the AURORA statistical core, and Xinming An, PhD, assistant professor of anesthesiology, is leading a team of statisticians performing longitudinal modeling efforts at UNC. Sarah Linnstaedt, PhD, assistant professor of anesthesiology, will help lead critical analyses evaluating the role of microRNA in disease pathogenesis. Kenneth Bollen, PhD, distinguished professor of psychology, neuroscience & sociology in the UNC College of Arts and Sciences, is a co-investigator on the award assisting with analytic design.

Trauma survivors are being enrolled at 30 emergency departments around the country, and are followed longitudinally for one year. Scientists will use sophisticated adaptive sampling methods to perform a comprehensive, state-of-the-art assessment of genomic, neuroimaging, physiologic, neurocognitive, psychophysical, behavioral, and self-report markers, including 1,600 MRI and functional MRI scans performed at four neuroimaging centers.

In addition to its unparalleled comprehensiveness, this research differs from previous studies in that it will assess the adverse effects of trauma more broadly, rather than focus on only one or a few diseases.

“We want to be patient-centered and not diagnosis-centered,” McLean said. The study is not relying on traditional symptom checklists to define illness, and instead is using the wealth of biologic and behavioral data collected to create new diagnostic categories. He added, “Assessing biologic and physiologic processes directly, during a critical period of recovery after trauma, is the best way to gain needed breakthroughs.”

Another major goal of the study is to develop tools clinicians can use to identify trauma survivors at high risk of persistent suffering. Such tools are urgently needed, McLean said, so that trauma survivors at high risk can be identified for early preventive treatments.

Graduate students, fellows, or faculty from underrepresented racial and ethnic groups who are interested in potentially developing an NIH Diversity Supplement application related to the proposal are invited to send a cover letter and CV to April Soward, Research Program Manager, UNC Department of Anesthesiology, at asoward@aims.unc.edu. The NIH offers diversity supplement funding mechanisms for individuals who have completed undergraduate training, post-master's degree students, graduate research assistants, individuals in postdoctoral training, and junior faculty investigators developing independent research careers.

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