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Neurology Today:
doi: 10.1097/01.NT.0000421896.13251.ce
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UP & COMING: Christopher Anderson, MD: What Role Do Genetic Variants Play in Stroke Outcomes?

Rukovets, Olga

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Christopher Anderson, MD, is raising a six-month-old boy in a two-physician household and admittedly does not have much time for extracurricular activities. So it's a good thing his work in stroke genetics keeps him constantly on his toes and actively learning.

DR. CHRISTOPHER ANDE...
DR. CHRISTOPHER ANDE...
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After receiving his MD from the Northwestern University Feinberg School of Medicine in 2005, Dr. Anderson completed an internal medicine internship at Beth Israel Deaconess Medical Center in 2006, and his neurology residency at Massachusetts General Hospital (MGH) and Brigham and Women's Hospital in 2009. Currently he works on the Neurocritical Care Service at MGH and as an instructor of neurology at Harvard Medical School.

Dr. Anderson was recently awarded an American Brain Foundation Clinical Research Training Fellowship, which he plans to use for research on genetic variation within the oxidative phosphorylation apparatus in stroke patients.

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WHAT IS YOUR RESEARCH QUESTION?

I will be looking at the interaction between genetics and bioenergetics [the study of the energy changes that accompany biochemical reactions]. So far, my preliminary data has shown that there is an association between genetic variation within the oxidative phosphorylation apparatus — which is the molecular machinery that results in the production of ATP [adenosine triphosphate], which the cells of our body use as energy — and stroke risk. People who have a high burden of genetic common variation in these genes have a higher risk of stroke and might have a tendency towards worse functional outcomes.

My goal is to try to determine whether or not the variation within these genes is causing changes in oxidative function (meaning that they produce ATP more poorly or they result in more free oxidative radical damage, etc.), or whether or not they could be interacting along some other pathway that we have not yet identified. With this fellowship, I hope to catalog the variation in oxidative function in stroke patients and controls and determine whether or not these gene variants actually play a role in the functional outcome of patients who suffer ischemic strokes.

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HOW WILL YOU CONDUCT THIS STUDY?

I'm based at Massachusetts General Hospital, where we recruit patients who have ischemic strokes and present to our hospital, and we also have control populations from the surrounding community. We enroll patients in the hospital and we take blood samples from the patients who consent to do both genetic testing (genotyping) as well as to give an extra tube of blood — which I will then use to determine the output of the oxidative phosphorylation apparatus.

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WHY DID YOU CHOOSE TO STUDY STROKE GENETICS?

My background is in population and statistical genetics. I've been working on genome-wide association studies of ischemic stroke with Jonathan Rosand here at MGH. I'm an intensivist/critical care neurologist, and so I see a huge burden of ischemic stroke in the population that I treat. So, that's the primary motivator: the fact that we have this horrible disease that is both highly prevalent in society and that is a huge burden on people after they've had the event in terms of getting around and returning to their former selves and to society.

My overarching goal with the research that we do is to try to understand the underpinnings of this disease better so that in the future we'll have more opportunities to prevent as well as treat these strokes in our patients.

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HOW HAS YOUR MENTOR INFLUENCED YOUR RESEARCH INTERESTS?

Dr. Jonathan Rosand is the director of the Neuroscience Intensive Care Unit here at MGH and has a publicly supported laboratory here as well. Jonathan has been a career mentor for me for the past 5 or 6 years — both on the clinical side of things in advancing my career as a neurointensivist but also in my research.

The best advice that Jonathan has ever given me was to take a year off between residency and fellowship. I was lucky enough to get a grant from the American Heart Association Bugher Foundation Centers for Stroke Prevention Research, which allowed me to devote an entire year completely to my research pursuits. That is really where I developed an interest in genetic research, and in this way it launched my career.

Since then, as I have gone through the clinical years of my fellowship, I've been able to maintain that research. And I certainly wouldn't have the AAN Brain Foundation Fellowship if it weren't for the groundwork that Jonathan helped me lay.

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WHAT SPARKED YOUR INTEREST IN NEUROLOGY?

When I did my medical school training, I worked in a rodent lab at Northwestern University, looking at neuroinflammatory cascades and their role in traumatic brain injury. I did a lot of immunohistochemical work at that time and that whet my appetite for both the complex as well as the fundamental level at which brain injuries can impact animals (such as the rodents I was treating at that time) as well as people.

I think that this idea of the nervous system sitting at the root of everything else that we experience really turned me on to getting involved with neurology at a career level, and it certainly still drives the research that I do.

It is a great motivator when the diseases that you see your patients develop are so devastating in terms of the day-to-day impacts and when their ability to return to their baselines is so dramatically altered. It's really hard to just sweep that sort of thing under the rug — and that is what gets me out of bed every day to come in and do the work that I do.

The American Brain Foundation, the foundation of the American Academy of Neurology, is one of the largest providers of neurology research grants in the United States. The Foundation supports the most promising research & education to discover causes, improved treatments, and cures for brain and other nervous system diseases. To apply for the Clinical Research Training Fellowship program, visit aan.com/go/foundation/research and CureBrainDisease.org. For more information about the program, visit http://bit.ly/Lxfov0.

©2012 American Academy of Neurology

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